Dental Caries: Diseases & Prevention | Tooth Decay | ScienceMonk

A lot of us, feel that caries are the last step to initiate any treatment to cure them You all are right there is no such cure for caries, but yes, you can prevent them. Today I’ll be writing about various ways you can prevent dental caries. I’d like to initiate by telling you the types of organisms which cause these caries.

Dental Caries

Dental decay is due to the dissolution of tooth mineral (primarily Hydroxyapatite-Ca10(PO4)6(OH)2) by acids derived from bacterial fermentation of sucrose and other dietary carbohydrates. These bacteria live in bacterial communities known as dental plaque which accumulates on the tooth surface.

Types of caries Micro-organisms
Pit and fissure caries Mutans, Sanguiis, Lactobacillius, Actinomycetes
Smooth surface caries Mutans, Salivarius
Root surface caries Viscous, Mutans, Sanguiis

These bacteria do not attack suddenly or by chance, they grow over time due to the consumption of excess sweets, beverages containing acids, food debris, improper brushing, etc.

It is essential to understand that once these microbes stick onto the tooth surface it creates an attachment between the microbe enzyme and the contents of the tooth, the microbes containing acid start deteriorating the tooth material initiating the dissolution of enamel, thus reaching the dentin over time and hence reaching the root canal stage.

A stage beyond root canal can not be cured and hence strictly needs extraction.


Illustrating the Caries Mechanism

The chart shown above is the procedure in which the microorganisms proceed with the caries formation.

Diseases Caused By These Bacteria–

1. Gingivitis

The simplest form of gingivitis is associated with the accumulation of supragingival plaque along the gingival margins of the teeth. This form of gingivitis has been extensively studied in human volunteers, and the sequence of events is well described. In these studies, individuals are brought to a state of health and then refrain from all forms of oral hygiene for a 3- to 4-week period.

The initial colonizers of the teeth are streptococci, which proliferate and in turn become colonized by other bacteria present in saliva, such as various Actinomyces species and Veillonella. The greatest growth of the plaque occurs at the gingival margin, where plaque accumulations usually are visible after several days.

Read More- Gingiva Or Gums- Microscopic & Clinical Features, Parts

This plaque may, in some instances, provoke bleeding gingivitis in which spirochetes and Actinomyces viscosus are prominent members of the plaque flora. If this plaque remains undisturbed, the flora gradually shifts toward an anaerobic, Gram-negative flora that includes black-pigmented Bacteroides and several types of spirochetes.

The increase in these anaerobic organisms can be explained by the low oxidation-reduction potential of the aged plaque and by nutrients derived from the inflammatory exudate at the site.

Gingivitis, the simplest form of gingivitis, is associated with the accumulation of supragingival plaque along the gingival margins of the teeth. The initial colonizers of the teeth are streptococci, which proliferate and in turn become colonized by other bacteria present in salivae, such as various Actinomyces species and Veillonella.

The greatest growth of the plaque occurs at the gingival margin, where plaque accumulations usually are visible after several days. This plaque may, in some instances, provoke bleeding gingivitis. This condition loosens teeth positioning.

2. Localized Juvenile Periodontitis (LJP)

LJP is different from all other periodontal infections, as it is not associated with plaque accumulations of calculus (in fact the absence of such led early investigators to consider it as a degenerative condition), is localized to certain anterior or front teeth and first molars, and is seen following puberty.

the diseased teeth were colonized by an essentially Gram-negative flora dominated by organisms subsequently identified as various Capnocytophaga and Wolinella species and Actinobacillus actinomycetemcomitans.

This condition causes bone loss and hence worsens the tooth condition. Secondary prevention of dental caries are as follows:-

  • Oral Hygiene:

Since dental caries does not progress without the bacteria present in dental plaques, daily plaque removal by brushing, flossing, and rinsing is one of the best ways to prevent dental caries and periodontal disease. Proper brushing and flossing methods may be taught at the dental office during routine check-ups.

  • Fluoride Application: Fluoride Prevents Dental Caries

Fluoride prevents dental caries by inhibiting the demineralization of the crystal structures inside the tooth and enhancing remineralization. The remineralized surface is resistant to acid attack. In addition, fluoride inhibits bacterial enzymes.

