Dentoword: Today's Word is 'Periodontitis'.

 Welcome to Dentoword:
Learn your dental terms with detailed explanation
 

  Today's word is "Periodontitis"

Periodontitis : 'One Advanced Step Beyond Gingivitis'

In our previous post, we discussed the early disease of the gums, i.e., gingivitis. Today we have one step more advanced than yesterday in the case of gum diseases, i.e. periodontitis which is a more severe form of gum disease that is not treated in the initial stages. If not treated, it will cause irreversible damage to the tooth and lead to tooth mobility. To understand the cause, prevention, and treatment, we can protect our teeth for as long as possible. So, without any further delay, let's start our dentoword journey with today's word: Periodontitis.

Definition :

An inflammatory disease of the supporting tissues of the teeth caused by microorganisms, resulting in progressive destruction of the periodontal ligament (PDL) and alveolar bone with increased probing depth formation, gingival recession, or both.

Causes of Periodontitis :

• The cause of periodontitis is the extension of inflammation, which progresses to the pathological deepening of the gingival sulcus towards the apical portion of the roots. 

• This transition marks the shift from gingivitis to periodontitis. 

• Periodontitis is always preceded by gingivitis, but not all gingivitis progresses into periodontitis. 

• For a detailed explanation of the causes of gingivitis, you can check out my previous post on gingivitis.

 Here is the link:

Gingivitis.

Clinical Features of Periodontitis:

• Swollen bluish-red marginal gingiva with a ‘rolled’ edge separated from the tooth surface.
  
  
  

• A break in the buccolingual continuity of the interdental gingiva.

• Shiny, discolored, and bulbous gingiva associated with exposed root surfaces.

• Gingival bleeding and purulent exudate from the gingival margin after probing.

• Mobility, extrusion, and migration of affected teeth due to periodontitis.

• The development of diastema due to the migration of teeth.

• Localised pain or a sensation of pressure in the gingiva after eating, which gradually diminishes over time.
• A foul taste in the mouth due to periodontitis.
  
  
  

• Radiating pain “deep in the bone,” a “gnawing” feeling, or a sensation of itching in the involved region.
  
  
  
• Patients complain that food accumulates between teeth and gums.
• Sensitivity to heat and cold, and toothache in the absence of caries.
  
  
  

Diagnosis of Periodontitis:

1.Medical and Habit History: 

A detailed medical and habit history of the patient before starting any treatment is important to properly understand the causes of periodontitis or any underlying conditions contributing to it.

2.Visual Examination:

Clinical examination of the gingiva's color, texture, consistency, inflammation, and bleeding on probing is important to distinguish normal gingiva from affected gingiva.

3.Radiographic Diagnosis:

Checking for bone loss due to periodontitis is crucial to understand the prognosis of the disease and to help plan the treatment accordingly.

Personal Insight:

During my college posting in the periodontology department, I encountered many cases of periodontitis. I learned how crucial it is to prevent periodontitis in its earlier stages to save teeth from extraction due to periodontal problems. For example, one patient came to our OPD with several teeth having slight mobility, mild pain, foul odor, and loss of attachment below the original position of the gingiva. After undergoing periodontal therapy, we achieved significant improvements in his oral health: the mobility was reduced, and all the above-mentioned symptoms were alleviated.This example underscores the importance of maintaining healthy teeth and surrounding tissues for a radiant smile. Understanding and addressing periodontal issues early can make a significant difference.

Prevention & Management of Periodontitis:

1.Oral Hygiene Practices:

• Brush twice daily, including flossing and tongue cleaning.
• Gingival massage is important to combat gum diseases.
• Professional cleaning is essential to remove plaque and improve gingival health.
• Use mouthwash to fight bacteria and prevent plaque formation.

2.Regular Dental Check-ups:

• Visit your dentist every six months to catch gum conditions early and prevent disease progression.
• Procedures like scaling and root planing, periodontal therapy, and the removal of the pocket side of the tooth by extraction, hemisection, or root section may be necessary.

