DENTAL CAVITY/CARIES

WHAT IS IT?

 Dental Cavity means a hole or undulation created on our tooth surface because of the demineralisation of the tooth structure both of its organic and inorganic contents. 

WHY DOES IT OCCUR?

Dental cavity mainly occurs because of the interaction of 3 important constituents that is:

1. The diet that you consume - more the starchiness in your food or more sugary and sticky food are more likely to predispose you to develop dental caries-like your favourite things such as candies, chocolates, pastries etc. 

2.  The microbes(dental plaque) involved - most commonly involved microbe is named Streptococcus mutans, actinobacillus, lactobacillus etc

3. The tooth structure(host) itself - that is its thickness if it is smooth or rough and most importantly its morphology and how accessible it is to cleansing by a toothbrush. 

The rougher the tooth surface is the more debris it will accumulate obviously and hence more chances of developing caries or cavities. However, some individuals who are prone to dental decay also can develop caries on the smooth surfaces of the tooth which are called as the smooth surface caries.

In the case of morphology, if the tooth structure has more grooves and fissures and if it is located in an area where the toothbrush is not able to reach then that tooth structure will definitely be highly predisposed to develop caries.

THE PROCESS OF CARIES DEVELOPMENT :

Step 1: eating food 

Step 2: sticky food gets stuck on the rough surfaces and grooves on the tooth structure

Step 3: bacteria present on the tooth acts on the food which is also stuck on the tooth 

Step 4: by the action of bacteria on the food, acids are released 

Step 5: acids released causes destruction of the tooth structure resulting in dental caries/cavities

This can be further simplified with this illustration. 

GENERAL AREAS WHERE IT CAN OCCUR :

1. Pit and fissures - this area perhaps is the most susceptible to decay because the food that you eat can easily get stuck in the pit and fissures of the tooth and can result in tooth destruction.

2.  Smooth surfaces - occurs in the people who are more prone to dental decay.

3.  Root surfaces - this is limited to the root surfaces of the tooth especially in patients who show gingival recession. gingival recession is nothing but the medical term for receding gums which are most commonly seen in the older individuals.

4.   Recurrent caries - as the name suggests to you, this is caries which has re-occurred after the previous carious process was halted and treated. this usually occurs beneath the dental fillings and other crown restorations. 

Here in this dental x-ray the radio-opaque or the white area represents the dental filling is done and the radiolucent area beneath the radiodense structure is the decay that is happening which is marked with an arrowhead.

HOW TO PREVENT DENTAL DECAY/CARIES:

1. The most obvious one obviously - brushing twice a day with regular flossing is highly recommended. 

    REMEMBER it is very very important to brush before going to bed because there is very little saliva production at that time and mouth-cleansing action is possible. 

    Also, its very important to adopt a correct brushing and flossing technique to achieve results and lessen the harm to the 

    surrounding soft tissues and the tooth itself.

correct brushing technique - modified bass technique.

correct flossing technique

2. avoid eating starchy and sugary food as much as possible. I know we all love it but the intake should be highly reduced.

    also if you want to eat them then eating such foodstuff during meals is better compared to eating them in between meals.

3. fluoride containing mouthwashes to be used since fluorides is appropriate amounts makes our tooth structure strong and therefore making it resistant to carious attack. Also, fluorides help to correct any new carious lesions which are still developing and causes its remineralisation.     

4. regular dental checkups and professional cleaning whenever required.

5. Use of pit and fissure sealants - these are nothing but flowy materials which can be used to occlude the pit and fissures on the recently erupted molars in children who are prone to dental decay showing deep pits and fissures which can easily harbour bacteria 

and food resulting in the destruction of the tooth structure.

Following these above-mentioned steps will definitely offer you protection against the dental decay. 

TREATMENT ASPECT:

If dental decay has developed or is in the process of developing then you will start noticing a blackish-brown discolouration on the tooth structure that was originally absent. while this can be confused with stains especially in tobacco and paan chewers hence you should visit your dentist so that he/she can diagnose it and further provide the correct and required treatment.

The treatment of dental caries depends on the amount of carious progression in the tooth.

In simple terms,

If on radiographic assessment caries is seen to be restricted only in enamel and in dentin portion which located away from the pulp then the dental filling is instituted.

However, if the carious destruction is seen extending to the pulp or in the dentinal portion close to the pulp then usually a dentist will proceed with a root canal treatment. ( root canal treatment will be explained in detail in the further blogs).

That's all for today. I hope you guys understood this blog! If not, then you can ping me with your queries and I will try to answer them as soon as possible!

Email me at. : muskan.3096@gmail.com

Next blog out on Thursday!

You can always suggest me new topics!

Till then, happy reading! :)