Mohammed Alawad's document discusses the progression of tooth caries in 5 phases from initial subsurface demineralization to extension into the pulp. It explains that caries progression is caused by an imbalance favoring demineralization over remineralization and that a larger imbalance leads to faster progression. The document describes the visual signs of caries at each phase from white spot lesions to cavities and pain upon reaching the dentin or pulp. It notes that the demineralization process is reversible at early stages but becomes irreversible once a cavity forms.

1. Student: Mohammed Alawad
ID: 371109026
C L I N I C A L F E A T U R E S I N
R E L A T I O N T O C A R I E S
P R O G R E S S I O N

2. Caries progression
• Caries progression is caused by an imbalance favouring demineralization.
• The magnitude of this imbalance will in turn affect not only the progress, but it will also
determine the rate at which the caries progress.
• Naturally, a larger imbalance would imply a faster progress of caries while a smaller
imbalance will lead to a much slower caries progression.

3. Tooth Caries Occur In 5 Phases:
1.Initial subsurface demineralization.
2.Extension of demineralized zone towards Dentine.
3.Collapse of surface Enamel layer to form cavity.
4.Extension of Cavity into Dentine.
5.Extension of Cavity into Pulp.

4. • The earliest sign of a new carious lesion is the appearance of a Chalky White Spot on the surface of
the tooth, indicating an area of demineralization of Enamel.
• This is referred to as a white spot lesion, an incipient carious lesion or a ("microcavity").
• The process is REVERSIBLE

5. • As the lesion continues to demineralize, it can turn brown but will eventually turn into a cavitation
("cavity").
• The process is IRREVERSIBLE, once a cavity forms, the lost tooth structure cannot
be regenerated.

6. Normal Microcavity Cavity

7. • As the enamel and dentin are destroyed, the cavity becomes more noticeable. The affected areas of the
tooth change color and become soft to the touch*.
• Once 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 transient, temporarily worsening with exposure to heat, cold, or sweet
foods and drinks.

8. • A tooth weakened by extensive internal decay can suddenly fracture under normal chewing forces.
• When the decay has progressed enough to allow the bacteria to overwhelm the pulp tissue in the center
of the tooth, a toothache can result and the pain will become more constant.
• Death of the pulp tissue and infection are common consequences. The tooth will no longer be sensitive
to hot or cold, but can be very tender to pressure. (As in extensive caries)

9. • A lesion that appears dark brown and shiny suggests dental caries were once present but the
demineralization process has stopped, leaving a stain.
• Active decay is LIGHTER in color and dull in appearance.

10. REFERENCES:
1. Miyauchi H, Iwaku M, Fusayama T. (1978). Physiological recalcification of carious dentine. Bull Tokyo Med Dent
Univ;25:169-179
2. Johnson, Clarke. "Biology of the Human Dentition" Archived 2015-10-30

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