Transcript people*s friendship university of russia medical faculty

Is a multifactorial microbial disease of the
calcified tissues of the teeth, characterised
by the deminerilasation of the inorganic
potion and destruction of the organic
substance of the tooth, which often leads
to cavitations .
 This is an irreversible disease but can be
treated.
 Tooth decay is caused by specific types of
acid producing bacteria(streptococcus
mutans) that causes damage in the
presence of fermentable carbohydrates
such as sucrose, fructose and glucose.

The mineral content of teeth is sensitive to
increase in acidity from the production of
lactic acid. Specifically a tooth (which is
primarily mineral in content). Is in a constant
state of back and for deminerilisation and
reminerilisation between the tooth and the
surrounding saliva.
 When the pH at the surface of the tooth
drops below 5.5 deminerilisation produces
faster than reminerilisation ( meaning that
there is a net loss of mineral structure on the
tooth surface). This results in the ensuring
decay.

Pulp lesion
C
A
R
I
E
S
Dentine lesion
Enamel lesion
Cavity
White spot
De-remineralisation
No cavity
Colonisation
Adhesion
Time
A susceptible tooth
 Sugar
 Bacteria
 Time

Limiting pathogen growth and
metabolism
 Limiting of caries activity
 Early detection of incipient caries
 Identification of high risk patients
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1.primary prevention
Actions taken prior to the onset of the disease,
which removes the possibility that the disease
will even occur.
By plaque control programme, caries activity
test, patient education, topical application, pit
and fissure sealants.
2.Secondary prevention
Limits the progression and extent of a disease
at an early stage as possible after onset.
By preventive resin restoration, pulp capping.
3.Tertiary prevention
 Limits the extent of disabilities once a
disease has caused any functional
limitation.
 By complex restorative dentistry

Methods to control caries
 *chemical methods
 *nutritional methods
 *mechanical methods

Chemical methods
 Substances which:
*Alter the tooth surface or structure:
-Fluorides, iodides, bisbiguandines,silver
nitrates,zinc chlorides etc..
*Interfere with carbohydrate degradation
through enzymatic alteration.
*Interfere with bacterial growth and
metabolism.
Fluorides: they participate in fluorapatite ,
remineralisation, mineralisation on
hypomineralised areas, interferes with
bacterial enzymatic process and also
modifies tooth morphology.

Fluorides
Systematic*fluoridated community water,school
waterfluoridation, salt and milk fluoridation ,fluoride
tablets and drops.
Topical*Professionally or self applied, dentifrices,
mouth rinses, varnishes and gels
chlorhexidine
Fluoride mouth
rinse
Dentifrices
Fluoride varnishes
Fluoride gels
Nutritional methods
 Restriction of refined carbohydrate intake.
 Avoiding sugar in between meals.
 Phosphated diet.
*foods with anticariogenic effects: milk(contain
lactose),cheese(casien phosphatase), fibrous
foods, tea( green and black tea) and xylitol(
prevents s.mutans from binding to sucrose and
also neutralises plaque acids)
Mechanical methods; *oral
prophylaxis, tooth brushing, interdental
cleaning, scaling, flossing. Oral
irrigators etc
Prevention is better than cure!
 Prevention is cheaper than cure!
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