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DENTAL CARIES

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by

Adnan Sukkarwalla

on 12 September 2016

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Transcript of DENTAL CARIES

DENTAL CARIES
DENTAL CARIES

is a bacterial disease of the calcified tissue of the teeth, characterized by demineralization of the inorganic and destruction of the organic substance of tooth.
CARRIES ACTIVITY TEST
IT MEASURES THE DEGREE TO WHICH LOCAL ENVIRONMENT CHALLENGE THE PROBABILITY OF CARIOUS LESIONS
DENTAL CARIES PREVENTION VACCINES..
DO THEY EXIST????

WHY WE DO THIS?

To identify high risk group
To determine the need of preventing measure
To monitor effectiveness of educational program.
To serve as index of success of therapeutic measure.
DENTAL CARIES
Lacto bacillus test
Snyder test
Reductase test
Buffer capacity test
Plaque toothpick method
Streptococcus mucus adherence test
Streptococcus mucus dipslide method

NUMBER OF TESTS
SUSCEPTIBILITY
OF DIFFERENT
TEETH
The rank order of susceptibilty of teeth according to Maryland Hagerstown(1937)
Mandibular first and second molars
Maxilary first and second molars.
Mandibular second bicuspids, maxillary central and lateral incisors
Maxilary canines and mandibular firstcuspids.
Mandibular central and lateral incisors, mandibular canines( third molars had not erupted in the children.
DEMOGRAPHIC RISK FACTORS
AGE
GENDER
RACE AND ETHNICITY
SOCIOECONOMIC STATUS
FAMILIAL AND GENETIC PATTERNS

AGE
GENDER
RACE AND ETHNICITY
SOCIOECONOMIC
STATUS
FAMILIAL AND GENETIC PATTERNS
LOCAl FACTORS
BACTERIA
DIET
SALIVA
BACTERIA
DIET
SALIVA
MAJOR EPIDEMIOLOGIC STUDIES ON DIET AND CARIES
WORLD WAR 2 STUDIES
TRISTAN DA CUNHA
HOPEWOOD HOUSE
HEREDITARY FRUCTOSE INTOLERANCE
VIPEHOM STUDY
17th CENTURY

increased refined food and availability of sugar.
1875
no import duty of sugar in Britain
19th CENTURY
dental caries was well established.
20th CENTURY
caries was a disease of developed countries with low prevelance in developing world
.
Late 20th century, caries rising in developing countries and reduction in caries of children and young adult in developed country.
Since 1952, flouridation of water was activated.
Then why DMF score was high in Norway and Newzealand?'+
Plaque+sucrose+cariogenic bacteria
Cariogenic plaque
+
Cariogenic diet
Acid production
Subsurface demineralization
Initial lession
Progression of carious lession
Cavitation
Female has high DMF score.
Early eruption of teeth than male
More visits to Dentist
Same amount of caries effects male and female but female goes more often to dentist and higher restored teeth
Its a life time desease
Any adults can develop lesion
Its belief that it DMF increase with time
In children by restored teeth and adult by missing teeth
As years will pass, those children, when gets old missing teeth dmf will decrease,
DMF rates is higher in white than African American.
More Access to Dentist
More availability of processed food
Between group cultural difference
t
continous sucrose consumption
repeated attack of cariogenic challenge
distruction of organic matrix
more of mineral loss
It includes factors like Education, Income, Occupation, Attitude and Values
Previously High SE had greater DMF, because of number of restored teeth
With years , higher SES enjoyed less amount of caries
Caries became the disease of poor with more decayed and missing teeth.
Genetic has weak linked till now in caries progression
It has been seen in twins that environment plays more role.
But genetics can effects salivary flow, tooth morphology, tooth composition that can give advantage to caries development
More studies are required

Bacteria is main factor, caries can not progress without it.
Mutan Streptococci and Lactobacilli
Its always present in mouth, so its ecologic imbalance than exogenous infection
Cariogenic diet is important for caries progression
Dietary factors have clear influence on caries
Refined carbohydrates like Sugar
Cooked starch
But larger molecule carbohydrates and in light cooked vegetable are considered as non-cariogenic food
Severe malnorished children is more prone to dental caries . argue?
Are constant contact with and bathed in saliva
It neutralize Ph after acidic environment
Every time we swallow, we clean bacteri from oral cavity
Normal saliva flow is 800ml.. if less?
Antibacterial
Viscosity . Thick or Thin
During world war 2 in 1950, no sugar available in Japan.
DMF
score
decreased
as compared to 1940.

The aquisition of Germany on Norway and then strict rationing of food, resulted in 3 to 4 time
increase
in
CARIES

FREE
children
Remote island, less connection with outer world
On dental examination,
0%
caries in
6 to 19 yrs
on 1 permanent molar.
But after contact with outside world,
50% increases
were found.
And after coming back to island
80% increases
were found.
Study of
15 years
were conducted with children on strict diet of vegetables,
no sucrose
4 to 9 yrs
caries free children were
77.8%
13 yrs
caries free children were
53%
And in the end of study, there were
34.7%
caries free children
Rare disease, person has to minimize sugar intake, long term benefits.
No caries observed as compared to normal.
Conducted in
Sweden
from
1945
to
1952
.
Conducted in
mental institute.
Ethically.. Consent....
Best known attempt which opens mind about caries.
CONCLUSIONS OF VIPEHOME STUDIES
increase carbohydrates increase caries
Increase sticky sugar , Increase caries
Sugar in between meal, Increase caries
Withdrawl of sugar, decrease caries.
Individual variation, Different caries result.
Absence of refined sugar, Caries still can occur.

CAN WE HAVE BEHVIOURAL CHANGES REGARDING DENTAL CARIES
LITERALLY MEANS SATURDAY CANDY
BY: DR ADNAN SUKKARWALLA
BDS, Msc (SWEDEN)
Department of CommunityDentistry
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