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Caries

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Caries, which is a Latin term for decay, is a bacterial disease involving teeth. Numerous bacteria are present in human bodies. Bacterial colonization usually starts immediately after birth because of contact with other individuals and the environment. Not all bacteria are harmful; eg., the bacterial flora in our intestinal tract are crucial for our survival; these are called symbiotic bacteria. Other bacteria simply settle in niches; these are called commensal bacteria. We do not benefit from them directly. However, the formation of such niches by commensal bacteria, such as in the skin, prevents these areas from being inhabited by other harmful bacteria. Sometimes, bacteria and hosts struggle for dominance. Doctors call such bacteria opportunists. When the host is damaged by bacterial dominance, meaning that the bacteria are winning the fight, the bacteria are called pathogens. There are a number of bacteria in our oral cavities. Some live in essential niches and prevent other aggressive forms from settling in, while others simply live alongside us. This means that humans have symbiotic as well as commensal bacteria in their oral cavities. However, bacterial flora can change instantly with changes in life circumstances. Commensal bacteria can suddenly transform into pathogens, resulting in caries formation.

Caries develops when certain factors come together, the most important ones being certain host factors, plaque, and time. Host factors encompass all the factors related to the host, such as tooth anatomy, saliva composition, and cleaning habits. The formation of mature plaque usually takes about 24 hours, which is originally the time taken by commensal and symbiotic bacteria to become pathogenic. Disorganized mouth bacteria are not harmful. Only mature plaque can cause caries and periodontitis. Therefore, it is very important to remove plaque efficiently with the help of a toothbrush, dental water jets, and floss. By doing so, the bacteria are deprived of their habitat. Without a suitable habitat, they cannot cause any more harm.

Plaque, which is a layer of saliva components, bacteria, and carbohydrates, forms on tooth surfaces when they are not cleaned properly. When all these factors; i.e., bad cleaning habits, plaque, and time come together, they lead to the formation of caries. We will now use the animation to take a little tour into a patch of plaque. Plaque is organized like a little city. There are bacteria that are specialized in just holding on to the teeth. Other bacteria transport nutrients by forming transport tubes. Streptococcus mutans bacteria, for example, produce nutrients from organic acids, which then attack the tooth by removing existing minerals from the tooth substance. These bacterial products within the plaque dissolve the enamel. Furthermore, the dentin (depicted in yellow) becomes colonized by bacteria as soon as caries reaches it because it contains proteins that supply the bacteria with a food source. Once this occurs, caries progression cannot be stopped even if plaque is removed thoroughly, and the disease gains it owns momentum. Toothache usually only occurs when caries reaches the tooth nerve, marked here in red. In this case, a root canal treatment becomes necessary because the tooth nerve is infected by bacteria. If the root canal treatment is done incorrectly, it can lead to bone inflammation, even after many years. Patients frequently refer to this as the disease focus; i.e., the location where the disease or infection originated. A root tip resection or even a tooth extraction is a possible consequence.

The above explanation will now facilitate the understanding of common caries. Common caries usually results in bridges, crowns, partial prostheses, and sometimes even a total prosthesis by the age of 50. In the Video caries they are various X-rays of patients from different dentist’s offices. Interestingly, all these patients have bad teeth mainly in the back (posterior) regions of the oral cavity – at the posterior teeth like premolars and molars here. Even a nonexpert can tell from these pictures that individuals get fillings, crowns, and bridges (the bright spots on the X-rays) in these teeth first. This can be explained as follows. Frequently, individuals only brush their teeth superficially because their minds are on other things and they get fooled by the fresh feeling coming from the toothpaste. They therefore clean the front (anterior) teeth properly and neglect the posterior teeth. This is not without consequence; hidden layers, especially in the gaps between teeth later lead to the destruction of enamel with subsequent caries formation, gum inflammation, and/or periodontitis. This is why patients get fillings in the posterior teeth first. This will lead to most individuals having bad teeth (or even no teeth) in the posterior regions of their oral cavities by the age of 50. As a consequence, the anterior teeth are overly strained, and by the age of 60, a total prosthesis will become unavoidable for a typical individual. Regular oral hygiene, quality work, and patient education prevent the formation of caries. Therefore, patients will have something to smile about all the way into old age with your dentist and checkdent.com!

Caries