Home » Dental Caries
Category Archives: Dental Caries
In this chapter, you will know about the treatment planning of dental caries. In previous chapter you studies the etio-pathogenesis and clinical characteristics of dental caries. If you have not gone through it, it is advised that you study the previous chapter before proceeding further.
Mechanism of Remineralisation of Enamel
When the oral environment of a person is favourable where the pH is above 5.5 and saliva contains enough calcium and phosphate ions, the remineralisation process of enamel occurs. The supersaturated saliva acts as driving force for remineralisation. In a non cavitated enamel caries lesion, the original crystalline structure of rods remains intact. When it is etched, it acts as nucleating agent for remineralisation. When trace amount of fluoride ions is added to the environment, it enhances the remineralisation process by enhancing the precipitation of calcium and phosphate. The inclusion of fluoride ions results in the formation of fluorapatite crystals in enamel rods which is more resistant to acid attack compared to calcium apatite of the natural enamel rods. Thus, the new enamel becomes resistant to caries process.
This lesson presents basic definitions, terminologies, etiologies, demineralisation-remineralisation of enamel and clinical characteristics of the caries lesion in the context of clinical operative dentistry.
Definitions of Dental Caries and Dental Plaque
Dental caries is defined as a multifactorial, transmissible, infectious oral disease caused primarily by the complex interaction of cariogenic oral flora (biofilm) with fermentable dietary carbohydrates on the tooth surface over time.
Dental plaque is a gelatinous mass of bacteria adhering to the tooth surface. Carious lesions occur only under the plaque. The plaque bacteria metabolises the refined carbohydrate (sucrose mainly) for energy production and produces organic acids as a by product. These acids cause dissolution of crystalline structures of enamel that result in caries lesions of the tooth.
Dental caries/tooth decay and periodontal diseases are probably the most common dental diseases in the world. The increase in the prevalence of dental caries is associated with higher consumption of refined sugars. The gradual decrease in the prevalence of dental caries started in the late 70s and early 80s in Australia, New Zealand, United States, and Western Europe due to inclusion of fluoride in public drinking water supply that had the ability to prevent the development of proximal surface caries. (more…)