All about caries
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All about caries

Caries is a chronic, multifactorial disease, which causes destruction and demineralization of hard tissues of teeth by acid production from bacterial fermentation of food.

The progression of caries depends on 4 factors.

Host (tooth and saliva): If the tooth composition and anatomy is defective ( weak enamel/dentin) or it is placed such that it is difficult to clean (crowding of teeth/ impacted wisdom teeth) then these teeth become more susceptible to caries.

Saliva plays a very important role in prevention of caries by maintaining the normal flora in the mouth. It has a direct antibacterial activity and the bicarbonates in saliva help in maintaining the pH. It also helps in remineralization of the tooth to some extent.

Biofilm Formation (Plaque): Plaque is a sticky substance that sticks to the surface of the teeth and is naturally formed at a regular interval (less than 24 hrs).This biofilm harbours the bacteria (Streptococcus mutans, lactobacillus,etc) which are responsible for decalcification of the enamel by producing lactic acid.

Dietary Sugars(Carbohydrates): What you eat and the frequency with which you eat has a direct impact on the number of cavities you may develop. The sticky, solid carbohydrates (Sucrose) are broken down by Streptococcus mutans into Dextran (which increases the stickiness of plaque). Lactic acid is produced as a by-product of this fermentation process which disrupts the pH of the saliva. To maintain the pH the tooth releases its Calcium and Phosphates and hence the tooth becomes demineralized. Time (Duration of contact): So, if you snack frequently and it contains sweets (sucrose) or carbohydrates in solid/ sticky form; then the above process becomes a constant loop. And, if the pH of the mouth is constantly low (< 5.5); this leads to dissolution (erosion by lactic acid attack) of inorganic structure (enamel) and formation of a cavity. Next week we will discuss how we can prevent and break this vicious cycle.

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