DENTAL CAVITIES (Caries)
Enamel
Dentine
Pulp
Root
Furcation
Cement
Ligament
Dental cavity
Definition
 What are cavities?
- Cavities are holes that damage the structure of teeth.
* What is caries?
- Caries is a process of demineralization (from food
fermentation of bacteria) resulting in holes on teeth
surfaces.
DENTAL CAVITIES (CARIES)
• Causes, incidence, risk factors:
- Tooth decay is one of the most common of
all disorders, second only to the common
cold.
It usually occurs in children and young
adults but can affect any person. It is the
most important cause of tooth loss in
younger people.
DENTAL CAVITIES (CARIES)
• Causes, incidence, risk factors:
- Plaque that is not removed from the teeth
mineralizes into tartar.
- Plaque and tartar irritate the gum, resulting in
gingivitis and ultimately periodontitis.
DENTAL CAVITIES (CARIES)
• Causes, incidence, risk factors:
- Bacteria are normally present in the mouth. The
bacteria convert all foods – especially sugar and
starch - into acid.
- Bacteria, acid, food debris, and saliva combine in
the mouth to form a sticky substance called
plaque that adheres to the teeth. It is the most
prominent on the back molars, just above the gum
line on all teeth, and at the edge of fillings.
DENTAL CAVITIES
Causes, incidence, risk factors:
- Plaque begins to accumulate on teeth within 20
minutes after eating ( the time when most
bacterial activity occurs).
- If this plaque is not removed thoroughly and
routinely, tooth decay will not only begin, but
flourish.
Exercise (15’)
1. What is plaque ?
2. What will happened if plaque is not
removed thoroughly and routinely?
Good luck
DENTAL CAVITIES (CARIES)
 Causes, incidence, risk factors:
- The acids in plaque dissolve the enamel surfaces of
the tooth and create holes in the tooth ( cavities).
- Cavities are usually painless until they grow very
large inside the tooth and destroy the nerve and blood
vessels in the tooth (pulp). If left untreated, a tooth
abscess can develop.
- Untreated tooth decay also destroys the internal
structures of the tooth (pulp) and ultimately causes the
loss of the tooth.
DENTAL CAVITIES (CARIES)
• Causes, incidence, risk factors:
- Sugars and starches increase the risk of tooth
decay. Sticky foods are more harmful than
nonsticky foods because they remain on the
tooth surface.
- Frequent snacking increases the time that
acids are in contact with the surface of the
tooth.
DENTAL CAVITIES (CARIES)
Symtoms:
- Toothache – particularly after sweet,
hot or cold foods and drinks.
- Visible pits or holes in the teeth.
DENTAL CAVITIES (CARIES)
*Signs and tests:
- Most cavities are discovered in the early
stages during routine checkups. The surface of
the tooth may be soft when probed with a
sharp instrument.
- Pain may not be present until the advanced
stages of tooth decay.
- Dental x–rays may show some cavities before
they are visible to the eye.
DENTAL CAVITIES (CARIES)
Treatment
- Destroy tooth structure does not regenerate.
However, the progression of cavities can be
stopped by treatment.
- The goal is to preserve the tooth and prevent
complications.
DENTAL CAVITIES (CARIES)
Treatment
*In filling teeth, the decayed material is removed (
by drilling) and replaced with a restorative
material such as:
- Silver alloy
- Gold
- Porcelain
- Composite resin
DENTAL CAVITIES (CARIES)
Treatment
- Porcelain and composite resin more
closely match the natural tooth
appearance, and may be preferred for
front teeth.
- Many dentists consider silver amalgam
(alloy) and gold as stronger and are
used on back teeth, although there is a
trend to use high strength composite
resin in the back teeth as well.
DENTAL CAVITIES (CARIES)
Treatment
- Crowns are used if decay is extensive and there is
limited tooth structure which may cause weakened
teeth.
- Large fillings and weak teeth increase the risk of
tooth breaking. The decayed or weakened area is
removed and repaired and a covering jacket or
“cap” ( crown) is fitted over the remainder of the
tooth.
- Crowns are often made of gold, porcelain or
porcelain fused to metal.
DENTAL CAVITIES (CARIES)
Treatment
- A root canal treatment is recommended if the nerve
in the tooth dies from decay or from a traumatic blow.
- The center of the tooth, including the nerve and
blood vessel tissue ( pulp), is removed along with
decayed portions of the tooth.
