Substantially reduce sucrose from diet Eliminate sucrose from between meal snacks

due to high salivary

Gross carious teeth are seen

Varied appearance, ranging from a shiny, white, opaque or discolored spot in the enamel to a hard, dark dentinal surface exposed to the oral environment

- commonly without clinical symptoms - hard, dry, and dark brown - very similar clinical appearance as arrested caries lesions

Excessive fluoride exposure (10 PPM/ more) results in

substances is facilitated by the flushing action of saliva

TRANSPARENT DENTIN Zone of carious dentin that is softer than normal dentin. Shows further loss of mineral from intertubular dentin and many large crystals in the lower of dentinal tubules

Clinically observed as intact, but discolored usually brown or black spots.

Lesions found adjacent to restorations

Due to inter-dental spacing.

• It recognized clinically, as a wet, mushy, easily removable mass. • This is structure less/ granular in histologic appearance and contain masses of bacteria.

Zones 3 and 4 - not significantly discolored - feels hard already - capable of remineralization

Often painful or hypersensitive - soft, wet and light yellow - demineralization penetrates deep into dentin

In 17 th and 18 th century,there emerged a concept that teeth are destroyed by acids formed in the oral cavity by fermentation of food particles around the teeth

TURBID DENTIN Zones of bacterial invasion marked by widening and distortion of dentinal tubules w/c filled with bacteria. Dentin in this zone will not self repair.

Fairly hard or leathery texture and highly discolored

least resistance to caries attach and allows rapid lateral spreading once caries has penetrated the enamel.

Lubrication

due to delayed or retarded eruption with consequently increased time for enamel maturation before exposure to the oral environment

3 Smooth enamel surfaces that shelter plaque

was the first well known scientist and investigator of dental caries and published his results in 1882.

5 BUFFERING SYSTEMS

(a proline-rich peptide) stabilizes Ca and PO4 ions and prevents excessive deposition of the ions to teeth

change in color is presumambly due to trapped organic debris and mettalic ions with the enamel.

due to aversion to sweet foods

process of neutralizing any added acid (H+ ions) or base (OH- ions) to maintain the moderate pH, making them a weaker acid or base.

Hard, shiny, smooth surface with brown- black discoloration

areas are protected physically and are relatively free from the effects of mastication, tongue movement, and salivary flow.

populated by organism with receptors specialized for attachment to the surface of epithelium.

plaque at the dorsum of the tongue.

Possibly related to delayed eruption & inter-dental spacing.

gross carious tooth is one of the clinical features

normal daily secretion of saliva

alteration in the enamel and an increased caries incidence.

Type of caries according to extent 2

Digestion

INFECTED DENTIN Outermost zone of infected dentin Decomposed dentin that is teeming with bacteria. No recognizable structure to dentin, seems to be absent of collagen and mineral.

Morphologic and Structural Characteristics of Teeth that Increase Tooth Susceptibility to Dental caries

5 Antimicrobial

due to prolonged antibiotic therapy

produces abundant quantities of watery saliva

mineralization occurs after cavitations , the remaining exposed surface becomes harder and softer and often becomes dark brown/ black in color

Factors needed cares initiation 4

produces more viscous saliva.

whole unstimulated saliva flow rate is approximately

Goal of diet counseling is to identify source of sucrose in the diet and reduce the intake of these foods

also known as dry mouth,is dryness in the mouth, which may be associated with a change in the composition of saliva, or reduced salivary flow.

Microorganisms were associated with the carious process

present in the oral cavity of almost all individuals.

The marked caries results from poor dental care resulting from a small mouth opening, misalignment of the teeth & mental retardation

Bactericidal mouth rinses (chlorhexidine) • Topical fluoride treatments • Antibiotic treatment (vancomycin, tetracycline, polymyxin B)

3 minerals

Zones 1 and 2 - significantly discolored - can be removed by excavators - stained with caries detector - needs to be removed unless judged to be within 0.5 mm of pulp

Soft, light- colored lesion

Importance of Saliva in the maintenance of normal flora (4)

SUB TRANSPARENT DENTIN Zone of demineralized (by acid from caries) of the intertubular dentin and initial formation of very fine crystals in the tubules and lumen at the advancing prone. Damage to the odontoblastic process is ended, however no bacteria are founf in this zone.

NORMAL DENTIN Has a tubule with odontoblastics rocesses that are smooth and no crystals in the line. no bacteria in the tubules

Enhances post-eruption maturation of teeth Remineralizes demineralized tooth structures

dominated the teeth normally have plaque community.

Lesions found in intact tooth surfaces

Rationale: Eliminate MS from mouth

Rationale: Reduce number, duration and intensity of acid attacks. Reduce selection pressure for MS

Increased susceptibility to caries has been found

due to high salivary pH

brownish discoloration of enamel term

Health History Factors Associated with Increased Caries Risk 6

In enamel, it has a dull, white, opaque appearance. In dentin, a soft, yellowish or light to dark brown discolorations of the demineralized tissues prevail.

Caries lesion left behind in the preparation or at the enamel margin of a preparation when a restoration is placed