2. Classification of Caries
Dental caries can be classified according to three major
factors,
A= According to morphology of teeth
B= According to severity and progress of lesion
C= According to age pattern
It can be defined as the microbial disease of the
calcified tissues of teeth, characterized by
demineralization of the inorganic portion and destruction
of organic substance of the tooth (shafer).
3. A= According to morphology of teeth
a. Pit and Fissure Caries: Caries occurring on
anatomical pits and fissures of all the teeth.
b. Smooth surface Caries: Caries occurring on smooth
surfaces of the teeth.
c. Root Caries: Caries occurring at the cemento
enamel junction or cementum.
d. Linear Enamel Caries:
Caries occurring on the labial surfaces of anterior teeth.
4. B= According to severity and progress of
lesion
Dental caries can be classified according to severity of
attack.
a. Incipient Caries
b. Rampant Caries
c. Arrested Caries
d. Recurrent Caries
e. Radiation Caries
5. 1. The worm theory:
According to concept of that time, the cause of caries
was thought to be invasion of ‘worms’ into teeth.
Therefore the character of caries was shown as a worm
over tooth surface.
ETIOLOGY OF DENTAL CARIES:
6. 2. The humoral theory:
The four recognized humors of the body were
blood, phlegm, black bile and yellow bile. The imbalance
in these humors resulted in the disease process.
7. 3. Vital theory:
Towards the end of the eighteenth century, it was postulated
that tooth decay originated from within the tooth itself.
4.Chemical/Parasitic theory:
In the early 19th century, a new concept was emerging, that
teeth were destroyed by acids formed in the oral cavity.
8. Acidogenic Theory:
Miller (1889) propagated the concept of acid formation
in the oral cavity and attributed the synthesis of acid to
the action of micro –organisms. He was of the view that
micro-organisms of the mouth, by secretion of enzymes
or by their own metabolites degrade the carbohydrates
into acids.
9. 6. Proteolytic Theory:
Gottlieb (1944), the initial action is due to the
proteolytic enzymes attacking the lamellae, rod sheaths,
tufts and walls of tubules etc. i.e. all organic
components.
7. Proteolysis Chelation Theory:
Schatz et al (1955) describing a new theory observed that
there is a simultaneous microbial degradation of organic
component by proteolysis and the dissolution of inorganic
part by the process of chelation.
10. The four factors contributing to the caries process,
1. The host factor
A. Tooth factor
a. Morphology and position in the arch
b. Chemical nature
B. Saliva
a. Composition, pH and antibacterial activity
b. Quantity and viscosity of flow
2. The microflora
3. The substrate or diet
a. Physical nature
b. Chemical nature
4. Time
11. 1.The Host Factor
A. Tooth factor
a. Morphology and position in the arch
.
b. Chemical nature:
Presence of inorganic constituents, such as dicalcium
phosphate dihydrate, and fluoroapatite etc. makes the enamel
resistant to some extent. It has been observed and proved
scientifically, that surface enamel is more caries resistant than
the subsurface enamel.
12. a.Occlusal Caries:
Streptococcus mutans, it is considered to be the significant
micro organism out of all the oral flora.
This micro-organism plays a vital role in initiation of
caries. The main etiological micro organism in occlusal
and pit and fissure caries is the streptococcus mutans.
13. b. Deep Dentinal Caries:
The predominantly present micro-organisms are
lactobacilli which account for one third of the oral flora.
Certain gram-positive anaerobes and filaments are also
present such as eubacterium, actinomyces, bacillus etc.
14. C. Cemental Caries: (Root Caries)
The organisms involved in root caries are different from
those in other smooth surface lesions. Predominantly
Actinomyces viscosus, A. naeslundi and Nocardia etc. have
been isolated
Streptococcus mutans and Streptococcus salivarius have been
shown to produce root caries
15. 3. The substrate or Diet:
a. Physical nature of diet
Modern diet includes refined foods, soft drinks and
eatables, which lead to collection of debris predisposing to
more caries.
16. b. Chemical nature of diet
The main ingredient is carbohydrate, which is accepted as
one of the most important factor in dental caries process.
Only refined carbohydrates are effective. For caries
production following factors are responsible.
17. I. Type of carbohydrate e.g. monosaccharides,
disaccharides or polysaccharides.
II. Frequency of intake
III. Time of Stagnation
19. VISUAL-TACTILEMETHODS
Visual methods:
Detection of white spot, discoloration / frank
cavitations Magnification loupes- Head worn prism
loupes (X 4.5) or
surgical microscopes(X 16) may be used
comfort, relatively inexpensive, available in various
magnification
Tactile methods:
Explorers are widely used for the
detection of carious tooth
structure
Dental floss