3.Quit Smoking:

Avoid smoking to prevent gum related  problems.

4.Treat Underlying Medical Conditions:

Manage conditions like diabetes, leukemia, and other systemic conditions to prevent gingival symptoms.

5.Balanced Diet:

Ensure a diet rich in nutrients and vitamins to support overall health and improve immunity.

Conclusion:

Periodontitis is a severe condition that can cause irreversible damage to the tooth and surrounding tissues if not treated early. By understanding its causes, prevention, and treatment, we can prevent its progression and halt the disease to save our beautiful smile and maintain the efficiency of our teeth for a lifetime.

Request to Readers:

Thank you for reading today's blog post. If you have any queries, please let me know in the comment section. If you experience any of the symptoms mentioned, please make an appointment with your dentist today to save your teeth from extraction.

References :

1. Carranza's Clinical Periodontology-Ebook: Third South Asia Edition,Chini Doraiswami Dwarakanath,

Elsevier.

2. Image credit: www.freepik.com.

Dentoword : Today's Word is 'Gingivitis'.

 Welcome to Dentoword:
Learn your dental terms with detailed explanation
 

Today's word is "Gingivitis"

Gingivitis : 'Swelling That Affects The Gums'.

In our previous post, we discussed non-carious lesions of teeth in detail. Today, we are shifting our focus to gum disease known as gingivitis, characterized by swelling of the gums. If left untreated, gingivitis can cause irreversible damage to the teeth and their surrounding tissues. So, let's explore more about gingivitis in today's Dentoword journey. 

Definition:

Gingivitis is the inflammation of the gums caused by the accumulation of plaque induced by bacteria, a soft, sticky film that forms on teeth and affects the gums.

Causes Of  Gingivitis :

1.Plaque-induced :

 Poor oral hygiene can lead to plaque accumulation, which affects the gingiva.

2.Poor oral habits : Smoking, mouth breathing, and external irritation by foreign objects can cause gingivitis.

3.Drug-induced : 

Certain medications like antihypertensive drugs and antiepileptic drugs can cause gingivitis.

4.Certain medical Conditions : 

Medical conditions such as HIV, diabetes, and leukemia can increase the risk of gingivitis.

5.Hormonal changes induced : 

Puberty, pregnancy, and menstruation can lead to gingivitis due to hormonal imbalance and poor oral hygiene.

6.Nutritional imbalance :  Deficiency in vitamins like Vitamin C, vitamin B and other nutrients can cause gingival problems.

Clinical Features of Gingivitis : 

A. Earliest signs of Gingivitis include :

• Increased gingival crevicular fluid rate.
• Bleeding on gentle probing examination.

B. Color of the gingiva : 

In gingivitis, the gingiva changes to red due to increased vascularization.

C. Consistency of gingiva : Swelling, loss of stippling, and discoloration occur when inflammatory exudate and edema predominate in the gingiva. The gingiva becomes soft, friable, and bleeds easily.

D. Receding gum line : Plaque accumulation can cause gingivitis and lead to receding gums.

E. Bad breath : 

Poor oral hygiene can cause gingivitis and bad breath.

Diagnosis of Gingivitis :

1.Clinical examination : Visual examination of gingival color, consistency, and contour changes is crucial. Probing around the gingiva is also important to check for initial signs of bleeding on probing.

2.Radiological examination : 

Dentists examine radiographs to detect any underlying damage associated with gingivitis.

3.Medical and habit history : 

A detailed patient history is essential for diagnosing gingivitis and determining its causes for appropriate treatment.

Prevention and Management of Gingivitis:

1.Oral hygiene practices : 

• Brush twice daily, including flossing and tongue cleaning.
• Gingival massage is important to combat gum diseases.
• Professional cleaning is essential to remove plaque and improve gingival health.
• Use mouthwash to fight bacteria and prevent plaque formation.

2.Regular dental check-ups :

Visit your dentist every six months to catch gum conditions early and prevent the progression of the disease.

3.Quit smoking :

Avoid smoking to prevent gum problems.

