What is ?Statistics on Risk Factors for Progression of Symptoms of Clinical Examination of How is Diagnosed?Prognosis of How is Treated? ReferencesWhat is ?
is an infectious disease that can lead to cavities (small holes) in the tooth structure that compromises both the structure and the health of the tooth.
Statistics onis the second most common disease in our community after the common cold. However, it can be prevented with proper oral hygiene. The rate of has declined due to fluoridated water and improved oral hygiene techniques.
The decline of caries is measured by the number of decayed, missing or filled teeth DMFT affect by caries. The DMFT rates of 5-6 years old, 12 years old, 21-24 years old, and 35-44 years old in 1999 were 1.66, 0.89, 3.7 and 13.5 respectively.
Risk Factors for
There are several risk factors associated with . The 3 main factors that lead to are sugars, oral bacteria and the time these are combined in the presence of the tooth. These factors increase a persons susceptibility to developing caries and play varying roles in the development of caries, depending on its nature.
For example, sticky sugary foods are much more likely to cause than non sticky sugary foods. It is important to recognize that people with teeth defects are predisposesd to .
Progression ofis caused by bacteria producing acids from the consumption of sugars. The acid can cause local demineralisation of the tooth surface. If damage to the tooth is not significant, the protective qualities of saliva may stop further demineralisation of the tooth and remineralization will occur. Also, proper oral hygiene e.g. brushing teeth 3 times a day reduces the development and progression of caries.
If caries are allowed to continue to progress, much more of the tooth structure will be lost and there is an increased risk of loss of the entire tooth and infection such as a tooth abscess.
Symptoms ofThe patient usually complains of a painful tooth that is made worse when eating hot, cold or sugary drinks. There may be discolouration or holes present on affected tooth, which may cause annoying impaction of small food pieces. If the tooth has become infected, the patient's face may appear swollen on the affected side.
Clinical Examination ofThe early sign of is a chalky white appearance of the enamel surface. If the caries progresses, the damaged enamel surface becomes dark brown or black. A late sign of is holes or cavites in the affected tooth. The affected tooth is probed to check the depth of the hole. If the tooth is painful when probed, the tooth is still alive. If not, the tooth is not vital any more.
How is Diagnosed?An x-ray confirms diagnosis of .
Prognosis ofThe prognosis of depends on the health of the patient, oral health practices and the extent of . Early signs of may be reversed with minor dental intervention and improved oral hygiene. If has lead to holes in the tooth, the lost tooth structure must be filled and rebuilt with dental materials. If there is significant damage to the tooth and signs of infection, the tooth should be removed and the infection treated.
How is Treated?The main goal is to keep as much tooth structure as well as preventing further complications. Caries that are superficial may require only fluoride treatments to help with remineralisation.
If caries have lead to cavities, the caries must be removed and the repaired with dental materials such as composite and amalgam. If a significant amount of tooth structure is lost, the tooth may have a crown placed over it. If much of the tooth structure is lost and the tooth is vulnerable to infection, the tooth may need root canal treatment.
The final stage will be to remove the tooth if it is untreatable. The patient may then chose to have an implant (a fake tooth put into the jaw) or partial denture, depending on oral health and financial status.
ReferencesAustralian Dental Association,viewed 28 March 2007, at http://www.ada.org.au/.Bowen, WH & Tabak, LA 1993, Cariology for the nineties, University of Rochester Press, NY.Fejerskov, O, & Kidd, EAM 2003, : the disease and its clinical management, Blackwell, Oxford. Mitchell, DA 2005, OXFORD HANDBOOK of Clinical Dentistry, 4th edn, Oxford University press, New York. Silverstone, LM 1981, : aetiology, pathology & prevention, 2nd edn, Macmillan, London.
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