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1. Presented by:-
Sushmita Bajagain

3. Content
Dental caries
 Introduction ,Incidence
 Causes , Pathophysiology
 Sign and symptom, Diagnosis ,Prevention
 Treatment
 Nursing management
 Complication

4. Dental caries
Introduction
 Dental caries is also known as tooth decay or dental
cavities. Cavities are permanently damaged areas in
the hard surface of the teeth that develop into tiny
openings or holes.

5. Introduction
 According to WHO," Dental caries is defined as
localized, post eruptive, pathological process of
external origin involving softening of the hard tooth
tissue and proceeding to the formation of cavity."

7. Incidence
 Globally, it is estimated that 2.3 billion people suffer
from caries of permanent teeth and more than 530
million children suffer from caries of primary teeth.
Source:- The Global Burden of Disease Study 2017

8. Prevalence:-
 The dental caries prevalence of 5-6-year- olds is 67%
(urban 64% ; rural 78% ). The caries prevalence of 12-
13-year-olds is 41% (urban 35%; rural 54%).
https://www.mohp.gov.np/downloads/National%20Or
al%20Health%20Policy.pdf

9. Causes

10. Causes
 Bacteria most common streptococci
 Food rich in carbohydrate
 Poor oral hygiene
 Inadequate dental care

11. Patho-physiology
 Bacteria, acid, food pieces, and saliva combine in the
mouth to form a sticky substance called plaque.
 Plaque adheres to the teeth.
 Plaque that is not removed from the teeth turns into
calculus (tartar).

12. Pathophysiology continue
Plaque that is not removed from the teeth turns into
calculus (tartar).
The acids in plaque damage the enamel covering the
teeth, and create holes in the tooth (cavities).
Cavities usually do not hurt, unless they grow very large
and affect nerves or cause a tooth fracture.

13. Pathophysiology continue..
An untreated cavity can lead to a tooth abscess.
Untreated tooth decay also destroys the inner layer of
tooth (pulp), which will require more extensive
treatment, or worse case removal of the tooth.

15. Signs and Symptoms
 A person experiencing carries may not be aware of the
disease.
 Appearance of a chalky white spot on the surface of the
tooth (earliest sign).
 Appearance of brown lesion continues to
demineralize, it can turn brown but will eventually
turn into a cavitations (cavity).

16. Signs and Symptoms
 Presence of dark brown and shiny lesion dental caries
were once present.
 The decay passes through enamel, the dentinal
tubules, which have passages to the nerve of the tooth,
become exposed
 Resulting in pain that can be temporarily worsening
with exposure to heat, cold or sweet foods and drinks.

18. Diagnosis

19. Diagnosis
 Inspection of all visible tooth surface using a good
light source, dental mirror and explorer.
 Large dental caries are often apparent to the naked
eye, but smaller lesions can be difficult to identify.

20. Prevention

21. Prevention

22. Prevention
Oral hygiene
 Personal hygiene care consists of proper brushing at
least twice a day .
 Use correct brushing technique
 Regular dental checkup

23. Prevention continue…
Dietary modification
 Minimizing snacks because snacks create a continuous
supply of nutrition for acid-creating bacteria in the
mouth.
 limiting the frequency of consumption of drinks with
sugar and not giving baby bottles to infants during
sleep.

24. Prevention continue.
Other measures
 Calcium containing food, vegetables, is often
recommended to protect against dental caries.
 Fluoride helps to prevent decay of a tooth.
 Avoid sticky foods such as biscuits, chocolate. If
possible, brush, the teeth or rinse the mouth with
water after eating these foods.

25. Management
 No carious lesion: No treatment.
 Inactive lesion: no treatment but regular checkup.
 Analgesics during pain, during tooth extraction or
pulpectomy (complete removal of pulp from the
crown and roots )
 Localized dental infection can be managed by
extraction, pulpectomy.

27. Nursing management
Assessment
 Assess the patient’s oral hygiene practices and
nutritional status.
 Assess the teeth, gums, mucous membranes, and
tongue for colour, moisture, texture, and infection.
 Assess the mouth for dryness and breathe for odour.

28. Nursing management continue..
Diagnosis
 Impaired dentition related to ineffective oral hygiene
 Imbalanced nutrition less than body requirements
related to inability to chew

29. Nursing management continue.
Intervention
 Provide a mouth care routine including tooth brushing
at regular intervals with a soft-bristle toothbrush and
fluoride toothpaste.
 Brushing teeth in an up-and-down manner

30. Nursing management continue.
Intervention
 Brushing of teeth at least twice a day.
 Encourage to avoid high-sugar foods.
 Instruct patient to obtain regular dental checkups and
follow up.

31. Complication
 Discomfort or pain
 Fractured tooth : A tooth fracture is a break or crack in
the hard shell of the tooth

32. Complication
 Tooth abscess: An abscessed tooth is a pocket of pus
that can form in different parts of a tooth as a result of
a bacterial infection. It’s sometimes called a dental
abscess

33. Complication
 Tooth sensitivity: Tooth sensitivity, or “dentin
hypersensitivity,” is pain or discomfort in the teeth as a
response to certain stimuli, such as hot or cold
temperatures.

34. References of dental caries
 Uprety K, Child Health Nursing, fourth Edition (2071
Bhadra), Tara Books and Stationery, Chhetrapati,
Kathmandu, page no.316-317.
 Shrestha T. Essential Child Health Nursing, first
Edition2015, Medhavi Publication; Jamal, Kathmandu Page
no.485-486
 https://www.nidcr.nih.gov/health-info/tooth-decay/more-
info#:~:text=Tooth%20decay%20(dental%20caries)%20is,i
nfection%2C%20and%20even%20tooth%20loss.
 https://www.who.int/news-room/fact-sheets/detail/oral-
health