Diagnosis and prevention of dental caries

2018 ◽  
Author(s):  
C. Deery ◽  
K.J. Toumba
Keyword(s):  
Dental Caries ◽  
Dental Plaque ◽  
Enamel Surface ◽  
Tooth Surface ◽  
Surface Phenomenon ◽  
Carious Lesion ◽  
Tooth Surfaces ◽  
Carious Process ◽  
Intact Surface ◽  
Micro Organisms

Almost all research on the process of dental caries supports the chemoparasitic theory proposed by W.D. Miller in 1890. This is now more commonly known as the acidogenic theory of caries aetiology. The main features of the caries process are as follows. 1. Fermentation of carbohydrate to organic acids by micro-organisms in plaque on the tooth surface. 2. Acid production, which lowers the pH at the enamel surface below the level (the critical pH) at which enamel will dissolve. 3. When carbohydrate is no longer available to the plaque microorganisms, the pH within plaque will rise because of the outward diffusion of acids and their metabolism and neutralization in plaque, so that remineralization of enamel can occur; 4. Dental caries progresses only when the balance between demineralization and remineralization favours the former. The realization that demineralization and remineralization are in equilibrium is key to understanding the dynamics of the carious lesion and its prevention. One of the interesting features of an initial carious lesion of the enamel is that the lesion is subsurface, i.e. most of the mineral loss occurs beneath a relatively intact enamel surface. This contrasts strongly with the histological appearance of enamel after a clean tooth surface has been exposed to acid, where the surface is etched and there is no subsurface lesion. This dissolution of the surface of enamel, or etching, is a feature of enamel erosion caused, among other things, by dietary acids. Therefore the carious process and erosion differ completely, as erosion is a surface phenomenon. The explanation for the intact surface layer in enamel caries seems to lie in diffusion dynamics: the layer of dental plaque on the tooth surface acts as a partial barrier to diffusion. Further erosion occurs at much lower pH values (pH <4) than caries. Dental plaque forms on uncleaned tooth surfaces and is readily apparent if toothbrushing is stopped for 2–3 days. Contrary to popular opinion, plaque does not consist of food debris, but is a biofilm; 70% is comprised of micro-organisms—about 100 million organisms per milligram of plaque. When plaque is young cocci predominate, but as plaque ages the proportions of filamentous organisms and veillonellae increase.

scholarly journals Combating dental decay

2005 ◽  
Vol 26 (3) ◽  
pp. 107 ◽  
Author(s):  
Stuart Dashper ◽  
Eric Reynolds
Keyword(s):  
Dental Caries ◽  
Dental Plaque ◽  
Health Surveys ◽  
Tooth Surface ◽  
Tooth Decay ◽  
Dental Services ◽  
Total Cost ◽  
Microbial Biofilms ◽  
Tooth Surfaces ◽  
Eventual Loss

Dental caries or tooth decay is one of the most prevalent bacterial infectious diseases of mankind. In recent oral health surveys, more than 60% of Australian teenagers surveyed had experienced the disease and most dentate adults surveyed exhibited multiple teeth affected by caries. Treating the consequences of dental caries accounts for over 50% of the total cost of providing dental services in Australia, which in 1998 was estimated at $2.6 billion. Dental caries is a dynamic process that is initiated by microbial biofilms on the tooth surfaces (dental plaque) resulting in a disturbance of the equilibrium between tooth mineral and the surrounding plaque fluid so that over time there is a net loss of mineral from the tooth surface. This demineralisation of the enamel may ultimately lead to cavitation of the surface of the tooth and once this stage of the disease has been reached only restorative methods (fillings) can be employed to limit the spread of decay and eventual loss of the tooth.

scholarly journals Isolation of Candida species in children and their biofilm-forming ability on nano-composite surfaces

2020 ◽  
Vol 1 (1) ◽  
pp. 40-52
Author(s):  
Harina Akila Che Hussin ◽  
Nadiah Arshad ◽  
Siti Nor Humaira Nor Azemi ◽  
Raja Izzatun Nisa Raja Sahrul Hishan ◽  
Wan Nur Fatihah Wan Mohd Kamaluddin ◽  
...  
Keyword(s):  
Dental Caries ◽  
Oral Cavity ◽  
Buccal Mucosa ◽  
Candida Species ◽  
Soft Tissues ◽  
Tooth Surface ◽  
Nano Composites ◽  
Candida Spp ◽  
Nano Composite ◽  
Tooth Surfaces

