Download Dental Caries - Operative Dentistry - Lecture Slides and more Slides Dental surgery in PDF only on Docsity! Dental Caries
J
Docsity.com
Eruption • Mechanisms of tooth eruption are complex • Teeth eventually appear in mouth through a combination of growth of supporting bone • Elongation of tooth root and growth of pulp Docsity.com Nutrition and Dental Caries • Direct cause-and-effect relationship between nutritional status and dental caries • Malnutrition is associated with retarded exfoliation of primary teeth • However unclear if cause by the process itself or the longer time before exfoliation • Permanent teeth eruption seem to be unaffected but have higher rates of caries Docsity.com Enamel Integrity • Tooth enamel structure may be damaged by trauma or acid demineralization • Loss of the tooth mineral structure begins when enamel surface pH is below 5.7 to 5.5 • Normal Neutral pH of the oral cavity is around 6 Docsity.com • Dynamic process of demineralization and remineralization is guided by several factors: – Oral bacteria, salivary flow and composition, presence of fluoride, tooth integrity and dietary habits • Equilibrium shifting of these factors towards demineralization results in enamel dissolution and hence caries formation • Calcium and phosphate ( pH) as well as fluoride, can help remineralize affected areas if the process has not reached the cementoenamel junction Docsity.com • Further facilitated by xerostomia xerostomia as the natural protection by saliva is absent • Important to differentiate this type of erosion from the caries process • Acid produced from plaque bacteria causes the enamel demineralization Docsity.com Caries Process • Dental caries is a multifactorial disease • Involves demineralization of the enamel and dentin • Bacteria in dental plaque metabolize fermentable carbohydrates into organic acids • Below the critical pH proteolytic enzymes break down the organic component Docsity.com • The length of exposure is influenced by a food’s inherent retention in the mouth – Eg. Liquids are cleared from the mouth more rapidly than solids; and foods that stimulate salivary flow though their consistency or chemical composition are cleared more rapidly than bland foods. • Proteins from saliva adsorb to the cleaned tooth and form the acquired enamel pellicle Docsity.com • S. mutans is the major pathogenic bacterial species involved in the caries process • Studies show that 93% of children with detectable caries were positive for S. mutans • The physiologic characteristics of the S. mutans that make them prime etiological agent in caries include their ability to: Docsity.com S. mutans 1. Adhere to tooth surface 2. Produce abundant insoluble extracellular polysaccharides from sucrose 3. Rapidly produce lactic acid from a number of sugar substrates 4. Be tolerant to acid 5. Produce intracellular polysaccharide stores Docsity.com • Cariogenic bacteria metabolize sugars to produce energy required for their growth and reproduction • The energy source may be exogenous or endogenous • Metabolism of mono or di saccharides • Once within the cell, glucose enters the Embden-Meyerhof glycolitic pathway Docsity.com • Smooth surface caries – Arise on intact enamel surfaces other than pit fissure – Can be divided into smooth surface caries (i.e., caries affecting the buccal and lingual tooth surfaces) – Approximal caries, affecting the contact area of adjoining tooth surface • Root surface caries • Secondary or recurrent caries Docsity.com • Earliest clinically detectable stage of caries in the enamel is the incipient lesion • Characterized by an opaque, white appearance • At this stage the process is amenable to remineralization • Further mineral loss result in enamel degradation and frank cavitation • Only treatment option in most cases is the placement of restoration Docsity.com