Dr. Bharat kumar FCPS Resident Dept of Prosthontics Dr.

Ishart-ul-Ibad Khan Institute of Oral Health Scinces Dow Universtiy

DENTAL CARIES
DEFINITION


It is a disease of microbial origin in which the dietary carbohydrates are fermented by the bacteria forming an acid which causes the demineralization of the inorganic part and disintegration of the organic part of the tooth

Dental caries

Etiology of Dental Caries

Bacteriology of Dental Caries

 

Streptococcus mutants Lactobacilli

Symptoms and Signs

 

Caries initially involves only the enamel and produces no symptoms. A cavity that invades the dentin causes pain, first when hot, cold, or sweet foods or beverages contact the involved tooth, and later with chewing or percussion. Pain can be intense and persistent when the pulp is severely involved

The earliest sign of decay is decalcification

SEVERELY DECAYED MOLAR

CLINICAL SIGNIFICANCE
Pulp involvement?  Reversible or irreversible pulpits?  Spread?


Consequences of Dental Caries

Consequences of Dental Caries

ORAL HEALTH CONSEQUENCES

Apical periodontitis,  Peri apical abscess,  Cellulitis,  Osteomyelitis of the jaw



Spread from maxillary teeth

May cause  Purulent sinusitis,  Meningitis,  Brain abscess,  Orbital cellulitis,  And cavernous sinus thrombosis.

SPREAD FROM MANDIBULAR TEETH

may cause  Ludwig's angina,  Para pharyngeal abscess,  Mediastinitis, pericarditis,  Emphysema, and jugular thrombophlebitis.

ALSO
Bacteria from tooth decay can enter bloodstream and inoculate heart valves, cause bacterial endocarditis  Oral-pharyngeal secretions inoculated with bacteria can cause aspiration pneumonia


CARIES MANAGEMENT


Detection of caries lesion followed by immediate restoration

The most important part in the treatment of disease is the caries prevention.