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Dental Caries
The slow disintegration of any biological hard tissue as a result of bacterial action.
WHO
defines dental caries as a localized posteruptive, pathological process of external origin involving softening of the hard tooth tissue and proceeding to the formation of a cavity.
GV Black
defined dental caries as the chemical dissolution of the calcium salts, first of the enamel then of the dentin by lactic acid.
Shafer
defined dental caries as an irreversible microbial disease of the calcified tissues of the teeth characterized by demineralization of the inorganic portion and destruction of the organic substance of the tooth.
Kess and Ash
Dental caries is a disease involving hard portions of the teeth exposed in the oral cavity and is characterized by disintegration of enamel, dentin, and cementum forming open cavities.
Last
Dental caries is an illness due to specific infectious agents or toxic products that arise through the transmission of that agent or its products from an infected person, animal, or reservoir to a susceptible host.
Sturdevant
Dental caries is an infectious microbiologic disease of the teeth that results in localized dissolution and destruction of calcified tissues.
GJ Mount
Caries is perceived to be a prolonged imbalance in the oral cavity such that the factors favoring demineralization of enamel and dentin overwhelm the factors that favor remineralization and repair of those tissues.
Cawson
Dental caries can be defined as progressive, irreversible bacterial damage to teeth exposed to the oral environment.
Kidd and Smith
Caries is a disease of the calcified tissues of the teeth caused by the action of microorganisms on fermentable carbohydrates.
Lundeen
Dental caries is an infectious microbiological disease that results in localized dissolution and destruction of the calcified tissues of the teeth and progresses as a series of exacerbations and remissions.
Ernest Newburn
Dental caries or tooth decay is a pathological process of localized destruction of tooth tissues by microorganisms.
Ostrom
Dental caries is a process of enamel or dentin dissolution that is caused by microbial action at the tooth surface and is mediated by the physiochemical flow of water dissolved ions.
Hume
Dental caries is essentially a progressive loss by acid dissolution of the apatite (mineral) component of the enamel then the dentin, or of the cementum, then dentin.
Fejerskov and Nyvad
Dental caries is a complex disease caused by an imbalance in physiologic equilibrium between tooth mineral and biofilm fluid.
Selwitz
Dental caries is a multifactorial disease that starts with microbiological shifts within the complex biofilm. It is affected by salivary flow and composition, exposure to fluoride, consumption of dietary sugars, and preventive behaviors, like cleaning the teeth. However, it is mainly a disease that dates back to antiquity and has also occurred in populations that have never used sugar or processed foods.
Sikri
Dental caries is an infectious disease caused by an imbalance of oral microorganisms leading to acid production and subsequently dissolving the hard tissues of the tooth.
Caries Lesion
Tooth demineralization as a result of the caries process. Other terms used are carious lesion or in layman’s term- cavity
Smooth-Surface Caries
A caries lesion on a smooth tooth surface.
OCCLUSAL CARIES
A caries lesion on an occlusal surface.
PROXIMAL CARIES
A caries lesion on a proximal surface.
ENAMEL CARIES
A caries lesion in enamel, typically indicating that the lesion has not penetrated into dentin.
Dentin Caries
A caries lesion that has penetrated into dentin.
Coronal Caries
A caries lesion on any surface of the tooth crown.
Root Caries
A caries lesion on the root surface of the tooth.
Primary Caries
A caries lesion not adjacent to an existing restoration or crown.
Secondary or Recurrent Caries
A caries lesion adjacent to an existing restoration, crown, or sealant, often with microleakage in the tooth.
Residual Caries
Carious tissue that was not completely excavated prior to placing a restoration, sometimes difficult to differentiate from secondary caries.
Cavitated Caries Lesion
A caries lesion that results in the breaking of the integrity of the tooth, forming a cavity.
Non-Cavitated Caries Lesion
A caries lesion that has not formed a cavity. In enamel caries, non-cavitated lesions are also known as "white spot" lesions.
Active Caries Lesion
A caries lesion that is considered biologically active, with ongoing tooth demineralization at the time of examination.
Inactive Caries Lesion
A caries lesion that is considered biologically inactive at the time of examination, with tooth demineralization having stopped and currently stalled. Also known as arrested caries.
Rampant Caries
The presence of extensive and multiple cavitated and active caries lesions in the same person, often associated with specific etiologies such as "baby bottle caries," "radiation therapy caries," or "meth-mouth caries."
Dental Caries
An infectious microbiologic disease of the teeth that results in localized dissolution and destruction of the calcified tissues.
Etiology
The study of where a disease came from.
Pathology
The study of diseases.
Epidemiology
The study of the distribution and determinants of health-related states or events in a specified population and the application of this study to control health problems.
Fluorosis or Dental Fluorosis
The appearance of faint white lines or streaks on the teeth, occurring when younger children consume excessive fluoride.
Dental Health Education
The process of providing information and promoting behaviors that contribute to oral health and prevent dental caries.