Candida species including Candida albicans, Candida krusei and Candida glabrata are opportunistic microorganisms that inhabit oral cavity. The objective of this study is to determine the effect of dental caries on Candida spp. biofilm-forming ability on nano- composite with the hypothesis that dental caries enhances the colonization of Candida spp. To assess Candida spp. colonisation in the oral cavity of the paediatric patient, samples were obtained from 30 subjects aged five to six years old from Kuantan, Pahang, Malaysia. The samples were collected from buccal mucosa, palate and tooth surfaces using sterile swabs. 10 mL of patient’s saliva suspension was also collected. Following that, the samples were inoculated on CHROMagar and incubated for 24 h at 37 ºC. Candida biofilm of caries isolate C. albicans (HNFC2), and C. albicans ATCC 32354 were developed on three different types of nano-composites. The study showed that no C. albicans was isolated from the caries-free oral cavity while 76% of children with caries possessed Candida spp. 65% of the yeasts were isolated from the tooth surface. Only 35% of the total isolates were obtained from soft tissues, including palatal and buccal mucosa. C. albicans is the most isolated Candida spp. with 82% and 67% of the yeast were obtained from the tooth surface and buccal mucosa, respectively. Besides, HNFC2 significantly colonised the nano- composites more than the ATCC (P < 0.05). In the comparison of the three types of nano- composites, nano-hybrid-based containing pre-polymerised filler (cB) exhibited the least C. albicans HNFC2 cells colonisation with 7.7 x 10³ cells mL-1. In contrast, the nano-composite that contained bulk-filled nanohybrid (cC) was the most colonised with 14.3 x 10³ cells mL-1. In conclusion, dental caries enhances the colonization of Candida spp. in children's oral cavity, and that caries isolate form more biofilm on nano-composites compared to the lab strain C. albicans.

Biological factors in dental caries: role of saliva and dental plaque in the dynamic process of demineralization and remineralization (part 1)

2004 ◽  
Vol 28 (1) ◽  
pp. 47-52 ◽  
Author(s):  
John Hicks ◽  
Franklin Garcia-Godoy ◽  
Catherine Flaitz
Keyword(s):  
Dental Caries ◽  
Low Socioeconomic Status ◽  
Dental Plaque ◽  
Complex Disease ◽  
Immune Surveillance ◽  
Disease Process ◽  
Tooth Surface ◽  
Biological Factors ◽  
Phosphate Binding ◽  
Carbohydrate Ingestion

Dental caries is a complex disease process that afflicts a large proportion of the world's population, regardless of gender, age and ethnicity, although it does tend to affect more indivduals with a low socioeconomic status to a greater extent. The process of dental caries is dependent upon biological factors that are present within the saliva and dental plaque. There are many different agents within saliva and plaque that serve to protect the tooth surface against caries development. Salivary flow rate, buffering capacity, antimicrobial activity, microorganism aggregation and clearance from the oral cavity, immune surveillance, and calcium phosphate binding proteins all interact to inhibit or reverse demineralization of exposed tooth surfaces. Cariogenic bacteria levels within the saliva and plaque determine whether caries will occur or not, and the concentration in saliva and plaque are intimately related to the type of carbohydrate ingestion and the frequency of ingestion, as well as the oral hygiene practiced by the individual.

scholarly journals ETHIOPATHOGENETIC PARALLELS OF MORPHOLOGICAL CHANGES IN CHRONIC DENTAL CARIES AND ITS COMPLICATIONS

2020 ◽  
pp. 40-46
Author(s):  
B.M. Fylenko
Keyword(s):  
Dental Caries ◽  
Dental Pulp ◽  
Dental Plaque ◽  
Tooth Enamel ◽  
Continuous Fermentation ◽  
Morphological Changes ◽  
Calcium Phosphates ◽  
Tooth Surface ◽  
Protective Mechanism ◽  
Oral Microorganisms

