dental caries 12003

8/2/2019 Dental Caries 12003

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• It is a irreversible microbial disease of calcified tissue of theteeth characterised by demineralisation of inorganic portionand destruction of organic substance which leads tocavitation.

• It’s a complex and dynamic process where a multitude offactors influence and initiate the progress of disease.



o It’s a major health problem and problem affecting mankindbecause its manifestation persists through out the life despitetreatment.

o It affects both genders,all races,all socioeconomic strate andall ages.

o Caries free individual- people who don’t develop caries.



Dental caries may be considered as a disease of MODERNCIVILISATION.

Prehistoric man rarely suffered from caries

Teeth are relatively imperishable in dry burial site for manyyears.

ANTHROPOLOGICAL STUDIES – by WON LENHOSSEK revealedthat dolicocephalic skull of man from preneolithic period(12000AD)- no dental caries.

But BRACHYCEPHALIC of neolithic period (12000-3000bc)-caroius teeth

Carious lesion found at or just below contact areas andincrease in frequency of caries at CEJ was noted.



By about 17th century there was a significant increase in totalcaries incidence and small increase in the carious lesioninvolving the interproximal contact area of tooth.

Today,dental caries is – UNIVERSAL DISEASE.

‘’MELLANBY’’-in 1934 revived on the literature of dentalcaries,in existing primitive race and noted that incidence wasinvariably less than that in modern man.

Isolated population tht have not acquired habits of modern

industrialised man,retained relative freedom from dentalcaries.



Living in north westterritories consumed nativefood-low incidence ofcarious lesion(like

canada,greenland etc) Price reported Alaskan

eskimos exhibit 0.1%ofcarious incidence,buteskimos living in area with

access to processed foodshowed incidence of 13%.



Change in diet fromessentially primitiveto one characteristic

of highlyindustrialisedsociety,indicatesthat modern

civilisation hasincreased incidenceof DENTAL CARIES.



Different parts of the worldhave different rates ofincidence of dentalcaries,eg:decayed tooth

persons at all ages upto 39yrs-in Ethiopia it is less than1 decayed,its 60 timesgreater in Alaska-Aleuts.

Figure shows least affected

areas.



Caries prevalence is lowest(0.5-1.7)DMF in Asia andAfrica.

Highest in America(12-18).

Generally highest cariousindices with decay,missingand fillied teeth approx is4.5.

Highest DMF-5.6 in

Newzealand,Brazil,Austalia.



Dental caries has its originrooted deep in history evenas early as 460-377BC.

Theories:

Worm theory Humors theory.

Vital theory.

Chemical theory.

Septic theory. Acidogenic theory.

Proteolysis theory.

Autoimmune theory.



According to Assyrianslegend,tooth ache wascaused by worm infection.

drank blood of teethand fed on the roots.

as a punshment for offence commited againstGod.



The ancient Greek considered that a personsphysical and mentalconstitution was

determined by four elements

blood

phlegm

black bile

yellow bile

All diseases including carieswas explained by animbalance of their humors.



This theory regarded dental

caries originated within thetooth itself,analogous tobone gangrene



Parmly proposed that anunidentified chemicalagent caused caries.

He stated that caries

begins on the enamelsurface in location wherefood putrified andacquired sufficientdesolving power.



Erdl proposed this theory.

He describes filamentousparasites in the surfacemembrane of the tooth or

plaque responsible for tooth decay.



In 1890 WD Miller put forththe acidogenic theory or chemico parasitic theory,toexplain the occurrence or

tooth decay. According to this

theory,dental caries causedecalcification of toothdue to acid produced by

parasite or micro organism.



In 1944 GOTTLIEB proposedthe proteolysis theory.

According to this theorythe protein component of

the tooth structure isdestroyed first prior to lossof tooth mineral.



It was SCHATZ and MARTINin 1955 who put forthproteolysis chelationtheory,which is extension of

proteolysis theory. The product of proteolysis

of tooth substanceacquired pellicle and foodby bacterial enzyme act as

a chelating agent,whichremoves calcium ions fromtooth.



By,

SANKEERTHY

dental caries 12003

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