From Latin: caries - decay
Synonym: Caries, tooth decay, dental cavities</br>
Approximately 98% of the population in Europe is afflicted with dental caries. So, caries is by far the most prevalent disease in industrial countries.
Dental caries is caused by a disturbance in the balance of demineralization and remineralization of the teeth. According to Koenig (1971), 4 factors interact in the development of caries. These must come together at the same time in order to initiate the disease:
The cariogenic microorganisms (primarily streptococci) produce organic acids as metabolic degradation products out of low-molecular carbohydrates (sugar), which disrupt the mineral salts (hydroxyapatite) of the hard substance of the tooth. This process is designated as "demineralization". It is reversible as long as the organic matrix of the hard substance of the tooth is not damaged. If the matrix itself is decomposed by the bacteria, there develop structural defects (cavities) that are irreversible.
The development and/or progression of dental caries are influenced by many different factors. They are:
Dental caries can be divided into 4 or 5 stages:
A special type constitutes the so-called caries sicca.
The symptoms are dependent on the stage of the caries. Initial caries and enamel caries are basically without any symptoms. In advanced caries, besides the visible structural defects, the following troubles may occur:
The diagnosis of caries is mostly carried out clinically by inspection and probing of the affected teeth. Moreover, special x-rays ("teeth film"), transillumination of the teeth with cold light and teeth sensitivity test with the air syringe are used.
The most important caries prophylaxis measure is the properly conducted dental care with toothbrush and dental floss, as well as, if necessary, with an interdental brush. In addition, the caries resistance of the teeth can be improved by using fluoride toothpastes and by local fluoridation. Other potential steps for children are:
The therapy of caries is the purpose of conserving dentistry. It consists of the removal of the affected hard substance of the teeth by excavation and subsequent filling of the resulting cavity with plastic, cast or precast filling material. Another method is the minimal-invasive removal of caries by softening of the lesion with a special gel and subsequent curretting with hand instruments (CarisolvÂ®).
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