Introduction to dental caries & tooth surface loss

What causes dental caries? 

Dental caries is caused by the demineralisation of the tooth surface, primarily due to acid production by bacteria fermenting dietary sugars

How many bacterial species have been identified in dental plaque? 

Over 700 bacterial species

What are the main bacterial species associated with dental caries? 

Streptococcus mutans, Streptococcus sanguis, and Lactobacillus

How do bacteria contribute to tooth decay? 

Bacteria ferment dietary sugars, producing lactic acid, which lowers pH and demineralises the enamel.

What makes caries-causing bacteria resistant to tooth decay? 

they can thrive in acidic environments, even with low pH levels in the mouth.

What tooth surfaces are more susceptible to caries? 

Deep fissures, carious cavities, imbricated teeth, and poorly fitted prosthetics.

What are the 4 main factors influencing dental caries? 

Host factors, time, microorganisms, and diet.

What is the first stage of dental caries? 

White spot lesions, where enamel begins to demineralise but may naturally remineralise.

How does enamel decay progress? 

The enamel erodes and breaks down, eventually exposing the dentine

What happens when caries progress to dentine? 

Dentine is softer than enamel, and pain may be experienced due to the exposure of nerve endings in dentinal tubules.

What occurs when caries reach the pulp? 

The pulp becomes inflamed and enlarged, causing severe pain and possible infection

What is the result of untreated pulp infection? 

It can lead to the formation of an abscess due to bacterial invasion and pus accumulation

What are the symptoms of acute pulpitis? 

Severe, throbbing pain, sensitivity to temperature changes, and pain that persists even after the stimulus is removed

How is acute pulpitis different from chronic pulpitis? 

Acute pulpitis involves severe pain, while chronic pulpitis involves mild, intermittent pain often triggered by temperature or sweet foods

What happens during an acute abscess formation? 

Bacteria invade the pulp, causing tissue destruction and pus formation. Symptoms include severe pain, sensitivity, and tooth mobility

What is a chronic abscess? 

A long-term abscess where drainage continues, often asymptomatic but can cause swelling if drainage is blocked

What is the key characteristic of enamel caries? 

Enamel caries initially appear as white spot lesions and progress to breakdown as demineralization increases

What is the appearance of dentine caries? 

appear brown and cause the tooth surface to soften and expose a cavity

What is pulpitis? 

inflammation of the dental pulp, which can lead to severe pain or, if untreated, to pulp necrosis

What is the difference between acute and chronic pulpitis? 

Acute pulpitis involves severe, persistent pain, while chronic pulpitis involves milder, intermittent pain

What is tooth surface loss & what is it caused by? 

the wearing down of the tooth surface, which can occur naturally with age or due to external factors

What is physiological tooth wear? 

normal wear that occurs with aging and is not caused by external factors

What is pathological tooth wear? 

Tooth wear caused by external factors, such as acidic foods or improper brushing

What is erosion? 

loss of tooth structure due to chemical agents, typically acids, and is non-bacterial in nature

What groups are most at risk for dental erosion? 

People with bulimia, gastric reflux, hazardous work environments, or those who drink excessive amounts of carbonated soft drinks or fruit juice

What causes attrition? 

wear of teeth caused by tooth-to-tooth contact, often seen in bruxism (teeth grinding)

What are the first areas of the teeth affected by attrition? 

The incisal edges of anterior teeth, followed by the occlusal surfaces of posterior teeth

What is abrasion? 

the wearing away of tooth structure due to external factors, such as improper brushing or using a hard toothbrush

Which surfaces of teeth are most affected by abrasion? 

The labial and buccal surfaces of the maxillary incisors, canines, and premolars

What is the typical appearance of an abrasion lesion? 

wedge-shaped cavities, especially near the gumline