4.Treat underlying medical conditions :

Manage conditions like diabetes and leukemia to prevent gingival symptoms.

5.Balanced diet :

Ensure a diet rich in nutrients and vitamins to support overall health.

6.Alternative medications :

If current medications cause gingivitis, consult your doctor to explore alternative drugs that minimize effects on the gums.

Conclusion: 

Gingivitis is a reversible condition if caught early. By understanding its causes, prevention, and treatment, we can combat gingivitis and prevent the disease from progressing, preserving our coral pink-covered smiles forever.

Request to Reader : 

Thank you for reading! If you have any doubts, please let me know in the comment section. If you experience any of the mentioned symptoms, make an appointment with your dentist today. Stay healthy with a healthy smile.

References :

1. Carranza's Clinical Periodontology-Ebook: Third South Asia Edition,Chini Doraiswami Dwarakanath,

Elsevier.

Dentoword : Today's Word is 'Dental Abfraction'.

Welcome to Dentoword:
Learn your dental terms with detailed explanation
 

Today's word is "Dental Abfraction"

Dental Abfraction : 'The Main Culprit - Invisible Cracks'

Yesterday, we learned about dental abrasion, caused by excessive external forces. Today, we're exploring another non-carious lesion: dental abfraction. This condition results from excessive forces on the teeth during function, creating fine fracture lines at the gingival region that may develop into defects. Let's begin our discussion on dental abfraction without delay. 

Definition :

Eccentric occlusal forces exerted strongly on teeth cause microfractures at the cervical area, resulting in wedge-shaped defects. This condition is termed dental abfraction.

Etiology of dental abfraction: 

1.Weak teeth: 

Teeth that lack rigidity can deform under normal loading, leading to microfractures at the gingival line. 

2.Missing teeth: 

Reduced number of teeth can result in excessive force on the remaining teeth during chewing, contributing to microfractures. 

3.Poor oral habits: 

• Excessive clenching can impose additional loads on teeth, contributing to abfraction. 
  
  
  
• Biting on hard objects can cause microfractures that may develop into notched defects at the gingival line region.

4.Malocclusion:

 Poor alignment of teeth can create irregular biting forces, increasing the risk of microfractures. 

Clinical features of dental abfraction :

• Abfraction lesions are characterized by sharp notches or wedge-shaped defects at the cervical region of the tooth. 

• These lesions primarily affect the thin enamel region at the cementoenamel junction. 

• If cement restorations are placed near the gingival line without adequate support, they may become dislodged due to excessive forces.

•  Tooth sensitivity can occur due to exposed dentin caused by abfraction.

 

• Pulpal inflammation can also occur occasionally due to dentin flexure, which can alter fluid flow and lead to micro-leakage.

Diagnosis of Dental Abfraction :

1.Visual examination: 

Teeth affected by abfraction typically exhibit wedge-shaped notches at the cervical region.

2.Patient habit history: 

Ask the patient about habits such as teeth clenching, biting on hard objects, and their diet history.

3.Tactile assessment: 

Feel the tooth surface with a probe to detect roughness or irregular texture.

4.Radiographic diagnosis: Radiographs are used to visualize underlying changes in enamel and dentin that may not be visible during a regular visual examination.

5.Transillumination: Passing light through the tooth can reveal fine cracks or abnormalities that may not be apparent under normal dental chair lighting.

Prevention of Dental Abfraction :

1.Counseling patients about their habits and their harmful effects on teeth is crucial.

2.Practice good oral hygiene: 

Brush gently with a soft-bristled toothbrush using fluoride toothpaste.

3.Maintain a proper diet and avoid abrasive and hard foods daily.

4.Custom mouthguards: Prescribe custom mouthguards to patients with habits that can cause abfraction, preventing direct force on teeth and reducing its effects.

5.Regular dental check-ups are essential to detect this type of lesion early, preventing further complications.

