Dental caries also known as tooth decay or a cavity, is an infection, bacterial in origin, that causes demineralization and destruction of the hard tissues of the teeth (enamel, dentin and cementum). It is a result of the production of acid by bacterial fermentation of food debris accumulated on the tooth surface.
Cause of dental decays:
Diagrammatic representation of acidogenic theory of etiology of dental caries. Four factors, namely, a suitable carbohydrate substrate (1), micro-organisms in dental plaque (2), a susceptible tooth surface (3) and time (4); must be present together for dental caries to occur (5). Saliva (6) and fluoride (7) are modifying factors.
There are four main criteria required for caries formation: a tooth surface (enamel or dentin), caries-causing bacteria, fermentable carbohydrates (such as sucrose), and time.
Four types of primary prevention are available reviewed:
•Fluorides (Systemic Fluorides; Professionally-Applied Topical Fluorides; Self- Applied Fluorides)
Fluoride helps prevent decay of a tooth by binding to the hydroxyapatite crystals in enamel. The incorporated calcium makes enamel more resistant to demineralization and, thus, resistant to decay. Topical fluoride is now more highly recommended than systemic intake such as by tablets or drops to protect the surface of the teeth. Our clinic provide many dental professionals include application of topical fluoride solutions as part of routine visits and recommend the use of Fluorides vanish or Amorphous calcium phosphate products.
•Pit and Fissure sealants
The use of dental sealants is a means of prevention. A sealant is a thin plastic-like coating applied to the chewing surfaces of the molars to prevent food from being trapped inside pits and fissures. This deprives resident plaque bacteria carbohydrate preventing the formation of pit and fissure caries. Sealants are usually applied on the teeth of children, as soon as the tooth erupt but adults are receiving them if not previously performed. Sealants can wear out and fail to prevent access of food and plaque bacteria inside pits and fissures and need to be replaced so they must be checked regularly by dental professionals.
For dental health, frequency of sugar intake is more important than the amount of sugar consumed. In the presence of sugar and other carbohydrates, bacteria in the mouth produce acids that can demineralize enamel, dentin, and cementum. The more frequently teeth are exposed to this environment the more likely dental caries are to occur.
For children, CDA recommend limiting the frequency of consumption of drinks with sugar, and not giving baby bottles to infants during sleep (see earlier discussion). Mothers are also recommended to avoid sharing utensils and cups with their infants to prevent transferring bacteria from the mother's mouth.
Personal hygiene care consists of proper brushing and flossing daily. Professional hygiene care consists of regular dental examinations and professional prophylaxis (cleaning). Sometimes, complete plaque removal is difficult, and a dentist or dental hygienist may be needed. Along with oral hygiene, radiographs may be taken at dental visits to detect possible dental caries development in high risk areas of the mouth (e.g. "bitewing" x-rays which visualize the crowns of the back teeth).
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