Dental caries

What is Dental caries

Dental Caries is a progressive bacterial breakdown of teeth exposed to the carbohydrate and bacterial plaque.

Classification of dental caries

  1. Enamel caries
  2. Dentine caries
  3. Root surface caries

Causes of dental caries

It develops over time in the presence of certain interacting variables including:

  1. Carbohydrate diet
  2. Viridans streptococci bacteria
  3. Susceptible tooth surface

Pathogenesis

Enamel caries progress in the following stages:

  • Incipient caries
  • Early (sub-microscopic) lesion
  • Phase of non-bacterial enamel crystal destruction
  • Cavity formation
  • Bacterial invasion of enamel

Symptoms and clinical features of dental caries

  1. Cavity formation in affected tooth
  2. It starts as a white spot
  3. Pain On exposure of the cavity to thermal changes or food particles

Complications of dental caries

  • Pulpitis
  • If dental caries is not treated, it can cause apical periodontitis and dentoalveolar abscess

Investigations

  • Periapical radiographs
  • Bitewing radiographs
  • Electric pulp testers
  • Thermal test

Treatment for dental caries

Non-drug treatment

Depending on the stage of the lesion:

  • Excision of lesion followed by:
  • Amalgam filling, Glass Ionomer Cement (GIC) composite and Atraumatic Restorative Technique (ART) for enamel caries
  • Amalgam filling, GIC for dentine caries
  • Root Canal Therapy, pulp capping pulpotomy, pulpectomy for pulpal involvement

Drug treatment

Analgesics pre-operatively
Paracetamol: 1 g 4 – 6 hourly orally to a
maximum of 4 g daily

Prevention of dental caries

  • Give oral health education to all especially those at risk
  • Do regular scaling and polishing
  • Systemic and topical fluoride application
  • Fissure sealants.
  • Routine dental check-ups