DENTAL CARIES - vinitha

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DENTAL CARIES: : 

DENTAL CARIES: G.Vinitha Bpharmacy Teegala ram reddy college of pharmacy Hyderabad, Andhrapradesh.

INTRODUCTION: : 

INTRODUCTION: Dental caries, also known as tooth decay or dental cavities, are holes that damage the structure of teeth. The occurrence of dental caries is globally widespread, and the disease can lead to pain, tooth loss, infection, and, in severe cases, death. An estimated 90% of schoolchildren worldwide and most adults have experienced dental caries, with the disease being more severe in Asian and Latin American countries and least in African countries. In the United States, dental caries is the most common chronic childhood disease; at least five times more common than asthma. It is the most important cause of tooth loss in children. The number of cases has decreased in some developed countries, and the decrease is usually attributed to increasingly better oral hygiene practices and preventive measures such as fluoride exposure.

CLASSIFICATION: : 

CLASSIFICATION: Caries can be classified by location, etiology, rate of progression, and affected hard tissues. BASED ON LOCATION: Generally, there are two types of caries when separated by location: caries found on smooth surfaces and caries found in pits and fissures.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 of Caries Lesions and also represents a smooth-surface carious lesion.

Contd…. : 

Contd…. Smooth-surface caries: There are three types of smooth-surface caries. Proximal caries, also called interproximal caries, are caries that form on the smooth surfaces between adjacent teeth. Root caries are caries that form on the root surfaces of teeth. The third type of smooth-surface caries is caries on any other smooth-surface of a tooth. Proximal caries are the most difficult type of caries to detect. Frequently, this type of caries cannot be detected visually or manually with a dental explorer. Proximal caries form cervically (toward the roots of a tooth) just under the contact between two teeth. As a result, radiographs are needed for early discovery of proximal caries.

Contd… : 

Contd… 2. Pit and fissure caries: The pits and fissures of teeth provide a location for caries formation. Pit and fissures are anatomic landmarks on a tooth where tooth enamel infolds to create an appearance of pits and fissures. Fissures are the grooves located on the occlusal (chewing) surfaces of posterior teeth and lingual surfaces of maxillary anterior teeth. 3. Other types of caries: Besides the two previously mentioned categories, carious lesions can be described further by their location on a particular surface of a tooth. Caries on a tooth's surface that are nearest the cheeks or lips are called "facial caries", and caries on surfaces facing the tongue are known as "lingual caries".

BASED ON ETIOLOGY: : 

BASED ON ETIOLOGY: In some instances, caries are described in other ways that might indicate the cause. "Baby bottle caries", "early childhood caries", or "baby bottle tooth decay" is a pattern of decay found in young children with their deciduous (baby) teeth. The teeth most likely affected are the maxillary anterior teeth, but all teeth can be affected. 1.Rampant caries :Rampant caries as seen here may possibly be due to methamphetamine use. Rampant caries may be seen in individuals with xerostomia, poor oral hygiene, stimulant use (due to drug-induced dry mouth), and/or large sugar intake. If rampant caries is a result of previous radiation to the head and neck, it may be described as radiation-induced caries.

BASED ON RATE OF PROGRESSION: : 

BASED ON RATE OF PROGRESSION: Temporal descriptions can be applied to caries to indicate the progression rate and previous history. "Acute" signifies a quickly developing condition, whereas "chronic" describes a condition which has taken an extended time to develop where thousands of meals and snacks, many causing some acid demineralisation that is not remineralized and eventually results in cavities. Fluoride treatment can help recalcification of tooth enamel. Recurrent caries, also described as secondary, are caries that appears at a location with a previous history of caries. This is frequently found on the margins of fillings and other dental restorations. Using fluoride treatments can help with recalcification.

BASED ON AFFECTED HARD TISSUE: : 

BASED ON AFFECTED HARD TISSUE: Depending on which hard tissues are affected, it is possible to describe caries as involving enamel, dentin, or cementum. Early in its development, caries may affect only enamel. Once the extent of decay reaches the deeper layer of dentin, "dentinal caries" is used. Since cementum is the hard tissue that covers the roots of teeth, it is not often affected by decay unless the roots of teeth are exposed to the mouth. Although the term "cementum caries" may be used to describe the decay on roots of teeth, very rarely does caries affect the cementum alone. Roots have a very thin layer of cementum over a large layer of dentin, and thus most caries affecting cementum also affects dentin.

CAUSES: : 

CAUSES: There are four players in the formation of caries: a tooth surface (enamel or dentin); cariogenic (or potentially caries-causing) bacteria; fermentable carbohydrates (such as sucrose); and time. 1. Tooth surface: Having "soft teeth" is usually not the cause of caries, despite commonly held belief to the contrary. There are certain diseases and disorders, however that affect teeth that can leave an individual at 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 form fully or in insufficient amounts and can fall off a tooth. Dentinogenesis imperfecta is a similar disease. In both cases, teeth may be left more vulnerable to decay because the enamel is not as able to protect the tooth as it would in health.