Management of Dental Abfraction :

Management of dental abfraction involves several strategies aimed at addressing the structural loss and preventing further damage to affected teeth:

1.Restorative Treatment: 

If dental abfraction causes significant tooth structure loss, the following treatments are typically performed:

• Tooth-colored restorations are applied to fill the notched areas caused by abfraction.
• Resin-modified glass ionomer cement is commonly used as a filling material for abfraction lesions.
• In cases of severe tooth structure loss, crowns may be recommended to provide support and protect the affected tooth from direct forces.
• For patients with receding gums associated with abfraction, a combined approach of soft tissue grafting and cement restoration may be employed.

2.Management of Associated Issues:

Patients with additional problems such as temporomandibular joint disorders or malocclusion are referred to specialist doctors such as orthodontists or oral surgeons for further evaluation and treatment.

Conclusion :

Dental abfraction occurs when microfractures progress into notches if the underlying causes are not identified and addressed early. By understanding its causes, features, and preventive measures, you can preserve your teeth through regular dental check-ups and maintain your smile for years to come.

References :

Sturdevant’s Art and Science of Operative Dentistry (Second South Asia Edition-2019),Adaptation Editor,

V.Gopikrishna,Elsevier.

Dentoword : Today's Word is 'Dental Abrasion'

 Welcome to Dentoword:
Learn your dental terms with detailed explanation
 

Today's word is "Dental Abrasion"

Dental Abrasion : 'External Force Is Going To Harm Your Teeth.'

Yesterday, we discussed a non-cariogenic disease that gradually wears down tooth enamel chemically. Today, we will explore another non-carious lesion caused by external forces that wear down tooth structure: dental abrasion. Without further delay, let's delve into a detailed discussion about dental abrasion.

Definition :

Dental abrasion refers to the abnormal loss of tooth surface caused by frictional forces between teeth and external objects, or between contacting tooth components in the presence of an abrasive medium.

Causes of dental abrasion :

1.Improper brushing habits: 

Factors influencing tooth brushing in abrasion include: 

i. Brushing technique : Improper technique

 ii. Brushing force : Excessive pressure

 iii. Bristle stiffness : Hard bristles 

iv. Time : Prolonged duration

 v. Frequency : More than 2-3 times a day

2. Poor oral habits : Chewing on hard objects (e.g., paper clips, pens, pencils), use of smokeless tobacco, use of abrasive toothpaste.

3.Diet : 

Regular consumption of hard and abrasive food items.

4.Workplace factors : 

Exposure to abrasive dust in the workplace can contribute to tooth abrasion.

Clinical features of dental abrasion :

• Commonly seen on the left side of right-handed persons and vice versa.

• Loss of tooth structure near the gum or gingival line.

• Abrasion is typically observed as a rounded notch in the cervical portion of the facial aspects of teeth.
  
  
  
• Canines and premolar teeth are most affected.

• Exposed surfaces appear smooth and polished.

• Patients develop sensitivity as dentin becomes exposed.

Treatment options for dental abrasion:

The primary goal of management should be to halt the underlying cause. Treatment may involve:

1.Fluoride Treatment : 

• Application of fluoride solutions to improve the tooth's resistance to caries, especially important since the enamel is already abraded. 
• This helps protect the remaining tooth structure.

2.Restorative Treatment: 

• If the lesion extends more than 0.5 mm into the dentin, it may require restoration with various types of dental cement:

• For anterior teeth, tooth-colored restorations are preferred.

• Posterior teeth may require metallic restorations.

• Resin-modified glass ionomer cement is commonly used for abrasive lesions.

• If the abrasive lesion is associated with gingival recession, a combined approach involving soft tissue coverage and restoration may be advised.

These treatments aim to restore tooth integrity and prevent further damage from abrasion.

Prevention of dental abrasion :

1. Counseling on harmful oral  habits.

2. Instructions on the proper selection and use of oral hygiene aids: 

• Use a soft or medium-bristled toothbrush, 

• Waxed thin floss, 

•  Non-abrasive toothpaste.

3. Correct brushing technique is important. Watch the video below for proper brushing and incorporate it into your daily routine.

