DENTAL CARIES

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Respected Mam, This is to inform you that before viewing this project slide show , you are requested to turn on the sound. Thanks for your co-ordination.

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DENTAL CARIES

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GROUP NAME

INTRODUCTION:

INTRODUCTION Teeth (singular tooth ) are small, calcified, whitish structures found in the jaws (or mouths) of many vertebrates that are used to tear, scrape, and chew food. Some animals, particularly carnivores, also use teeth for hunting or defense. The roots of teeth are covered by gums. Teeth are not made of bone, but rather of tissues of varying density and hardness. Teeth are among the most distinctive (and long-lasting) features of mammal species. Paleontologists use teeth to identify fossil species and determine their relationships. The shape of the animal’s teeth is related to its diet. For example, plant matter is hard to digest, so herbivores have many molars for chewing. Carnivores, on the other hand, need canines to kill prey and to tear meat.

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Mammals are diphyodont, meaning that they develop two sets of teeth. In humans, the first set (the "baby," "milk," "primary" or "deciduous" set) normally starts to appear at about six months of age, although some babies are born with one or more visible teeth, known as neonatal teeth. Normal tooth eruption at about six months is known as teething and can be painful. Some animals develop only one set of teeth (monophyodont) while others develop many sets (polyphyodont). Sharks, for example, grow a new set of teeth every two weeks to replace worn teeth. Rodent incisors grow and wear away continually through gnawing, maintaining relatively constant length. The industry of the beaver is due in part to this qualification. Many rodents such as voles (but not mice) and guinea pigs, as well as rabbits, have continuously growing molars in ad Parts

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1. Enamel Enamel is the hardest and most highly mineralized substance of the body and is one of the four major tissues which make up the tooth, along with dentin, cementum, and dental pulp. It is normally visible and must be supported by underlying dentin. 2. Dentin Dentin is the substance between enamel or cementum and the pulp chamber. It is secreted by the odontoblasts of the dental pulp. The formation of dentin is known as dentin genesis.

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3. Cementum Cementum is a specialized bony substance covering the root of a tooth. The principal role of cementum is to serve as a medium by which the periodontal ligaments can attach to the tooth for stability. 4. Pulp The dental pulp is the central part of the tooth filled with soft connective tissue. This tissue contains blood vessels and nerves that enter the tooth from a hole at the apex of the root.

Tooth decay is a common health problem, second in prevalence only to the common cold. It has been estimated that 90% of people in the United States have at least one cavity and that 75% of people had their first cavity by the age of five. Although anyone can have a problem with tooth decay, children and senior citizens are the two groups at highest risk. Other high-risk groups include people who eat a lot of starchy and sugary foods; people living in areas without a fluoridated water supply; and people who already have numerous dental restorations (fillings and crowns). :

Tooth decay is a common health problem, second in prevalence only to the common cold. It has been estimated that 90% of people in the United States have at least one cavity and that 75% of people had their first cavity by the age of five. Although anyone can have a problem with tooth decay, children and senior citizens are the two groups at highest risk. Other high-risk groups include people who eat a lot of starchy and sugary foods; people living in areas without a fluoridated water supply; and people who already have numerous dental restorations (fillings and crowns). DENTAL CARIES

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Dental caries , also known as tooth decay or cavity , is a disease wherein bacterial processes damage hard tooth structure (enamel, dentin, and cementum). These tissues progressively break down, producing dental caries (cavities, holes in the teeth). Two groups of bacteria are responsible for initiating caries: Streptococcus mutans and Lactobacillus . If left untreated, the disease can lead to pain, tooth loss, infection, and, in severe cases, death. Today, caries remains one of the most common diseases throughout the world. Cariology is the study of dental caries.

LOCATION :

LOCATION Generally, there are two types of caries when separated by location: caries found on smooth surfaces and caries found in pits and fissures. The location, development, and progression of smooth-surface caries differ from those of pit and fissure caries. G.V. Black created a classification system that is widely used and based on the location of the caries on the tooth. The original classification distinguished caries into five groups, indicated by the word, "Class", and a Roman numeral . Pit and fissure caries is indicated as Class I; smooth surface caries is further divided into Class II, Class III, Class IV, and Class V. A Class VI was added onto Black's classification and also represents a smooth-surface carious lesion.