Tetralogy
The four factors involved in the development of dental caries
Microorganisms
Time
Tooth
Food
The First 3 Tetra of previous Era
Host
Bacteria
Diet
Streptococcus Mutans
Microorganisms of the enamel (Coronal) Caries
Lactobacillus Acidophilus
Microorganisms of the dentinal Caries
Actinomyces Actinomycetemcomitans
A type of bacteria that contributes to the formation of root caries.
Saliva
The fluid in the mouth that acts as a vehicle for the transfer of microorganisms.
Kissing
A method of transferring microorganisms from one person to another.
Mechanism of Disease Formation
Factors such as:
the virulence of microorganisms
time of exposure
environment/food, and
host
that contribute to the development of diseases.
Dental Plaque
A gelatinous mass of bacteria that adheres to the tooth surface.
Dental Plaque
A transparent film (without color) and looks like a thick saliva, but it’s inhabited by the bacteria.
Pellicle
A film that forms on the teeth within 30 minutes after toothbrushing, without bacteria.
Bacteria or Microorganism
the main/primary composition of plaque
Carbohydrates
Sugars that serve as the food source for microorganisms in dental plaque.
Order that leads to demineralization
Food → sugar → plaque → acid → demineralization
Acid
byproduct of the activities of the microorganisms is
Demineralization
The process in which acid produced by microorganisms removes minerals and inorganic substances from the tooth, leading to decay.
Normal Flora
The naturally occurring microorganisms in the mouth that become disease-causing when they reproduce and increase in numbers.
Parasitic Relationship
cause by microorganisms being brough into contact with the tooth surface via a bacterial plaque
Tooth
The host surface that is susceptible to dental caries.
Susceptible
How prone a tooth is to developing a disease.
Newly Erupted Teeth
Teeth that have recently emerged and have immature enamel, making them more susceptible to caries.
Fluoridization
recommended with kids to strengthen the enamel and increase the mineral content (mineralization)
Tight Contact Areas
Areas where plaque can accumulate due to the close proximity of teeth.
Morphology
The shape and structure of the tooth surface, which affects its ability to self-cleanse.
Morphology
Self cleansability of tooth surface
Location
The position of the tooth in the mouth, with posterior teeth being less reachable for cleaning.
Composition
The fluoride and calcium content of the tooth, which inversely affects its susceptibility to caries.
Higher Fluoride and Calcium leads to
Lower Caries Susceptibility
Lower Fluoride and Caries leads to
Higher Caries Susceptibility
Time
The frequency and duration of food exposure in the mouth, which contributes to the development of cavities.
Critical pH
The pH level at which demineralization of the tooth occurs (5.5-5.7).
Lower 5.5 -5.7
Demineralization
Higher than 5.5 -5.7
Remineralization
Oral pH Fluctuations
Changes in the acidity of the mouth due to repeated consumption of food, which increases the susceptibility to caries.
Oral Ph Fluctuates
Repeated consumption food → Increase acid → Increase susceptibility to caries
Saliva
The fluid in the mouth helps flush the oral cavity, but becomes stagnant during sleep..
Bad breath (halitosis)
odor from the mouth caused by factors such as bleeding gums
Buffering effect
Ability of saliva to maintain a stable pH level in the mouth.
Saliva Viscosity is Directly proportional to
Caries Susceptibility
Flowable Saliva is
Low Viscosity
Thick Saliva
High Viscocity
Caries susceptibility
Likelihood of developing tooth decay.
Xerostomia
Dry mouth condition often caused by radiation therapy.
Fluoride
Induce Remineralization
Remineralization
Process of restoring minerals to partially demineralized enamel.
Demineralization
Loss of minerals from the tooth surface due to acid production by bacteria.
4 Primary Factors of Dental Caries
Host (Tooth Surface)
Substrate (Carbohydrate)
Presence of Oral Bacteria
Time
Modified Keyes-Jordan Diagram
Diagram of the Modified risk and protective factors that influence dental caries
3 circles of Keyes Jordan Diagram
Factors that directly contribute to caries development
Oral Environmental factors
Personal Factors
Dysbiosis
Imbalance or disruption of the normal microbiome in the mouth.
Restorative treatment
Dental procedures to repair or fill cavities caused by caries lesions.
Caries balance
Is a process of Demineralization in which the pathological factors dominate the protective factors
Demineralization
The low pH drives calcium and phosphate from the tooth to the biofilm in an attempt to reach equilibrium results to
When the pH in the biofilm returns to neutral and the concentration of soluble calcium and phosphate is supersaturated relative to that in the tooth results to
Demineralization
Pathologic Factors
Remineralization
Protective Factors
5.5
Critical Low Ph level of Enamel
6.2
Critical Low Ph level of Dentin
Acidogenic
Bacteria that produce acid as a by-product of metabolizing carbohydrates.
Aciduric
Bacteria that can survive and thrive in an acidic environment.
Symbiosis
Cooperative relationship between different organisms.