4. Avoid biting on hard objects. Our teeth are a precious gift; refrain from using them to open bottles or hold pins.

5. Regular dental check-ups are required to catch this abrasion in its early stages.

Conclusion: 

Proper oral hygiene practices, along with appropriate aids, can help prevent dental abrasion. By understanding its causes, features, treatment, and preventive measures, we can halt this condition early and preserve our beautiful enamel-covered smile for the long term.

Request To Reader : 

Thank you for reading. If you have any doubts or queries, please let me know in the comment section below. Remember to brush your teeth gently; being harsh can permanently alter your smile and affect your quality of life.

References :

1.Sturdevant’s Art and Science of Operative Dentistry (Second South Asia Edition-2019),Adaptation Editor,

V.Gopikrishna,Elsevier

2.Shafer’s Textbook of Oral

Pathology,Ninth edition (2020),

B Sivapathasundharam, MDS.

3.Image credit : www.shutterstock.com

Dentoword : Today's Word is 'Dental Erosion'

 Welcome to Dentoword:
Learn your dental terms with detailed explanation
 

Today's word is "Dental Erosion"

Dental Erosion : 'The Silent Teeth Eater'

In the previous blog, we discussed dental attrition. Today, we are going to delve into another non-carious lesion: dental erosion. Dental erosion slowly dissolves the hardest structure of our teeth, the enamel, and reduces tooth dimension in an acidic medium. In this blog, we'll understand how it happens, its causes, prevention, and treatment. So, let's dive into this journey with today's word: dental erosion.

Definition:

Dental erosion is the wear or loss of tooth surface due to chemical action by demineralizing agents with low pH.

 

Classification of Dental Erosion :

Based on Etiology (Cause) :

1. Intrinsic Erosion : 

Caused by endogenous acids of gastric origin.

 Examples :

 A)  Recurrent Vomiting: 

Due to anorexia nervosa, bulimia nervosa, and certain medical conditions like peptic ulcers, hiatus hernia, intestinal obstruction, metabolic and endocrine disorders, side effects of drugs, and chronic alcoholism.

 B) GERD (Gastroesophageal Reflux Disease) : 

Acid reflux occurs without nausea or abdominal contraction, causing acid to reach the mouth and lead to dental erosion.

2. Extrinsic Erosion : Associated with external factors :

 

a) Occupational : 

• Professional wine tasters
•  Professional swimmers.

  b) Diet : 

• Consumption of citrus fruits
•  Acidic beverages.

 

c) Medications : 

• Aspirin 
• Ascorbic acid.

 

 d) Lifestyle:

• Personal habits and routines.

Clinical Features of Dental Erosion :

1. Diagnosis of dental erosion varies based on its location.

2. Erosion on the palatal surface of upper teeth suggests regurgitation of stomach acid.

3. Erosion on the facial aspects of anterior teeth and buccal aspects of posterior teeth points to extrinsic factors.

4. Dental erosion causes loss of tooth structure, often presenting as cupped-out areas on occlusal surfaces.

5.Increased tooth sensitivity due to enamel loss.

6.Discoloration of teeth, as the underlying dentin becomes exposed.

7.Transparency or thinning of teeth, especially at the edges, due to enamel erosion.

Prevention and Management of Dental Erosion:

Identification of the etiology is crucial as the first step in managing dental erosion.

1.Diet Modifications: Counseling patients who habitually consume acidic drinks or foods (e.g., lemons) is essential to halt erosion.

2.GERD Management: Referral to a physician for complete evaluation and treatment is necessary if GERD symptoms are present.

3.Eating Disorders: 

Patients with conditions like bulimia nervosa should be referred to a physician for appropriate treatment.

4.Dry Mouth or Reduced Saliva Production: Sugarless chewing gum or medications like pilocarpine can increase saliva flow, acting as a buffer to reduce erosion.

5.Chronic Alcoholism: Counseling patients is crucial to reduce erosion risks associated with chronic alcohol consumption.