Tooth decay is a global health problem and a major cause of tooth loss in the adult population. Currently, the most recognized theory of dental caries development is the chemical-parasitic theory of V.D. Miller that was suggested in 1884, and is relevant to date. According to this theory, oral microorganisms are capable of converting food carbohydrates to acids, which in turn dissolve the calcium phosphates present in the enamel, causing its demineralization. Dental plaque is considered the key element in the development of dental caries, subsequently leading to the gradual formation of a dental plaque. Dental plaque (biofilm) is resulted from structurally and functionally ordered colonization of microorganisms on the tooth surface. This process is gradual and involves several links. Potential virulence factors are enzymes that are involved in the metabolism of sucrose and other carbohydrates that come with food. Continuous fermentation of carbohydrates results in a rapid local decrease in pH on the tooth enamel surface, reaching a critical level and dissolving of the apatite on the surface of the enamel in the most vulnerable areas. The prolonged existence of the foci of demineralization results in the dissolution of a more stable superficial enamel layer with the formation of a visible defect. In the projection of carious lesion of the enamel at the stages of the pigmented spot and superficial caries, pathological processes in the dentin are observed. Subsequently, the exposure to an acidic environment leads to destruction of the dentin-enamel border, contributing to spread of carious process onto the hard tooth tissues and forming a cavity in the dentin. Microscopically, the bottom of the carious cavity is represented by three layers of altered dentin. In dental caries, a physico-chemical type of occlusion of the dentinal tubules is observed, which is considered a protective mechanism, which significantly reduces the permeability of the affected dentin for microorganisms. At the stage of medium caries, the odontoblast processes are affected by bacteria and their toxins, triggering a cascade of protective reactions in the pulp mediated by odontoblasts. After recognition of the pathogen, odontoblasts produce antibacterial substances, among which the most important are beta-defensins (BD) and nitric oxide (NO). The pro-inflammatory effect of BD-2 can be exacerbated by chemoattraction of immature antigen-presenting dendritic cells, macrophages, CD4 memory cells, and natural killers by binding to chemokine receptors. Activation of TLR4 increases BD-2 gene expression, indicating different odontoblasts’ response to gram-positive and gram-negative bacteria. Exogenous factors, such as microorganisms and their toxins in dental caries, gradually destroy odontoblasts, and the stem cells of the dental pulp are differentiated into odontoblast-like cells, which provide the formation of reparative (replacement, irregular, secondary) dentine. However, the factors involved in the differentiation of odontoblast precursors and odontoblast-like cells are not known to date. In deep dental caries, a significant destruction of the hard tooth tissues is determined with the formation of a large cavity, the walls of which may lose a layer of transparent and intact dentin, while the zone of the replacement dentin is more pronounced. Moreover, deep dental caries causes the prominent inflammatory processes in the dental pulp. In the deep layers of the carious cavity Lactobacilli are found, which make up the vast majority of all microorganisms in deep dental caries. This fact should be taken into account during treatment and use inlays with antimicrobial activity to maintain the viability of the pulp. Consequently, the development of dental caries and its course depends on the factors of virulence of the oral microorganisms and the severity of the compensatory protective mechanisms. Along with the processes of demineralization, the intensity of remineralization of the enamel and dentin is crucial. Superficial, medium and deep caries leads to changes in the dental pulp which should be considered in its treatment.

scholarly journals Exploration of the antimicrobial synergy between selected natural substances on Streptococcus mutans to identify candidates for the control of dental caries

2021 ◽  
Author(s):  
Alisha Evangeline Prince ◽  
David J McDonald ◽  
Soumya Roy
Keyword(s):  
Dental Caries ◽  
Streptococcus Mutans ◽  
Dental Plaque ◽  
Synergistic Effects ◽  
Treatment Options ◽  
Antimicrobial Effect ◽  
Antimicrobial Action ◽  
Tooth Surface ◽  
Manuka Honey ◽  
Synergistic Combinations

Dental caries is caused by dental plaque, a community of micro-organisms embedded in an extracellular polymer matrix as a biofilm on the tooth surface. Natural products that are widely available could be used as an alternative or adjunctive anti-caries therapy. Sometimes, when two products are used together, they yield a more powerful antimicrobial effect than the anticipated additive effect. These synergistic combinations are often better treatment options because individual agents may not have sufficient antimicrobial action to be effective when used alone. Cranberries contain phenolic compounds like proanthocyanidins (PAC) that disrupt biofilm formation. Manuka honey has high concentrations of the agent methylglyoxal, which is cariostatic. Because these agents have varied modes of antimicrobial action, they show potential for possible synergistic effects when paired. Various cranberry extracts were tested pairwise with manuka honey or methylglyoxal by well-diffusion assays and 96-well checkerboard assays in the presence of Streptococcus mutans to test for synergy. Synergy was demonstrated in two of the cranberry extracts paired with manuka honey. The synergistic combinations found in this research thus can be considered as candidates for the formulation of a dentifrice that could be used to inhibit the formation of dental plaque and thereby avoid the development of caries.

