Dental caries is the process of tooth decay by specific type of bacteria residing in mouth. They cause decay by producing acid from the sugar and carbohydrate that we consume in our food.
Pits and fissure caries: On the biting/ chewing surfaces of the teeth. Most common. Smooth surface caries: On the surfaces of the teeth facing cheeks, lips and tongue.
Root caries: Developing on the portion of the tooth normally covered by the gum.
Rampant caries: Rapidly developing caries affecting surfaces of many teeth that are caries resistant. It can include Baby bottle tooth decay/ Early childhood caries (caused by prolonged use of feeding bottle especially at night which causes milk to remain in mouth thus allowing bacteria to produce tooth destroying acids).
Radiation caries: Caused by decrease in salivary flow due to damage to salivary glands by radiation therapy.
Drug induced caries: Caused by use of drugs that decrease saliva flow.
Poor oral hygiene. The frequent intake of sweet and sugary food that can be metabolized by bacteria. Susceptible tooth surfaces; some surfaces of teeth are more prone to develop caries than others especially the newly erupted permanent molar teeth in children because of the difference in height compared to deciduous teeth.
The following table presents summary of signs and symptoms of different stages of dental caries and few tips to prevent and manage the process of dental caries.
1.Early caries may cause no symptom.
2.Food packing between teeth.
4.Sensitivity to hot and cold food.
5.Tooth pain especially after taking sweet foods.
6.Cavity formation in tooth.
7.Swelling near tooth.
Proper oral hygiene; brush at least 2 times daily with the last brushing before going to bed. Using Fluoride based toothpastes. In children, the quantity of Fluoride in toothpastes need to be monitored because of the risk of discoloration of permanent teeth. Reducing the frequency of intake of refined carbohydrates. Frequent rinsing with water. Avoiding soft drinks, alcohol and tobacco. Avoiding sticky foods e.g. toffees, chips.
Adding tea, fish and raw vegetables in diet. Regular intake of milk, butter and cheese (cheese should be consumed at the end of the meal to neutralize bacterial acids) Xylitol chewing gums can prevent caries as well increase salivary flow. Fissure sealants in children.
For early lesions that do not involve cavity formation; Diet modification, increasing Fluoride exposure (by properly brushing with Fluoride containing toothpaste or by Fluoride application by dentist) and proper cleaning of mouth.
For advanced lesions that involve cavity formation; removal of diseased portion of tooth, followed by restoration of removed portion of tooth by filling materials. If the disease has involved living structure of tooth, root canal treatment may be needed. If tooth cannot be saved at all, extraction of the tooth may be the only option.
Pain, abscess, tooth loss (which can bring difficulties in eating, speaking and maintenance of good aesthetics as well as earlier loss of teeth may cause space problems for the permanent teeth resulting in mal-aligned teeth), ulceration by the fractured portion of the tooth. Loss of teeth is also associated with aggravation of systemic disorders as discussed later in the book.