Erosion prevention heavily relies on patient compliance with dietary changes, use of topical fluorides, and sometimes the use of occlusal splints.

Diagnosis of Dental Erosion:

1.Visual Examination: Observe for smooth, shiny enamel surfaces or transparent edges, and note any yellow discoloration. Perform tactile assessment to detect pitting enamel.

2.Patient Medical and Diet History :

 Include inquiry about acidic beverages or fruits in the patient's diet, as this is crucial. Also, assess for a history of chronic acidity issues, dry mouth, or any eating disorders to identify potential causes.

3.Radiographic Diagnosis: Utilize radiographs to assess the extent of erosion and identify any underlying issues.

Conclusion :

Dental erosion is a common condition that can significantly impact your oral health if the underlying causes are not treated or eliminated early. By understanding its etiology, prevention, and management, we can protect our teeth from this silent eater in its early stages and preserve our beloved smiles.

Request to Readers: 

Thank you for reading today's blog. If you found it helpful or have any queries, please let me know in the comments section. Don't forget to visit your dentist if you experience any of the issues mentioned. Stay tuned for more detailed blogs.

References :

1.Sturdevant’s 
Art and Science of 
Operative Dentistry (Second South Asia Edition-2019),Adaptation Editor
V. Gopikrishna,Elsevier.

2.Image credit : www.shutterstock.com.

3.Shafer’s Textbook of Oral

Pathology

NINTH EDITION,

B Sivapathasundharam, MDS.(2020).

Dentoword : Today's Word is 'Dental Attrition'

 

Welcome to Dentoword:

Learn your dental terms with detailed explanation
 

Today's word is "Dental Attrition"

Dental Attrition : 'Gradually Reduced Teeth Dimension' 

In the previous post, we discussed dental caries, a disease of bacterial origin. Today, we are going to talk about a non-carious condition that gradually reduces teeth dimensions by wearing them down, called attrition. So, without any delay, let's start our Dentoword journey with today's word: Dental Attrition.

Definition :

Attrition is defined as the physiological wearing away of tooth surfaces due to tooth-to-tooth contact, such as during mastication.

Causes of Attrition:

• Poor oral habits:

 Examples include biting fingernails, holding objects with teeth, and chewing on pens or pencils.

• Stress: 

Stress can lead to clenching of teeth, which contributes to attrition.

• Airway issues or sleep apnea: 

These systemic conditions can cause teeth clenching, leading to attrition.

• Habitual clenching /bruxism: 

Habitual grinding or clenching of teeth, often unconscious, especially during sleep or in moments of anger.

• Diet: 

Consuming hard substances regularly can caused attrition.

• Malocclusion: 

Improperly aligned teeth can cause attrition due to heavy or uneven pressure on teeth.

• Workplace factors: 

Exposure to an atmosphere of abrasive dust can lead to material getting into the mouth, causing attrition.

General Features of Dental Attrition:

• Attrition occurs only on the occlusal/incisal and proximal surfaces of teeth due to physiological tooth movement.
• It is not caused by microbes, so it is not a pathological but a physiological process.
• Attrition is associated with the aging process. 
• As age progresses, more attrition is exhibited.It may be seen in both permanent and deciduous dentition.
• Men usually exhibit more severe attrition than women due to greater masticatory force.

Clinical manifestations of dental attrition include the following:

- Appearance of small polished facets on cusp tips or ridges.

- Flattening of cusps or incisal edges.

- Shortening of the length of the arch of teeth due to proximal attrition.

- Increased tooth sensitivity.

- Decreased chewing efficiency.

Diagnosis of dental attrition involves the following :

1.Visual examination: During routine examinations, it is the dentist's duty to identify early signs of wear and halt the progression through various treatments.

2.Dental and habit history: Understanding the origin of attrition is crucial.

3.Radiographic examination: 

This helps detect the extent of tooth attrition and identify any underlying pathology.

Treatment of dental attrition :

Treatment of dental attrition involves a two-pronged approach: 

halting the etiological factors and using appropriate restorative protocols.

