Cariology - Introduction

Dental caries

A bacterial infection caused by specific bacteria.

Reversible multifactorial process of tooth demineralization and remineralization.

• 1st point is that caries is a bacterial infection caused by specific bacteria

• 2nd point is that caries is a reversible, multifactorial process of demineralization and remineralization.

The first point is?

The second point is?

mutans streptococcus (ms)
lactobacillus

In 1976 Loesch (Oral Sci Rev, 1976) postulated that dental caries is a specific and treatable bacterial infection due to ___ and in the later stages to ___

mutans streptococcus (ms)

lactobacillus

Other acidogenic organisms are also involved, but these two appear to be the main organisms.

communicable, transmissible, infectious bacteria infection

Since that time there has been extensive evidence in the literature using animal models that caries is a ____ (3)

primary responsible source and transmitted from other humans

Clinical investigation on humans has supported the concept that ms is the ______

source or reservoir (person, animal, soil)

For an infectious disease to occur, it must have a

mother

In dental caries the source may be the ___ who transfers the infection to the infant.

or

In dental caries, the carrier would usually be the _____

directly

indirectly

Potential microorganisms may be transferred ___ (by people, insects) or ___ (through water, air or soil).

saliva

In dental caries the transfer agent is through ___ of the mother to the infant.

Pathogens

_____ must survive the transfer and successfully establish within the host.

colonization
bacterial multiplication

In dental caries this occurs. Additionally, ___ and ___ in dental caries is dependent upon sugar intake and other local factors.

sugar intake

Colonization (multiplication of the organism) may occur.

In dental caries this occurs. Additionally, colonization and bacterial multiplication in dental caries is dependent upon ____ and other local factors.

indicated by damage to the tissue

Infection indicates that colonization has occurred and the discase process has begun as?

Warm

Dark

Moist (with saliva)

The oral cavity is suitable for bacterial growth because it is? (3)

host response

The _____ will determine if there is a manifestation of the disease (demineralization).

person’s total condition

Caries is not only a disease of the tooth, but also influenced by the _______

oral hygiene habits

diet

saliva flow

general health

lifestyle.

In studying caries, it is not enough to just look at the tooth itself.

In reality, we also need to look at the individual as a whole — their _____ (5)

Caries activity

describes the status of the carious process (demin/remin) on an individual tooth surface.

demin

an active lesion is progressing toward cavitation

remin

an inactive lesion is not progressing or is healing

Caries activity

Refers to the status of the carious process on an individual tooth surface.

You check if the tooth is demineralizing (active lesion, progressing disease) or remineralizing (healing, not progressing to cavity).

Caries risk

describes the status of the whole patient and can be defined as the likelihood of the patient getting a new cavitation.

• Medical history

• Dental caries status

• Fluoride use

• Salivary assessment

• Diet assessment

• Bacterial assessment

• Tooth surface activity assessment

Host risk factors (7)

hydroxyapatite crystals

enamel is made of

fluorapatite crystals

With fluoride, these (hydroxyapatite crystals) change into ____, which are harder and more resistant to acid attack.

Fluoridation

adding fluoride to drinking water (community-level prevention).

Fluoridization

applying fluoride directly to teeth (like fluoride toothpaste, mouth rinses, gels, or professional fluoride treatment).

• Use of oral hygiene

• Use of fluoride

• Pit and fissure sealants

• Diet counseling

• Prevention of extension

Caries prevention has also been applied in the form of? (5)

1. Identify the individuals caries risk and activity by a complete assessment procedure.

2. Control oral bacterial levels.

3. Identify measures which will shift the patient at risk to a low-risk category.

4. Identify how non-cavitated lesions should be treated for remineralization and reversal.

5. Cavitated lesions will be treated in the traditional manner.

6. Home and office maintenance procedures.

STRATEGIES TO FOLLOW FOR CARIES CONTROL IN THE CURRENT MEDICAL

MODEL

D.E. junction or slightly into dentin

In the U.S. tradition was to restore dental caries when it reaches the ____.

radical treatment

60% into dentin

Internationally this is considered as ____. It has been recommend that a restoration should be placed only after penetration of ____.