- The roots are filled with a sealing material. The tooth
is filled and a crown may be placed over the tooth if
needed.
DENTAL CAVITIES (CARIES)
Expectations (prognosis)
- Treatment often preserve the tooth. Early treatment
is less painful and less expensive than treatment of
extensive decay.
- Anesthetics- local, nitrous oxide (laughing gas), or
other prescription medications – may be required in
some cases to relieve pain during or following drilling
or other treatment of decay teeth.
- For those who fear dental treatment, nitrous oxide in
combination with anesthesia may be preferred.
DENTAL CAVITIES (CARIES)
Complications
- Tooth abscess
- Fracture tooth
- Discomfort or pain
- Tooth sensitivity
- Inability to bite down on tooth
DENTAL CAVITIES (CARIES)
Prevention
- Oral hygiene is necessary to prevent cavities.
This consists of brushing at least twice a day
and flossing at least daily, and regular
professional cleaning ( every 6 months).
- X-rays may be taken yearly to detect possible
cavity development in high risk areas of the
mouth.
DENTAL CAVITIES (CARIES)
Prevention
- Chewy, sticky foods (such as dried fruits or
candy) are best if eaten as part of a meal
rather than as a snack. If possible, brush the
teeth or rinse the mouth with water after
eating these foods.
- Minimize snacking, which creates a constant
supply of acid in the mouth. Avoid constant
sipping of sugar drinks or frequent sucking on
candy and mints.
DENTAL CAVITIES (CARIES)
Prevention
Dental sealant can prevent cavities. Sealants
are thin plastic like coating applied to the
chewing surfaces of the molars. This coating
prevents the accumulation of plaque in the
deep grooves on these vulnerable surfaces.
- Sealants are usually applied on the teeth of
children, shortly after the molars erupt. Older
people may also benefit from the use of tooth
sealants.
DENTAL CAVITIES (CARIES)
Prevention
- Fluoride is often recommended to protect against
dental caries. It has been demonstrated that people
who ingest fluoride in their drinking water or by fluoride
supplements have fewer dental caries.
- Fluoride ingested when the teeth are developing is
incorporated into structure of the enamel and protect it
against the action of acids.
DENTAL CAVITIES (CARIES)
Prevention
- Topical fluoride is also recommended to protect
the surface of the teeth. This may include a
fluoride toothpaste or mouthwash.
- Many dentists include application of topical
fluoride solutions as part of routine visits.
Remember
- If you want to prevent cavities, how often you
eat can be just as important as what you eat.
That's because food affects your teeth and
mouth long after you swallow.
- Eating the cookies with dinner will do less
harm to your teeth than eating them in the
middle of the afternoon as a separate snack.
Remember
- Of course, overall poor nutrition can contribute
to periodontal (gum) disease and can have
other long-term effects on your mouth.
- Learning how food affects your oral health -
long-term and short-term - is the first step
toward mouth-healthy eating.
DENTAL CARIES PREVENTION
Dental hygiene
* Definition:
- Dental hygiene :
- keeping the mouth clean
* Information:
- Oral hygiene is the best means of prevention of
cavities (dental caries), gingivitis, periodontitis, and
other dental disorders. It also helps to prevent bad
breath (halitosis).
DENTAL CARIES PREVENTION
Dental hygiene
- Oral hygiene is necessary for all persons to
maintain the health of their teeth and mouth.
- Healthy teeth have less cavities. They are clean
and have minimal or no plaque deposits.
- Healthy gums are pink and firm.
DENTAL CARIES PREVENTION
Dental hygiene
Personal care:
- Careful brushing and flossing help to prevent build-up
of plaque and calculus (tartar).
- The teeth should be brushed at least twice daily and
flossed at least once per day. For some people,
brushing and flossing may be recommended after
every meal and at bedtime.
- Consult the dentist or dental hygienist if instruction or
demonstration of proper brushing and flossing
techniques is needed.
DENTAL CARIES PREVENTION
Dental hygiene
- Oral hygiene consists of both personal and
professional care.
- Dental X-rays may be performed as part of
routine professional examinations.
DENTAL CARIES PREVENTION
Dental hygiene
- Special appliances or tools may be recommended to
supplement (but not to replace) tooth brushing and
flossing. These include special toothpicks,
toothbrushes, water irrigation, or other devices.
- Initially electric toothbrushes were only recommended
for persons who have problems with strength or
dexterity of their hands, but many dentists are now
recommending them to many other patients in order
to improve their dental home care.