1.Restorative procedures: Crowns, veneers, or bonding can restore worn teeth. In cases of severe attrition, root canal therapy may be required before placing the crown.

2.Mouthguards: Custom-fitted guards protect the teeth from grinding and help break the habit.

3.Behavioral management: If the patient is stressed, behavioral counseling can help reduce stress and manage its effects on the teeth.

4.Orthodontic treatment: If attrition is due to malocclusion, it can be treated with braces or orthodontic appliances.

5.Treatment of sleep apnea: If the patient has a sleep apnea disorder, treating this condition can prevent further tooth structure loss due to bruxism.

Early treatment is crucial to halt further tooth loss and restore function, thereby improving the patient's quality of life.

Care and maintenance to prevent dental attrition:

- Regular dental check-ups
- Use of mouthguards
- Diet modification
- Stress management
- Good oral hygiene practices
- Avoidance of harmful habits

Interesting facts:

• Enamel is the hardest substance in the body, yet it can wear down due to teeth grinding, which can be caused by stress or systemic problems. 
• Dental attrition is a natural process that occurs with age, but it progresses very slowly. However, it can accelerate if caused by external factors such as grinding or clenching.

Conclusion:

Today we learned about dental attrition, including its causes, symptoms, signs, and treatment options. To maintain healthy teeth and prevent further damage, regular dental check-ups and proper oral care are essential. Early detection of dental attrition can prevent reduced tooth size and preserve our bright smiles.

Request to the reader :

Thank you for reading! If you think you might be experiencing dental attrition, or if others have noticed it in you, don't forget to visit your dentist.

References :

1.Shafer’s Textbook of Oral

Pathology

NINTH EDITION,

B Sivapathasundharam, MDS.(2020)

Dentoword : Today's Word is 'Dental Caries'

 Welcome to Dentoword:

Learn your dental terms with detailed explanation
 

Today's word is "Dental Caries"

Dental Caries : 'The Biggest Enemy of Our Teeth'.

Today we are going to deal with the enemy of our teeth, dental caries. Also known as tooth decay or cavities, dental caries is a disease that slowly destroys teeth by dissolving their components. It can occur at any age, from childhood to old age. So, without taking too much time, let's dive into today's topic : dental caries.

Definition :

Dental caries is an irreversible microbial disease of the calcified tissues of the teeth. It is characterized by the demineralization of the inorganic part and the destruction of the organic substance of the tooth, which often leads to cavitation.

Causes of Dental Caries :

1.Multifactorial Disease: Dental caries is a multifactorial disease. The primary factors involved are the host, the microbial flora, the substrate, and time.

2.Poor Oral Hygiene: 

Poor oral hygiene leads to plaque buildup on teeth, which causes cavities.

3.Diet High in Sugar: 

High sugar consumption decreases the pH of the mouth, leading to cavities.

4.Dehydration: 

Dry mouth can cause dental caries.

5.Radiation Therapy: Cancer patients undergoing radiation therapy can suffer from radiation caries.

6.Age: 

Aging can cause receding gums, which leads to root caries.

Classification of Dental Caries:

1.Based on Anatomical Site of the Lesion on the Tooth and Causative Agents:

• Pit and Fissure Caries: Caused by Streptococcus mutans and Lactobacillus bacteria.

• Smooth Surface Caries: Also caused by s. mutans.

• Root Surface Caries: Caused by Actinomyces viscosus and Actinomyces naeslundii.
  
  
  

• Deep Dentinal Caries: Caused by Lactobacillus,     A. naeslundii, and other filamentous rods.
  
  
  
• Cervical Caries: 
  
  
  

2.Based on Severity and Rate of Progression:

• Acute Caries 
• Chronic Caries 

3.Other Types:

• Rampant Caries :

• Nursing Bottle Caries  :
  
  
  
• Early Childhood Caries

• Adolescent Caries 

• Recurrent Caries :

• Arrested Caries :

                               

• Radiation Caries :

Signs and Symptoms of Dental Caries :

 A. Initial Signs:

• White spots on Teeth, 
• Slight discoloration, 
• Tooth sensitivity, 
• Mild pain.