CAUSES:

CAUSES There are four main criteria required for caries formation: a tooth surface (enamel or dentin); caries-causing bacteria; fermentable carbohydrates (such as sucrose); and time. The caries process does not have an inevitable outcome, and different individuals will be susceptible to different degrees depending on the shape of their teeth, oral hygiene habits, and the buffering capacity of their saliva. Dental caries can occur on any surface of a tooth which is exposed to the oral cavity, but not the structures which are retained within the bone.

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CAUSES FOR DENTAL CARIES

1. TEETH:

1. TEETH There are certain diseases and disorders affecting teeth which may leave an individual at a greater risk for caries. Amelogenesis imperfecta, which occurs between 1 in 718 and 1 in 14,000 individuals, is a disease in which the enamel does not fully form or forms in insufficient amounts and can fall off a tooth. In both cases, teeth may be left more vulnerable to decay because the enamel is not able to protect the tooth. In most people, disorders or diseases affecting teeth are not the primary cause of dental caries. Ninety-six percent of tooth enamel is composed of minerals. These minerals, especially hydroxyapatite, will become soluble when exposed to acidic environments. Dentin and cementum are more susceptible to caries than enamel because they have lower mineral content. Thus, when root surfaces of teeth are exposed from gingival recession or periodontal disease, caries can develop more readily. Even in a healthy oral environment, however, the tooth is susceptible to dental caries.

2. BACTERIA:

2. BACTERIA The mouth contains a wide variety of oral bacteria, but only a few specific species of bacteria are believed to cause dental caries: Streptococcus mutans and Lactobacilli among them. Lactobacillus acidophilus, Actinomyces viscosus, Nocardia spp., and Streptococcus mutans are most closely associated with caries, particularly root caries. Bacteria collect around the teeth and gums in a sticky, creamy- colored mass called plaque, which serves as a biofilm. Some sites collect plaque more commonly than others. The grooves on the biting surfaces of molar and premolar teeth provide microscopic retention, as does the point of contact between teeth. Plaque may also collect along the gingiva.

3.Fermentable carbohydrates:

3. Fermentable carbohydrates Bacteria in a person's mouth convert glucose, fructose, and most commonly sucrose (table sugar) into acids such as lactic acid through a glycolytic process called fermentation. If left in contact with the tooth, these acids may cause demineralization, which is the dissolution of its mineral content. The process is dynamic, however, as remineralization can also occur if the acid is neutralized by saliva or mouthwash. Fluoride toothpaste or dental varnish may aid remineralization. If demineralization continues over time, enough mineral content may be lost so that the soft organic material left behind disintegrates, forming a cavity or hole. The impact such sugars have on the progress of dental caries is called cariogenicity. Sucrose, although a bound glucose and fructose unit, is in fact more cariogenic than a mixture of equal parts of glucose and fructose. This is due to the bacteria utilising the energy in the saccharide bond between the glucose and fructose subunits.

4. TIME:

4 . TIME The frequency of which teeth are exposed to cariogenic (acidic) environments affects the likelihood of caries development. After meals or snacks, the bacteria in the mouth metabolize sugar, resulting in an acidic by-product which decreases pH. As time progresses, the pH returns to normal due to the buffering capacity of saliva and the dissolved mineral content of tooth surfaces. During every exposure to the acidic environment, portions of the inorganic mineral content at the surface of teeth dissolves and can remain dissolved for two hours. Since teeth are vulnerable during these acidic periods, the development of dental caries relies heavily on the frequency of acid exposure.

