2/01/2015
DENTAL CARIOLOGY
Dr. Gaurav Garg (M.D.S.)
Lecturer, College of Dentistry
Al Zulfi, M.U.
Objectives
At the end of the lecture students should
know:
 Definition of dental caries
 Etiology of dental caries
 Classifications of dental caries
 Detection of dental caries
 Management

DENTAL CARIES

DEFINITION:

“DENTAL CARIES IS AN INFECTIOUS MICROBIOLOGIC
DISEASE OF THE TEETH THAT RESULTS IN LOCALIZED
DISSOLUTION AND DESTRUCTION OF THE CALCIFIED
TISSUES.”(Sturdevent’s art and science of operative dentistry- 5th
edition)
Dental Caries is the most common disease in the world
ETIOLOGY
OF
DENTAL CARIES
DENTAL PLAQUE

It is a highly variable, fixed,
structural entity formed by
the sequential colonization
of micro-organisms on
tooth, restoration and oral
mucosal surfaces

The plaque provides shelter
for micro-organisms

Caries activity are
characterized by periods of
high metabolic activity and
low pH around plaque
Microorganisms
Major bacteria - Streptococcus mutans
 Other organisms implicated:
* Lactobacilli
* Actinomyces
* Veilonella

Carbohydrates
Act as “food” for bacteria
 Mainly Sucrose is associated with high
caries
 Sticky, refined carbohydrates cause more
caries as compared to raw, unrefined
carbohydrates
 Also the increased frequency of taking
carbohydrates increases caries

 Three
important
factors for caries
causation:
* Micro-organisms
for acid production
* Carbohydrate
substrate (mainly
Sucrose)
* The acid which
causes dissolution
Etiology of caries
Tooth morphology & position

Presence of deep, narrow occlusal fissures or
pits favours bacterial accumulation.

The most susceptible tooth in dentition is
mandibular 1st molars

Misaligned, out of position, rotations favor
plaque accumulation and make hygiene
procedures difficult to accomplish
CARIES CLASSIFICATIONS

Can be classified
according to 3 major
factors
A) Location
a. Primary caries
b. Secondary caries
B) Severity and progress
C) Age pattern

i) Primary
caries -3
morphologic
types are
evident
Pit and Fissure
Caries
 Smooth
surface Caries
 Root caries

Residual caries

ii) Secondary caries-
- Caries that occurs beneath
restorations
B) Severity and
progress of
lesion
i)
ii)
iii)
iv)
Incipient caries
Cavitated caries
Acute (Rampant)
caries
Chronic / arrested
caries
C) According to Age
Pattern

i) Nursing bottle caries

ii) Adolescent caries

iii) Geriatric caries
G.V. BLACK’S
CLASSIFICATION OF CARIES
DENTAL CARIES DETECTION
VISUAL EXAMINATION
VERY POPULAR.
 AIDED BY USE OF
COMPRESSED AIR.
 INCLUDES LOOKING
FOR




OPACIFICATION
SURFACE
ROUGHNESS
DISCOLORATION
CAVITATION
TACTILE EXAMINATION
 Includes
determining
roughness or softness of the
tooth surface with a sharp
explorer.
 Both
penetration & resistance
to removal of an explorer tip
(catch) have been interpreted
as an evidence of caries
(demineralisation).
Radiographs
IOPA radiograph ( intraoral periapical radiograph)
Bitewing radiograph
OPG ( Orthopentogram) radiograph
MANAGEMENT
Removal of Caries
 Restoration with appropriate restorative
materials such as: Amalgam, Composite,
Glass ionomer etc.

Composite restoration
Amalgam restoration
References & Suggested
readings



Sturdevant's art & science of operative dentistry- Theodore M.
Roberson, Harald O. Heymann, Edward J. Swift, Jr.
Principles of operative dentistry (2005)- A.J.E. Qualtrough, J.D.
Satterthwaite, L.A. Morrow and P.A. Brunton.
Fundamentals of Operative Dentistry- 2nd Edition- Summitt &
Robbins