Dental Caries; Risk factor, Prevention and Treatment

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Have you felt pain/sensitivity while in taking food beverages or any kind of sweeteners either hot or cold? Is there any discoloration or black hole on tooth surface or any sign of decay bothering your tooth and your confidence? Have you noticed any gum swelling or any infection? Are you having difficulty or pain during chewing?


Yes, we often have come across this, many have actually noticed & used pain killers or home remedies to subside pain and after few days have ignored completely. Most of the people think dental treatment is usually not required (usually a stereotype thinking) and goes to professionals only when it becomes unbearable painful and at the same time which may led to the extent where their teeth are invariably advised for extraction(pulled out).

 Ignorance is not always bliss. If you have ever come through the above condition do not simply take it for granted. Visit your near dentist to know about the disease and its measures. And before any delay, let us discuss about the most prevailing disease affecting oral health, that is DENTAL CARIES. It’s the major public health problem globally.

WE frequently refer them as “dental cavity” or “tooth decay” – the most common type of oral disease. This can affect any of us but with proper care and prevention, they can be easily avoided or addressed. 

INTRODUCTION 


Simply saying, Dental Caries are areas where the hard tissue of the tooth begin to break down due to acid produced by bacteria on the teeth surfaces utilizing sugars from food that we eat. Acid that is produced on the teeth surfaces then begin to dissolve enamel, dentin and eventually the pulp of the tooth.

The consequences of the caries process from its earliest stage includes: cavity, tooth ache, inflammation and death of pulp tissue and later of the periapical tissues. Infection in periapical tissues causes abscesses, cyst then spreads to jaw bones simultaneously involving other delicate structures causing space infection, osteomyelitis, etc.

However, it is completely preventable following regular dental checkups and oral hygiene maintenance. Half of the population of world is affected by caries making it most common of all dental conditions.

Anyone can be affected by dental caries but certain group of people are said to be at high caries risk.         

  • Patient on medication which causes hypo-salivation            
  • Young children, babies on feeder esp, in their bedtime            
  • Patient with past dental history of  multiple caries,restorations & undergoing dental treatments and dentures           
  • People having no facility of dental care and consuming sugary, sticky snacks in between meals           
  • Systemic illness which reduces manual dexterity                               
  • Senility 

RISK FACTORS:

  1. Tooth(Host)        
  2. Substrate (Environmental factors) Saliva Diet 
  3. Microorganisms (Bacteria) 
  4. Time Period  
dental-caries

TOOTH

Anyone who has tooth is at risk of having caries. Susceptible tooth surfaces for caries are deep & narrow occlusal fissures, deep buccal or lingual pits, exposed root surfaces, gingival to contact areas & margins of existing restoration. Teeth with developmental defects and malocclusion also favors its initiation. 

SUBSTRATE

Saliva is rich in calcium, phosphate and fluoride which helps in remineralization of enamel. Other functions are: buffering capacity, cleansing action, antibacterial property, etc. Oral cavity is in contact with saliva and normal flow of it help protect the teeth from caries

More refined and less fibrous food are responsible for the initiation of caries since it requires less chewing, also it is easily fermented by bacteria therefore less saliva and more acid. Exposure of sugary, sticky foods in between meals also possess great risk as they remain in teeth for longer time and bacteria breaks down sugars producing acid.

MICROORGANISMS 

Oral cavity is full of bacteria, Streptococcus mutans are considered as main Causative factor for caries. Harboring on the dental plaque the bacteria become dominant, continue it’s metabolism producing acid leading to decalcification of tooth enamel, thereby initiating caries process. For caries progression others are responsible like Lactobacillus, Actinomyces, etc.

TIME

Caries doesn’t develop over night, it takes time. Provided with no dental care and all the above risk factors caries can occur with time. There is no fixed time to develop caries.

CLINICAL EXAMINATION

Early sign of dental caries is a chalky whitish appearance on the enamel surface. Later with the caries progression, it becomes dark brown or black with cavity. Dentists use explorer and mouth mirror for caries examination.

DIAGNOSIS

Radiographs, Dyes are used to detect dental caries. Other advance technology and equipment have also been introduced for detection. The most common of all is radiographic method.

PREVENTION

Good oral hygiene and dental care can help you  avoid dental caries or decay. Following are some tips preventing it’s occurrence.

  • Brush your teeth with fluoridated tooth paste twice a day after eating meal. Use dental floss to clean in between your teeth.
  • Avoid intake of refined sugars. Don’t take sugary, sticky snacks in between the meals. Avoid bottle feeding habit for infants and toddlers during night.
  • Rinse your mouth regularly with fluoride containing mouth washes.
  • Drink a lot of water, chew sugar free gums like xylitol for hyposalivation and always contact your physician if any serious problems.
  • Visit your dentist on a regular basis.
  • Drink fluoridated water.
  • Diet modification by intaking maximum amount of fibrous and low carbs foods.
  • Pit and fissure sealants for deep and narrow pits and fissures. Fluoride treatment and supplements if required.

TREATMENT 

Dental caries at its very early stage can be reversed if detected. Enamel can repair itself by using minerals from saliva and also by fluoridated toothpaste, water and fluoride supplements. The sooner you seek care, the better your chances of reversing the decay process and preventing its progression.

The main objective of treatment is to preserve as much tooth structure as possible.

  • Cavity: Restored with different types of materials like Composite, Amalgam, GIC
  • Pulp involvement: Root canal treatment with crown placement.
  • Periapical tissue involvement: Root canal treatment with other procedures as required.
  • If tooth is irreversibly damaged it becomes impossible for the dentist to save the tooth. So extraction is done in such cases

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