DENTAL CARIES PREVENTION
Dental hygiene
- Fluoride-containing, or anti-plaque (tartar
control) toothpastes or mouth rinses may be
recommended by the dentist or dental
hygienist.
- Dentures and other appliances must be kept
extremely clean. This includes regular brushing
and may include soaking them in a cleansing
solution.
DENTAL CARIES PREVENTION
Dental hygiene
Professional care:
- Regular tooth cleaning by the dentist or dental
hygienist is important to remove plaque that may
develop even with careful brushing and flossing,
especially in areas that are difficult for a patient to
reach on his own at home.
- Professional cleaning includes scaling and polishing.
This involves the use of various instruments or devices
to loosen and remove deposits from the teeth.
DENTAL CARIES PREVENTION
Dental hygiene
Professional care:
- Many dentists recommend having the teeth
professionally cleaned every 6 months. More frequent
cleaning and examination may be necessary during
the treatment of many of the dental/oral disorders.
- Routine examination of the teeth is recommended at
least every year.
DENTAL CARIES PREVENTION
Dental hygiene
• Complications:
- Usually there are no complications; however,
overly vigorous or improperly performed
brushing and flossing may result in injury to the
gingiva (gums).
- Call the dentist or dental hygienist if instructions
or demonstration of proper brushing or flossing
techniques is needed, or to schedule routine
dental cleaning and examination.
Remember in dental caries prevention:
CARIES PREVENTIVE METHODS AND MEANS
• Fluoride and different vehicles to provide fluoride
• Diet measures
• Oral hygiene measures
• Antimicrobial treatments
• Saliva - quality and quantity improvement
Questions:
1. What is oral hygiene? How is it important?
2. How often our teeth should be brushed and
flossed ?
3. How to keep clean the dentures?
DENTAL CARIES PREVENTION
Immediate Effects Of Food
- Changes begin in your mouth the minute you started
to eat certain foods.
- Bacteria in your mouth become more acidic and the
acid starts the process that can lead to cavities.
 How does this happen?
- All carbohydrate foods eventually break down into
simple sugars: glucose, fructose, maltose and lactose.
Some foods, called "fermentable carbohydrates,"
break down in the mouth, while others don't break
down until they move further down the digestive tract.
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  • 1.
  • 2.
    Definition  What arecavities? - Cavities are holes that damage the structure of teeth. * What is caries? - Caries is a process of demineralization (from food fermentation of bacteria) resulting in holes on teeth surfaces.
  • 3.
    DENTAL CAVITIES (CARIES) •Causes, incidence, risk factors: - Tooth decay is one of the most common of all disorders, second only to the common cold. It usually occurs in children and young adults but can affect any person. It is the most important cause of tooth loss in younger people.
  • 4.
    DENTAL CAVITIES (CARIES) •Causes, incidence, risk factors: - Plaque that is not removed from the teeth mineralizes into tartar. - Plaque and tartar irritate the gum, resulting in gingivitis and ultimately periodontitis.
  • 5.
    DENTAL CAVITIES (CARIES) •Causes, incidence, risk factors: - Bacteria are normally present in the mouth. The bacteria convert all foods – especially sugar and starch - into acid. - Bacteria, acid, food debris, and saliva combine in the mouth to form a sticky substance called plaque that adheres to the teeth. It is the most prominent on the back molars, just above the gum line on all teeth, and at the edge of fillings.
  • 6.
    DENTAL CAVITIES Causes, incidence,risk factors: - Plaque begins to accumulate on teeth within 20 minutes after eating ( the time when most bacterial activity occurs). - If this plaque is not removed thoroughly and routinely, tooth decay will not only begin, but flourish.
  • 7.
    Exercise (15’) 1. Whatis plaque ? 2. What will happened if plaque is not removed thoroughly and routinely? Good luck
  • 8.
    DENTAL CAVITIES (CARIES) Causes, incidence, risk factors: - The acids in plaque dissolve the enamel surfaces of the tooth and create holes in the tooth ( cavities). - Cavities are usually painless until they grow very large inside the tooth and destroy the nerve and blood vessels in the tooth (pulp). If left untreated, a tooth abscess can develop. - Untreated tooth decay also destroys the internal structures of the tooth (pulp) and ultimately causes the loss of the tooth.
  • 9.