scholarly journals THE EFFECTIVENESS OF PROPOLIS FLUORIDE APPLICATION IN INHIBITING DENTAL CARIES ACTIVITY IN SCHOOL CHILDREN AGE 6-9 YEARS OLD

2018 ◽  
Vol 9 ◽  
pp. 1 ◽  
Author(s):  
Risqa Rina Darwita ◽  
Andalina Rhukul Finisha ◽  
Hardiati Nur Wahyuni ◽  
Salsabila Ghina ◽  
Rajiv Muhammad ◽  
...  
Keyword(s):  
Dental Caries ◽  
Primary School ◽  
Topical Application ◽  
School Children ◽  
Tooth Brushing ◽  
Tooth Surface ◽  
Caries Lesion ◽  
Caries Activity ◽  
Tooth Surfaces ◽  
Black Discoloration

Objective: To obtain the effectiveness of propolis fluoride application in inhibiting dental caries activity. Methods: The study was included 170 children aged 6–9 years old with active dentinal carries surface was 532 tooth surfaces, all of 532 tooth surface will applicate use propolis fluoride in school children at primary school SD Kukusan. Evaluation of the amount of dentinal caries lesion that has been arrested was conducted after 1 month, 2 months, and 4 months after topical application. Results: After propolis fluoride applicated shows, that the activated process caries of dentinal caries lesion after 1 month was found in 104 tooth surfaces, 2 months were 115 tooth surfaces, and after 4 months evaluated were found significant increase to be 226 tooth surfaces on dentinal caries activated from 2nd to 4th month after application propolis fluoride (p<0.01). The percentages of arrested caries in, respectively, for 1st month after the application is 99.80%, 2nd month application is 78.32%, and in the 4th month is 57.52% while the score plaque of school children was decline significantly until 36.5% (p<0.05) after 4 months intervention by tooth brushing every week at school. Conclusion: The application of propolis fluoride is effective in inhibiting dentinal caries lesion activity, has the advantage of making no black discoloration to the teeth.

scholarly journals Erythritol Is More Effective Than Xylitol and Sorbitol in Managing Oral Health Endpoints

2016 ◽  
Vol 2016 ◽  
pp. 1-15 ◽  
Author(s):  
Peter de Cock ◽  
Kauko Mäkinen ◽  
Eino Honkala ◽  
Mare Saag ◽  
Elke Kennepohl ◽  
...  
Keyword(s):  
Oral Health ◽  
Dental Caries ◽  
Dental Plaque ◽  
Oral Bacteria ◽  
Comprehensive Overview ◽  
Published Evidence ◽  
Tooth Surfaces ◽  
Bacterial Genes ◽  
The Impact ◽  
Plaque Biofilm

Objective. To provide a comprehensive overview of published evidence on the impact of erythritol, a noncaloric polyol bulk sweetener, on oral health.Methods. A literature review was conducted regarding the potential effects of erythritol on dental plaque (biofilm), dental caries, and periodontal therapy. The efficacy of erythritol on oral health was compared with xylitol and sorbitol.Results. Erythritol effectively decreased weight of dental plaque and adherence of common streptococcal oral bacteria to tooth surfaces, inhibited growth and activity of associated bacteria likeS. mutans, decreased expression of bacterial genes involved in sucrose metabolism, reduced the overall number of dental caries, and served as a suitable matrix for subgingival air-polishing to replace traditional root scaling.Conclusions. Important differences were reported in the effect of individual polyols on oral health. The current review provides evidence demonstrating better efficacy of erythritol compared to sorbitol and xylitol to maintain and improve oral health.

scholarly journals Identification of Initial Colonizing Bacteria in Dental Plaques from Young Adults Using Full-Length 16S rRNA Gene Sequencing

mSystems ◽  
2019 ◽  
Vol 4 (5) ◽  
Author(s):  
Yukari Ihara ◽  
Toru Takeshita ◽  
Shinya Kageyama ◽  
Rie Matsumi ◽  
Mikari Asakawa ◽  
...  
Keyword(s):  
Young Adults ◽  
Dental Caries ◽  
16S Rrna ◽  
16S Rrna Gene ◽  
Dental Plaque ◽  
Plaque Formation ◽  
Full Length ◽  
Tooth Surface ◽  
Rrna Gene ◽  
Content Type

