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dental caries[¦dent·əl ′kar·ēz]
an affection of the solid tissues of the teeth manifested by their gradual destruction (enamel, dentin, cemen-tum) and the formation of cavities.
The causes of dental caries are varied and have not been completely determined. According to the chemical-parasitic theory, it results from the mineral part of the teeth being dissolved by acids formed in the mouth during the breakdown of the carbohydrates in food; the organic portion of the teeth is subsequently decomposed by microbes. Dental caries may also develop without the action of microbes as a result of metabolic disturbances in the dental tissues. Diet is an important factor in the origin of dental caries. Dental caries was induced experimentally by giving animals food containing a large quantity of sugar. In localities where the drinking water is low in fluorine, the incidence of dental caries is particularly high. The individual enzyme peculiarities of the body, diseases, a mother’s diet during pregnancy, improper artificial feeding of infants, and rickets also affect the incidence of dental caries.
Caries generally affects the teeth of the upper jaw, especially the fifth milk and first molar teech. The carious process is usually concentrated near natural depressions on the tooth surface and on the contiguous surfaces in the neck of a tooth (region next to the gum). The disease starts with the formation of a defect in the enamel or neck part of the cementum projecting freely into the mouth. On reaching the dentin, the process spreads wide and deep, forming a carious cavity. Once started, the process does not stop but gradually progresses. The enamel loses its luster and transparency at the site of dental caries, and pigmentation and roughness appear. When the integrity of the enamel is impaired, pain is felt on eating sweet, acid, salty, hot, or cold food. Dental caries is usually chronic. Acute dental caries is generally found in young people, and it is often due to a disturbance of internal secretion.
Treatment consists in restoration of the anatomical structure and function of the tooth by filling it. The procedure involves removal of the soft dentin and formation of a suitable cavity to hold the filling.
Prevention consists in taking action to increase tooth resistance to caries (providing the body with the essential salts, chiefly calcium and phosphorus, and vitamin D) during formation and mineralization of the teeth (from the fourth to fifth month of intrauterine development to age 11 years). After the teeth erupt prevention consists in proper diet and oral hygiene.
REFERENCESRukovodstvo po terapevticheskoi stomatologii.Moscow, 1967.
Pilz, W., C. Plathner, and H. Taatz. Grundlagen der Kariologie undEndodontie. Leipzig, 1969.
V. N. ISAEV