    DENTAL CAVITIES (CARIES) •Causes, incidence, risk factors: - Sugars and starches increase the risk of tooth decay. Sticky foods are more harmful than nonsticky foods because they remain on the tooth surface. - Frequent snacking increases the time that acids are in contact with the surface of the tooth.
  • 10.
    DENTAL CAVITIES (CARIES) Symtoms: -Toothache – particularly after sweet, hot or cold foods and drinks. - Visible pits or holes in the teeth.
  • 11.
    DENTAL CAVITIES (CARIES) *Signsand tests: - Most cavities are discovered in the early stages during routine checkups. The surface of the tooth may be soft when probed with a sharp instrument. - Pain may not be present until the advanced stages of tooth decay. - Dental x–rays may show some cavities before they are visible to the eye.
  • 12.
    DENTAL CAVITIES (CARIES) Treatment -Destroy tooth structure does not regenerate. However, the progression of cavities can be stopped by treatment. - The goal is to preserve the tooth and prevent complications.
  • 13.
    DENTAL CAVITIES (CARIES) Treatment *Infilling teeth, the decayed material is removed ( by drilling) and replaced with a restorative material such as: - Silver alloy - Gold - Porcelain - Composite resin
  • 14.
    DENTAL CAVITIES (CARIES) Treatment -Porcelain and composite resin more closely match the natural tooth appearance, and may be preferred for front teeth. - Many dentists consider silver amalgam (alloy) and gold as stronger and are used on back teeth, although there is a trend to use high strength composite resin in the back teeth as well.
  • 15.
    DENTAL CAVITIES (CARIES) Treatment -Crowns are used if decay is extensive and there is limited tooth structure which may cause weakened teeth. - Large fillings and weak teeth increase the risk of tooth breaking. The decayed or weakened area is removed and repaired and a covering jacket or “cap” ( crown) is fitted over the remainder of the tooth. - Crowns are often made of gold, porcelain or porcelain fused to metal.
  • 16.
    DENTAL CAVITIES (CARIES) Treatment -A root canal treatment is recommended if the nerve in the tooth dies from decay or from a traumatic blow. - The center of the tooth, including the nerve and blood vessel tissue ( pulp), is removed along with decayed portions of the tooth. - The roots are filled with a sealing material. The tooth is filled and a crown may be placed over the tooth if needed.
  • 17.
    DENTAL CAVITIES (CARIES) Expectations(prognosis) - Treatment often preserve the tooth. Early treatment is less painful and less expensive than treatment of extensive decay. - Anesthetics- local, nitrous oxide (laughing gas), or other prescription medications – may be required in some cases to relieve pain during or following drilling or other treatment of decay teeth. - For those who fear dental treatment, nitrous oxide in combination with anesthesia may be preferred.
  • 18.
    DENTAL CAVITIES (CARIES) Complications -Tooth abscess - Fracture tooth - Discomfort or pain - Tooth sensitivity - Inability to bite down on tooth
  • 19.
    DENTAL CAVITIES (CARIES) Prevention -Oral hygiene is necessary to prevent cavities. This consists of brushing at least twice a day and flossing at least daily, and regular professional cleaning ( every 6 months). - X-rays may be taken yearly to detect possible cavity development in high risk areas of the mouth.
  • 20.
    DENTAL CAVITIES (CARIES) Prevention -Chewy, sticky foods (such as dried fruits or candy) are best if eaten as part of a meal rather than as a snack. If possible, brush the teeth or rinse the mouth with water after eating these foods. - Minimize snacking, which creates a constant supply of acid in the mouth. Avoid constant sipping of sugar drinks or frequent sucking on candy and mints.
  • 21.
    DENTAL CAVITIES (CARIES) Prevention Dentalsealant can prevent cavities. Sealants are thin plastic like coating applied to the chewing surfaces of the molars. This coating prevents the accumulation of plaque in the deep grooves on these vulnerable surfaces. - Sealants are usually applied on the teeth of children, shortly after the molars erupt. Older people may also benefit from the use of tooth sealants.
  • 22.
    DENTAL CAVITIES (CARIES) Prevention -Fluoride is often recommended to protect against dental caries. It has been demonstrated that people who ingest fluoride in their drinking water or by fluoride supplements have fewer dental caries. - Fluoride ingested when the teeth are developing is incorporated into structure of the enamel and protect it against the action of acids.
  • 23.
    DENTAL CAVITIES (CARIES) Prevention -Topical fluoride is also recommended to protect the surface of the teeth. This may include a fluoride toothpaste or mouthwash. - Many dentists include application of topical fluoride solutions as part of routine visits.