Contd… : 

Contd… 2. Cariogenic Bacteria: The mouth contains a wide variety of bacteria, but only a few specific species of bacteria are believed to cause dental caries: Streptococcus mutans and Lactobacilli among them. Particular for root caries, the most closely associated bacteria frequently identified are Lactobacillus acidophilus, Actinomyces viscosus, Nocardia spp., and Streptococcus mutans. Bacteria collect around the teeth and gums in a sticky, creamy-coloured mass called plaque. 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

Contd… : 

Contd… 3. Fermentable carbohydrates: Two contradictory hypotheses on the role of dietary carbohydrates in health and disease shape how dental-systemic associations are regarded. On one side, Cleave and Yudkin postulated that excessive dietary fermentable carbohydrate intake led-in the absence of dental interventions such as fluorides-first to dental diseases and then to systemic diseases. 4. Time: The frequency of which teeth are exposed to cariogenic (acidic) environments affects the likelihood of caries development. After meals or snacks containing sugars, the bacteria in the mouth metabolize them resulting in acids as by-products which decreases pH.

SIGNS AND SYMPTOMS: : 

SIGNS AND SYMPTOMS: Until caries progresses, a person may not be aware of it. The earliest sign of a carious lesion is the appearance of a chalky white spot on the surface of the tooth, indicating an area of demineralization of enamel. As the lesion continues to demineralize, it can turn brown but will eventually turn into a cavitation, a "cavity".

DIAGNOSIS: : 

DIAGNOSIS: Dental explorer used for caries diagnosis. Primary diagnosis involves inspection of all visible tooth surfaces using a good light source, dental mirror and explorer. Dental radiographs, produced when X-rays are passed through the jaw and picked up on film or digital sensor, may show dental caries before it is otherwise visible, particularly in the case of caries on interproximal (between the teeth) surfaces.

TREATMENT: : 

TREATMENT: Destroyed tooth structure does not fully regenerate, although remineralization of very small cavities may occur if dental hygiene is kept at optimal level. For the small lesions, topical fluoride is sometimes used to encourage remineralization. For larger lesions, the progression of dental caries can be stopped by treatment. The goal of treatment is to preserve tooth structures and prevent further destruction of the tooth. Generally, the treatment can be performed in three ways.

1. FILLING: : 

1. FILLING: A filling is a way to restore a tooth damaged by decay back to its normal function and shape. When a dentist gives you a filling, he or she first removes the decayed tooth material, cleans the affected area, and then fills the cleaned out cavity with a filling material. By closing off spaces where bacteria can enter, a filling also helps prevent further decay. Materials used for fillings include gold, porcelain, a composite resin (tooth-colored fillings), and an amalgam (an alloy of mercury, silver, copper, tin and sometimes zinc).

Types of fillings: : 

Types of fillings: Gold fillings: These are made to order in a laboratory and then cemented into place. Gold inlays are well tolerated by gum tissues, and may last more than 20 years. For these reasons, many authorities consider gold the best filling material. However, it is often the most expensive choice and requires multiple visits.

Types: : 

Types: Amalgam (silver) fillings: These are resistant to wear and relatively inexpensive. However, due to their dark color, they are more noticeable than porcelain or composite restorations and are not usually used in very visible areas, such as front teeth.

Types: : 

Types: These are matched to be the same color as your teeth and therefore used where a natural appearance is desired. The ingredients are mixed and placed directly into the cavity, where they harden. Composites may not be the ideal material for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco, and do not last as long as other types of fillings generally from three to 10 years.

Types: : 

Types: These are called inlays or onlays and are produced to order in a lab and then bonded to the tooth. They can be matched to the color of the tooth and resist staining. A porcelain restoration generally covers most of the tooth. Their cost is similar to gold.

2. CROWNS: : 

2. CROWNS: A crown is a tooth-shaped cover placed over a tooth that is badly damaged or decayed. A crown is made to look like your tooth. Many people call it a cap. Crowns may be placed for several reasons. Usually the tooth has been broken or damaged a great deal by decay. Crowns usually last at least seven years. In many cases they last much longer, up to 40 years or so. Crowns can be all metal, porcelain fused to metal (PFM), or all ceramic. Metals include gold alloy, other alloys (palladium) or a base-metal alloy (nickel or chromium).

3. ROOT CANAL THERAPY: : 

3. ROOT CANAL THERAPY: Root canal is a dental procedure which helps in removing the entire internal parts, mainly pulp chamber of the tooth. The procedure that involves the root canal is also called as root canal therapy or root canal treatment. This is the only procedure that can help when the entire pulp and its contents are decayed. This procedure of root canal treatment can be done by a general dentist, but the one who specializes in this field is an Endodontist.

Slide 22: 

Medicinal plants in the treatment of dental caries:

PREVENTION: : 

PREVENTION: 1 . Oral hygiene: Toothbrushes are commonly used to clean teeth. 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

Contd… : 

Contd… 2 .Dietary modification: For dental health, the 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 it is that dental caries will occur.

CONCLUSION: : 

CONCLUSION: Caries remains a major public health problem. Extensive damage from caries can lead to major problems for the individual, affecting quality of life both functionally and aesthetically. Professional treatment using fluoride varnish at least twice annually has preventive effects on caries. The IOCCC supports all reasonable and scientifically valid efforts to reduce tooth decay. Optimal use of fluoride in toothpaste and mouth rinses is the most effective way of eliminating the disease.

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