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VARIOUS STAGES IN DENTAL CARIES

EARLY CHILDHOOD CARIES:

EARLY CHILDHOOD CARIES Early childhood caries is a “virulent” form of dental caries that can destroy the teeth of preschool children and toddlers. Early childhood caries can also be defined as the occurrence of any sign of dental caries on any tooth surface during the first 3 years of a child’s life. Economically disadvantaged children are the most vulnerable to ECC. The clinical pattern of ECC is rampant and characteristic: First affecting the primary upper anterior teeth, followed by the upper primary molar teeth. The initial appearance of early childhood caries is white areas of demineralization on the surface of the enamel along the gum line of the upper incisor teeth. These white spot lesions progress such that they later become cavities that have been discolored. The mandibular incisors are protected by saliva and the position of the tongue during feeding.

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The ECC process may be so rapid that the teeth appear to have cavities “from the moment they erupt.” The first event in the natural history of ECC is primary infection with S. mutans . The second event is the accumulation of S. mutans to pathologic levels, due to prolonged exposure to sugars. The third event is demineralization of enamel, which leads to cavity formation in teeth.

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DATA REGARDING DENTAL CARIES

CARIES PREVENTION IN CHILDREN – THE INDIAN CHALEENGE:

CARIES PREVENTION IN CHILDREN – THE INDIAN CHALEENGE In the modern society, the human life expectancy is showing an upward trend, thanks to the improved health care, nutrition, sanitation, and relief from communicable diseases. To-day, our country is progressing in all fields, leading to changes in the individual’s life- style. Improved marketing strategies and increased transport facilities have brought food materials like bread and chocolates to even the remotest villages. Children who consume these sticky food stuffs are not trained to clean the teeth properly afterwards. Moreover, such items are freely consumed as in between snacks. Dental caries is highly prevalent in India, which is influenced by the lack of dental awareness among the public at large. Epidemiological survey conducted by Ramachandran and others4 during 1966-68 in Tamil Nadu, a south Indian state, revealed a caries prevalence of 66.2% in urban population and 47.8% in rural population.

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Dental caries is highly prevalent in India, which is influenced by the lack of dental awareness among the public at large. Epidemiological survey conducted by Ramachandran and others4 during 1966-68 in Tamil Nadu, a south Indian state, revealed a caries prevalence of 66.2% in urban population and 47.8% in rural population. The 20th century has given tremendous knowledge in the understanding of oral diseases and possibilities for preventing and treating these diseases. This knowledge cannot be put into action in a developing country like India due to financial constraints and lack of man power. In a country where 70% of population inhabit the villages the dentist population ratio is 1: 35,000, and only one out of five dentists return back to the rural area to serve, prevention of caries will be a much more viable option than rendering restorative treatment.

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One fourth of the country’s population is below the age of 14 years. To persuade the children to modify or start any new habit, it is very important to gain their parent’s co-operation. So any nationwide policy should have a two pronged approach. 1. Community based programmes. 2. School based programmes. Coming to the school based activities, regular oral health programmes should be conducted in schools, to reach large number of children. At the beginning teachers need to be trained intensely for proper implementation. These programs should be based on fluoride rinsing, topical fluoride applications, supervised tooth brushing, professional tooth cleaning, occlusal sealants, health education and dietary advice. There is acute need for simple, robust, easy to service and inexpensive equipment for use in rural surroundings.

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We, Indians are habituated to drinking lot of water. Consumption of sweetened, aerated beverages is replacing the water intake in the younger generations. What implications this would have in future has to be observed. Education of school children with audiovisual aids on the extreme harmful effects of these in between snacks is highly necessary. Components in traditional diets that may favor oral health have to be identified and propagated.

OTHER RISK FACTORS:

OTHER RISK FACTORS Reduced saliva is associated with increased caries since the buffering capability of saliva is not present to counterbalance the acidic environment created by certain foods. As a result, medical conditions that reduce the amount of saliva produced by salivary glands, particularly the submandibular gland and parotid gland, are likely to lead to widespread tooth decay. Examples include Sjögren's syndrome, diabetes mellitus, diabetes insipid us, and sarcoidosis. Medications, such as antihistamines and antidepressants, can also impair salivary flow. Moreover, sixty-three percent of the most commonly prescribed medications in the United States list dry mouth as a known side effect. Radiation therapy of the head and neck may also damage the cells in salivary glands, increasing the likelihood of caries formation.