  • 24.
    Remember - If youwant to prevent cavities, how often you eat can be just as important as what you eat. That's because food affects your teeth and mouth long after you swallow. - Eating the cookies with dinner will do less harm to your teeth than eating them in the middle of the afternoon as a separate snack.
  • 25.
    Remember - Of course,overall poor nutrition can contribute to periodontal (gum) disease and can have other long-term effects on your mouth. - Learning how food affects your oral health - long-term and short-term - is the first step toward mouth-healthy eating.
  • 26.
    DENTAL CARIES PREVENTION Dentalhygiene * Definition: - Dental hygiene : - keeping the mouth clean * Information: - Oral hygiene is the best means of prevention of cavities (dental caries), gingivitis, periodontitis, and other dental disorders. It also helps to prevent bad breath (halitosis).
  • 27.
    DENTAL CARIES PREVENTION Dentalhygiene - Oral hygiene is necessary for all persons to maintain the health of their teeth and mouth. - Healthy teeth have less cavities. They are clean and have minimal or no plaque deposits. - Healthy gums are pink and firm.
  • 28.
    DENTAL CARIES PREVENTION Dentalhygiene Personal care: - Careful brushing and flossing help to prevent build-up of plaque and calculus (tartar). - The teeth should be brushed at least twice daily and flossed at least once per day. For some people, brushing and flossing may be recommended after every meal and at bedtime. - Consult the dentist or dental hygienist if instruction or demonstration of proper brushing and flossing techniques is needed.
  • 29.
    DENTAL CARIES PREVENTION Dentalhygiene - Oral hygiene consists of both personal and professional care. - Dental X-rays may be performed as part of routine professional examinations.
  • 30.
    DENTAL CARIES PREVENTION Dentalhygiene - Special appliances or tools may be recommended to supplement (but not to replace) tooth brushing and flossing. These include special toothpicks, toothbrushes, water irrigation, or other devices. - Initially electric toothbrushes were only recommended for persons who have problems with strength or dexterity of their hands, but many dentists are now recommending them to many other patients in order to improve their dental home care.
  • 31.
    DENTAL CARIES PREVENTION Dentalhygiene - Fluoride-containing, or anti-plaque (tartar control) toothpastes or mouth rinses may be recommended by the dentist or dental hygienist. - Dentures and other appliances must be kept extremely clean. This includes regular brushing and may include soaking them in a cleansing solution.
  • 32.
    DENTAL CARIES PREVENTION Dentalhygiene Professional care: - Regular tooth cleaning by the dentist or dental hygienist is important to remove plaque that may develop even with careful brushing and flossing, especially in areas that are difficult for a patient to reach on his own at home. - Professional cleaning includes scaling and polishing. This involves the use of various instruments or devices to loosen and remove deposits from the teeth.
  • 33.
    DENTAL CARIES PREVENTION Dentalhygiene Professional care: - Many dentists recommend having the teeth professionally cleaned every 6 months. More frequent cleaning and examination may be necessary during the treatment of many of the dental/oral disorders. - Routine examination of the teeth is recommended at least every year.
  • 34.
    DENTAL CARIES PREVENTION Dentalhygiene • Complications: - Usually there are no complications; however, overly vigorous or improperly performed brushing and flossing may result in injury to the gingiva (gums). - Call the dentist or dental hygienist if instructions or demonstration of proper brushing or flossing techniques is needed, or to schedule routine dental cleaning and examination.
  • 35.
    Remember in dentalcaries prevention: CARIES PREVENTIVE METHODS AND MEANS • Fluoride and different vehicles to provide fluoride • Diet measures • Oral hygiene measures • Antimicrobial treatments • Saliva - quality and quantity improvement
  • 37.
    Questions: 1. What isoral hygiene? How is it important? 2. How often our teeth should be brushed and flossed ? 3. How to keep clean the dentures?
  • 38.
    DENTAL CARIES PREVENTION ImmediateEffects Of Food - Changes begin in your mouth the minute you started to eat certain foods. - Bacteria in your mouth become more acidic and the acid starts the process that can lead to cavities.  How does this happen? - All carbohydrate foods eventually break down into simple sugars: glucose, fructose, maltose and lactose. Some foods, called "fermentable carbohydrates," break down in the mouth, while others don't break down until they move further down the digestive tract.