Dental caries is a sugar-dependent, infectious disease caused by the metabolic activity of bacteria on fermentable carbohydrates. These bacteria produce acid as a by-product, which lowers the pH on the tooth surface. This acidic environment causes calcium and phosphate ions to leach out from the enamel, leading to demineralization and the formation of cavities
Types of Dental Caries
• Enamel Caries:
- The initial sign can be observed as a white spot on the enamel. As the lesion progresses, the surface becomes rough, may develop stains, and pitting can occur, ultimately leading to cavitation.
• Dentinal Caries:
- This involves bacterial invasion into the dentin. Once bacteria reach the amelo-dentinal junction, they spread laterally, causing deeper damage.
• Arrested Caries:
Under certain conditions, caries can become inactive. These lesions are hard in texture and appear darker in color, indicating they are no longer progressing
• Root Caries:
When the gums recede, the root surfaces of the teeth become exposed and more susceptible to decay, especially in older adults
• Pit and Fissure Caries:
These develop in the natural grooves and pits on the chewing surfaces of the teeth, particularly the molars and premolars
• Smooth Surface Caries:
This type affects the flat, smooth surfaces of teeth that do not have pits, fissures, or grooves.
What Causes Dental Caries?
Dental caries is a multifactorial disease, triggered by a combination of factors which are as follows:
- Tooth surface condition
- Dental plaque (bacterial biofilm)
- Diet (particularly high in sugars)
- Time (duration of acid exposure)
For caries to develop, bacteria in dental plaque must feed on fermentable carbohydrates over a sustained period. The acid produced during this process damages the tooth surface
Bacteria Involved in Dental Caries
The key bacterial species associated with tooth decay include:
- Streptococcus mutans
- Streptococcus salivarius
- Lactobacillus species
- Actinomyces
These bacteria play a central role in acid production and enamel breakdown.
How to Prevent Dental Caries
Preventing dental caries involves a combination of good oral hygiene practices and dietary habits:
• Diet Control:
- Limit the frequency of sugary food and drink consumption, especially between meals. Diets high in carbohydrates promote acid production by oral bacteria.
• Fluoride Therapy:
Fluoride helps in remineralizing early carious lesions. Use fluoridated toothpaste and drink fluoridated water. Professional fluoride applications like fluoride varnish can also aid in caries prevention
• Toothbrushing:
Regular brushing removes plaque, but toothbrush bristles may not reach deep into pits and fissures, where decay often starts.
• Fissure Sealants:
Sealants act as a barrier over pits and fissures, preventing food particles and bacteria from accumulating in these hard-to-clean areas..
Conclusion
Dental caries is a preventable disease which is sugar dependent and is caused by bacterial acid production from sugar metabolism. Understanding its causes, types, and prevention strategies can help maintain better oral health and prevent the need for extensive dental treatments.