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The use of tobacco may also increase the risk for caries formation. Some brands of smokeless tobacco contain high sugar content, increasing susceptibility to caries. Tobacco use is a significant risk factor for periodontal disease, which can cause the gingiva to recede . As the gingiva loses attachment to the teeth, the root surface becomes more visible in the mouth. If this occurs, root caries is a concern since the cementum covering the roots of teeth is more easily demineralized by acids than enamel. Currently, there is not enough evidence to support a causal relationship between smoking and coronal caries, but evidence does suggest a relationship between smoking and root-surface caries.

TREATMENT:

TREATMENT The goal of treatment is to preserve tooth structures and prevent further destruction of the tooth. Generally, early treatment is less painful and less expensive than treatment of extensive decay. Anesthetics—local, nitrous oxide ("laughing gas"), or other prescription medications—may be required in some cases to relieve pain during or following treatment or to relieve anxiety during treatment. A dental headpiece ("drill") is used to remove large portions of decayed material from a tooth. A spoon is a dental instrument used to remove decay carefully and is sometimes employed when the decay in dentin reaches near the pulp. Once the decay is removed, the missing tooth structure requires a dental restoration of some sort to return the tooth to functionality and aesthetic condition.

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An extraction can also serve as treatment for dental caries. The removal of the decayed tooth is performed if the tooth is too far destroyed from the decay process to effectively restore the tooth. Extractions are sometimes considered if the tooth lacks an opposing tooth or will probably cause further problems in the future, as may be the case for wisdom teeth. Extractions may also be preferred by patients unable or unwilling to undergo the expense or difficulties in restoring the tooth.

Prevention :

Prevention 1. ORAL HYGIENE Personal hygiene care consists of proper brushing and flossing daily. The purpose of oral hygiene is to minimize any etiologic agents of disease in the mouth. The primary focus of brushing and flossing is to remove and prevent the formation of plaque. Plaque consists mostly of bacteria. As the amount of bacterial plaque increases, the tooth is more vulnerable to dental caries when carbohydrates in the food are left on teeth after every meal or snack. A toothbrush can be used to remove plaque on accessible surfaces, but not between teeth or inside pits and fissures on chewing surfaces. When used correctly, dental floss removes plaque from areas which could otherwise develop proximal caries. Other adjunct hygiene aids include interdentally brushes, water picks, and mouthwashes .

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PROPER WAY OF BRUSHING

Prevention :

Prevention 2. DIETARY MODIFICATION For dental health, frequency of sugar intake is more important than the amount of sugar consumed. In the presence of sugar and other carbohydrates, bacteria in the mouth produce acids which can demineralize enamel, dentin, and cementum. The more frequently teeth are exposed to this environment, the more likely dental caries are to occur. Therefore, minimizing snacking is recommended, since snacking creates a continual supply of nutrition for acid-creating bacteria in the mouth. Also, chewy and sticky foods (such as dried fruit or candy) tend to adhere to teeth longer, and consequently are best eaten as part of a meal. Brushing the teeth after meals is recommended. For children, the American Dental Association and the European Academy of Pediatric Dentistry recommend limiting the frequency of consumption of drinks with sugar, and not giving baby bottles to infants during sleep. Mothers are also recommended to avoid sharing utensils and cups with their infants to prevent transferring bacteria from the mother's mouth. P.T.O

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ACKNOWLEDGEMENT ANY ATTEMPT AT ANY LEVEL CANNOT BE SATISFACTORILY COMPLETED WITHOUT THE SUPPORT AND GUIDANCE OF LEARNED PEOPLE. We would like to express my special thanks of gratitude to our teacher Ms. DEEP SHIKHA who gave us the golden opportunity to do this wonderful project on the topic DENTAL CARIES , which also helped us in doing a lot of Research and we came to know about so many new things. We are really thankful to them. Secondly we would also like to thank our parents and friends who helped us a lot in finishing this project within the limited time. We are making this project not only for marks but to also increase our knowledge . THANKS AGAIN TO ALL WHO HELPED US .