Dental caries is a post eruptive localised
pathological process of external origin
involving the softening of dental hard tissues
and progressing to cavity formation due to
demineralization of the inorganic components
and destruction of the organic portion.
There are four major factors responsible for
the aetiology of Dental Caries namely;
Although these four factors are the major aetiological
factors of Dental caries, there are also some sub-
factors that also aid the afore mentioned factors.
DENTAL PLAQUE: This is a soft tenacious material found on
the tooth surface and can’t be easily rinsed or washed away with
water. They are formed as a result adherence of saliva pellicle
which are soft cell free, structure less material which after
adherence, are invaded by microorganism colonies such as the
Streptococcus mutans . This bacteria accounts for 70-80% of the
bacteria in the plaque before it is now joined by other
filamentous microbes (Lactobacillus and Actinomyses spp).
These microbes altogether secrete extracellular polysaccharide
which assists in further adherence and thickness of the plaque.
THE DIET: The diet basically means the kind of food we eat. This has
been more or less the most important risk factor for DC, it can also
affect DC either positively or negatively. The most common substrate
that is acted upon by the bacteria is usually Carbohydrate to release
acid and mucopolyssacharide which demineralizes the tooth and
eventually leads to DC. There are some things to note when we talk
about the diet with regards to DC;
The physical nature of the diet: the physical nature of the food we eat
also increases the susceptibility of a man to caries. For example, a
sticky meal are more susceptible to be acted on by the dental plaque
bacteria than the liquid or solid substrates.
Chemical composition of the food: the chemical composition of the
food substrate also goes a long way in telling the suseptibility of one to
caries, it is known that monosaccharaides are more cariogenic than
disaccharides and polysaccharides.
Frequency of intake: this is also important, because the
number of times a particular substrate is taken also gives us
an idea of the person being caries prone.
Presence of other diets: the presence of other diets such as protein
and fats have been found out to reduce the cariogenic effects of
NB :- Sucrose is the most cariogenic sugar and is the most
abundantly consumed sugar.
THE TOOTH FACTOR: We all know that the teeth are important
tissues that are found in the oral cavity(mouth). Therefore, there were
investigations carried out to determine whether there is a relationship
between the chemical composition of the tooth and a carious tooth. It
was discovered that there was no difference in CA+, Phosphorus,
Carbonate and Magnesium ion in either enamel of both sound tooth
and carious tooth, but there was a difference in the their fluoride
it was found that fluoride in sound enamel of the tooth was
higher than in carious tooth and it inhibits demineralization.
there are some factors that must be taken into consideration
when talking about the tooth factor they are;
MORPHOLOGICAL CHARACTERISTICS OF THE TOOTH:- the
form and structure of the tooth also affects the susceptibility of a tooth
to caries for example,
The presence of deep pits and fissures on the occlusal surface of the
tooth serve as stagnation areas for food which are then acted upon
by the bacterial plaque, leading to caries formation.
The proximal surfaces of contact areas also serve as stagnation
TOOTH POSITIONING:- Malpositioned or malrotated teeth can
produce stagnation areas which may become difficult to clean,
thereby increasing the chances of caries attack on the teeth.
DISTURBANCES IN THE FORMATION OF TOOTH
STRUCTURE:- a disturbance in the formation of tooth structure
such as amelogenesis imperfecta and other disturbances also
influence the progression of Dental Caries.
There are various side-effects that Dental caries cause they are;
Dental caries are classified clinically according to the following;
Sight of caries attack
Extent of caries
Rate of spread
Caries attacking intact surfaces or margin of restorations
Others e.g. active or arrested caries.
Dental caries is diagnosed using the following methods;
Visual:- This is by inspection with the eyes, they appear as white
spot lesion or as frank cavitations on tooth surface.
Tactile:- The cavitations that are present on the pits and fissures on
the occlusal surface of the tooth can be detected by tactile sensation,
using the tip of a blunt explorer.
Radiographic:- Dental caries appear as radiolucent areas on
periapical or bite wing radiographs.
NB:- Mouth mirrors, explorers, good light and radiographs are still the
commonest and most reliable methods of caries diagnosis.
Since dental caries formation is a condition that progresses or regresses
as a result of both demineralization and remineralization respectively,
its necessary to educate people and then gain control by either reducing
the demineralization factor and enhancing the remineralization factor
Reducing the demineralizing factors
Enhancing protective Factors
Preventive measures provided by dental professionals.
Frequency of intake of fermented CHO:- This is the most
common and significant cariogenic factor. Therefore dietary
counseling is essential in controlling such etiological factors.
Effective Oral Hygiene:- The first oral hygiene routine
should be carried out before or after breakfast. This is
because the primary objective is removal of plaque rather
than demineralization of food debris. Also topical fluoride
application by brushing with a fluoride containing toothpaste
should be carried out twice daily.
Basically this has to do with the saliva since it’s a significant
protective factor because it bathes the entire dentition constantly. It
is a great buffer of the oral cavity because of its great calcium,
phosphorus and also to a minimal extent the fluoride ions. Therefore
a condition such as xerostomia also known as dry mouth would
favor demineralization and therefore saliva stimulants are
Pits and Fissure sealants:- Use of flow able resin bounded
firmly to the enamel surface which then isolates the pits and
fissures from the cariogenic environs. They are used to seal
deep pits and fissures.
Restorations:- filling of deep pits and fissures with amalgam
to prevent caries.
Extraction of carious teeth/tooth.
Fluoride therapy:- this is the use of topical fluoride
application in the dental clinic to strengthen the teeth. This is
done for younger people rather than teenagers and adults.