 B.Advanced Symptoms:

• Visible black holes with discoloration ,
• Severe toothache,
•  Swelling

Methods of Dental Caries Diagnosis  :

1.Visual Examination: Conducted with the help of a mirror and probe under adequate light.

2.Radiographic Diagnosis:

Many carious lesions are accessible and visible for easy diagnosis, but some hidden or interproximal lesions require radiographs for detection.

3.Infrared Laser Fluorescence:

Developed for the detection and quantification of dental caries on occlusal and smooth surfaces.

4.Digital Imaging Fiber-Optic Transillumination (DIFOTI): 

Used to identify lesions located on interproximal surfaces.

5.Cone-Beam Computed Tomography (CBCT):

Provides detailed imaging of teeth but should not be used with metal or radiopaque materials present.

6.Caries Activity Tests:

Measure the degree to which the local environment challenges favor the probability of carious lesions.

Treatment of Dental Caries :

The treatment depends on the condition of the tooth and includes the following options:

A.Fluoride Treatment:

Effective in the initial stages of dental caries.

B.Restoration (Filling) with Various Cements:

For mild or moderate caries, treatment involves restoration with cements like glass ionomer cement, composite, etc.

C.Inlay, Onlay, or Cast Restoration:

For moderate carious lesions involving one or more cusps, inlay, onlay, or cast restorations are recommended.

D.Crown:

For extensively decayed teeth, a crown is used to support the remaining tooth structure.

E.Root Canal Therapy (RCT):

If tooth decay reaches the pulp, RCT is performed to save the tooth.

F.Extraction of Tooth:

• As a last resort, if the tooth is not restorable, it is extracted. 
• Post-extraction, the tooth can be replaced with a fixed implant, fixed bridge, or removable denture.

Prevention of Dental Caries : 

1.Oral Hygiene Practices :

• Brushing:

Brush twice a day with fluoride toothpaste to prevent dental caries.

• Flossing and Tongue Cleaning:

Floss daily and clean your tongue regularly to prevent caries.

• Minimize Snacking:

Reduce snacking between meals and limit sugary and acidic food items.

• Hydration:

Drink plenty of water to avoid dry mouth.

2.Regular Dental Check-ups:

• Dental Visits:

Regular dental check-ups at least every 6 months are mandatory.

• Professional Cleaning:

Professional cleaning is recommended every 6 months.

3.Pit and Fissure Sealants and Fluoride Application:

• Sealants:

For children with erupting teeth, pit and fissure sealants are beneficial.

• Fluoride Application:

Fluoride application is important for children to prevent dental caries.

Interesting Facts:

1.Historical Context:

• Dental caries is likely a disease of modern civilization. 
• Before 12,000 BCE, there is no evidence of dental caries, but after 12,000 BCE, evidence shows carious teeth.

2.Nature of the Disease:

• Dental caries is a non-communicable disease and does not transfer from person to person like infectious diseases.
•  However, bacteria can transfer through saliva, for example, from parent to child through sharing utensils or kissing.

Conclusion :

 Dental caries is a common disease present worldwide, but it is preventable if we take proper action. By understanding its types, causes, and preventive measures, we can halt its progress and maintain our bright and healthy smile for life.

Request to Reader :

Thank you for reading. If you found today's blog informative, it's time to visit your dentist and check your teeth for any hidden enemies.

If you want to understand dental caries in brief, watch the video below:

New Terminology Alert :

 In today's blog, we introduced several new dental terms. Don't worry if some of these are unfamiliar; we will discuss them in more detail in upcoming posts. Stay tuned for more insights and explanations as we continue our journey through the fascinating world of dental health!!!

References :

1.Shafer's Textbook of Oral Pathology,B Sivapathasundharam
Elsevier Health Sciences -9th edition(2020)

2.image credit : www. shutterstock.com/