Methods of fluoride application include water fluoridation, fluoride toothpaste, fluoride mouth rinse, dietary fluoride supplements, and professionally applied fluoride compounds such as gels and varnishes.

  • Pit and Fissure Sealants:

The majority of dental caries in young children occur in pits and fissures. Pits and fissures are more susceptible to dental caries because the anatomy favours plaque accumulation; these areas are often too narrow for any oral hygiene measures to be effective.

By filling such irregularities with flowable restorative material, the area becomes less morphologically susceptible. This is especially recommended in young patients with erupting teeth and adults with a high caries index.

  • Xylitol: A Well-Known Cause Of Dental Caries

Sucrose is a well-known cause of dental caries, and higher sucrose intake increases the risk of dental caries. However, it is impossible to eliminate sugar from the modern diet. Therefore, sugar substitutes have been developed to reduce caries risks. Xylitol is one of these sugar substitutes.

Xylitol has a sweet flavour comparable to sugar, and it is not only non-cariogenic but also anti-cariogenic. It keeps sucrose molecules from binding with MS, thereby blocking its metabolism. It also reduces the adhesion ability. The anticariogenicity of xylitol is affected more by the frequency of intake than by the amount consumed.

  • Vaccine:

As dental caries is an infectious microbiologic disease, there have been attempts to develop a vaccine. Some vaccines against MS in the form of proteins, recombinant or synthetic peptides, or protein-carbohydrate conjugates, as well as those based on DNA, have been successful experimentally.

However, none of these vaccines has appeared on the market thus far due to difficulty in inducing and maintaining high levels of antibodies in oral fluids, research is still ongoing for clinical applications.

  • Role Of The Primary Caregiver In Children to avoid Dental Caries:

As dental caries is an infectious disease, the primary caregiver of infants (most often the mother) can transmit caries-causing microorganisms to a child, resulting in the colonization of MS in the infant’s oral cavity.

There is a direct relationship between MS (Streptococci Mutans )levels in parents and their children. Therefore, efforts to reduce the MS level in the parent, including maintaining oral hygiene and undergoing dental treatment when necessary, are also important for the prevention of dental caries in young children.

Read More- What is the yellow layer on your tooth & How to get rid of it?

The Basic Way For Dental Caries Prevention

  1. Brush Regularly– You should brush your teeth at least twice a day with fluoride toothpaste for two minutes. Or, for improved care, brush after every meal and snack. If you are unable to brush, at least make an effort to rinse your mouth with water carefully.
  2. Use Mouthwash- For added protection against tooth decay, use fluoride mouthwash twice daily after brushing.
  3. Make Dental Visits A Routine- Professional tooth cleanings and regular oral exams should be scheduled at least every six months. If you are prone to dental issues or have a case that needs more attention your family dentistry practitioner may recommend more frequent visits.
  4. Consider Dental Sealants- Ask your dentist about sealants. These can seal off grooves and nooks and crannies where food can become easily trapped. This will help in preventing tooth decay and other dental issues. Plus, sealants can last up to ten years with good dental care.
  5. Drink Some Tap Water- Most cities have added fluoride to their public water supply, making it a worthy treatment for preventing tooth decay. Not only does tap water help to remineralize the teeth, but drinking water, in general, promotes saliva production to help rinse away harmful bacteria. Try to mix in some tap water, if you exclusively drink bottled water, to help protect your teeth.
  6. Eat Tooth-Healthy Foods- Believe it or not, there are foods that are good for your teeth. Much like a heart-healthy diet reduces your risk of heart disease, certain foods can protect your pearly whites. Foods that protect your teeth include cheese, fresh fruits and vegetables, unsweetened coffee, tea, and sugar-free gum. Each of these foods has specific properties that make them good for your smile.
  7. Talk To Your Dentist- If you aren’t sure about all the options available for preventing tooth decay and the onslaught of bacteria and disease, a good dentist can make recommendations specific to your needs and help you achieve a forever beautiful, award-winning smile.

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