ABSTRACT Development of dental plaque begins with the adhesion of salivary bacteria to the acquired pellicle covering the tooth surface. In this study, we collected in vivo dental plaque formed on hydroxyapatite disks for 6 h from 74 young adults and identified initial colonizing taxa based on full-length 16S rRNA gene sequences. A long-read, single-molecule sequencer, PacBio Sequel, provided 100,109 high-quality full-length 16S rRNA gene sequence reads from the early plaque microbiota, which were assigned to 90 oral bacterial taxa. The microbiota obtained from every individual mostly comprised the 21 predominant taxa with the maximum relative abundance of over 10% (95.8 ± 6.2%, mean ± SD), which included Streptococcus species as well as nonstreptococcal species. A hierarchical cluster analysis of their relative abundance distribution suggested three major patterns of microbiota compositions: a Streptococcus mitis/Streptococcus sp. HMT-423-dominant profile, a Neisseria sicca/Neisseria flava/Neisseria mucosa-dominant profile, and a complex profile with high diversity. No notable variations in the community structures were associated with the dental caries status, although the total bacterial amounts were larger in the subjects with a high number of caries-experienced teeth (≥8) than in those with no or a low number of caries-experienced teeth. Our results revealed the bacterial taxa primarily involved in early plaque formation on hydroxyapatite disks in young adults. IMPORTANCE Selective attachment of salivary bacteria to the tooth surface is an initial and repetitive phase in dental plaque development. We employed full-length 16S rRNA gene sequence analysis with a high taxonomic resolution using a third-generation sequencer, PacBio Sequel, to determine the bacterial composition during early plaque formation in 74 young adults accurately and in detail. The results revealed 21 bacterial taxa primarily involved in early plaque formation on hydroxyapatite disks in young adults, which include several streptococcal species as well as nonstreptococcal species, such as Neisseria sicca/N. flava/N. mucosa and Rothia dentocariosa. Given that no notable variations in the microbiota composition were associated with the dental caries status, the maturation process, rather than the specific bacterial species that are the initial colonizers, is likely to play an important role in the development of dysbiotic microbiota associated with dental caries.

scholarly journals Effectiveness and safety of a new dental plaque removal device utilizing micro mist spray for removing oral biofilm in vitro

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroki Hihara ◽  
Ryo Tagaino ◽  
Jumpei Washio ◽  
Kittipong Laosuwan ◽  
Dimas Prasetianto Wicaksono ◽  
...  
Keyword(s):  
Surface Roughness ◽  
Mucous Membrane ◽  
Oral Mucosa ◽  
Dental Plaque ◽  
Tooth Surface ◽  
Oral Biofilm ◽  
Plaque Removal ◽  
Treated Area ◽  
Biofilm Removal ◽  
Significant Difference

Abstract Background Removal of oral biofilm from the oral mucosa is essential for preventing risk of respiratory and gastrointestinal infection in elderly people. Currently, no device is available which can remove oral biofilm from oral mucosa effectively and safely. Therefore, the effectiveness and safety of the Micro Scale Mist UNIT (MSM-UNIT), a newly developed dental plaque removal device utilizing high speed sprays of fine water droplets, were evaluated for biofilm removal, including the rate and surface roughness for simulated tooth surface and mucous membrane. Methods Simulated tooth and oral mucosa coated with an artificial biofilm of Streptococcus mutans were used for evaluation of effectiveness, with uncoated substrates as the controls. The MSM-UNIT and a conventional air ablation device were operated under recommended instructions. The effectiveness was evaluated from the rate of removal of the biofilm, and the safety was evaluated from the damage observed by scanning electron microscope and surface roughness. Results The biofilm removal rate of the MSM-UNIT was significantly higher than that of AIRFLOW. Little damage was observed in the area treated by the MSM-UNIT. The surface roughness of the MSM-UNIT treated area on simulated tooth surface and oral mucosa showed no significant difference to the control area. In contrast, cracks and powder were observed in the area treated by AIRFLOW. In particular, the surface roughness of the AIRFLOW treated area for Toughsilon was significantly larger than that of the control. Conclusions The MSM-UNIT could be used safely and effectively for removing biofilm not only on simulated tooth surfaces but also simulated mucous membrane. The MSM-UNIT has no harmful effect on teeth or oral mucosa, and may be used for comprehensive oral care for patients during nursing care and the perioperative period.

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