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Causation and Prevention of Dental Caries

KN252 Honors Activity

Joanna Kopytek

on 30 April 2013

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Transcript of Causation and Prevention of Dental Caries

CARIES-CAUSING BACTERIA According to Professor William Wade from King's College London Dental Institute, "there are 100 million [bacteria] in every milliliter of saliva and more than 600 different species in the mouth." Even though there is a tremendous amount of bacteria in your mouth, there are only few specific species which are known to cause dental caries. Species of bacteria most commonly associated with caries are: ETIOLOGY OF DENTAL CARIES The four main ingredients needed to create a dental cavity are:
1.) A tooth surface, such as enamel or dentin
2.) Caries-causing bacteria
3.) Fermentable carbohydrates, such as sucrose, fructose, and glucose
4.) Time KNOW THE FACTS! - According to the States Surgeon General's report on oral health in the U.S.A. published in May 2000, dental caries is the single most common chronic childhood disease.

- Dental caries is five times more common than asthma and seven times more common than hay fever.

- Dental caries is a preventable disease. SALIVA ADDITIONAL FACTORS THAT CAN INFLUENCE
DENTAL CARIES Joanna Kopytek Etiology and Prevention
Enamel: hard white substance covering the crown of a tooth; hardest tissue in the body

Cementum: bone-like connective tissue that covers the root of tooth; very thin layer

Dentin: hard, calcareous tissue; found
under the enamel and cementum;
harder than bone

Pulp: soft tissue located in the inner
most part of the tooth; made up of
blood vessels, nerves, and cellular
substances Plaque is a biofilm made up of saliva, bacteria, and a dietary substrate which firmly attaches to the surface of the tooth. The biofilm can be easily removed by brushing the teeth, but within 48 hours it begins to harden and becomes tartar, which is difficult to remove. The substrate, fermentable carbohydrates, in the plaque serves as food for the bacteria, and the bacteria produces acids that can demineralize the enamel or dentin of a tooth. The acids that the bacteria produce are metabolic by-products created by the breakdown of carbohydrates. The acids that demineralize the enamel have a pH of 5.5 to 5.2, sometimes even less. Saliva is composed of calcium and phosphate and it dilutes and buffers the acid. It diffuses into the plaque where it neutralizes and repairs the demineralized enamel. Fluoride increases the rate of remineralization of enamel by saliva, and it increases the enamels' resistance against future demineralization. If the acid demineralization process exceeds the saliva remineralization process then dental caries will occur. If plaque has developed 12 hours ago or less, then it will take 10 minutes for the demineralized enamel to be remineralized. If plaque has been attached to the tooth for 48 or more hours, then it will take the saliva 4 hours to repair the damage. The reason why the rate of demineralization is not constant is because the outer surface of enamel contains a higher percentage of minerals, and is more resistant to demineralization by acid than the deeper portion of the enamel. As you can see, the development of dental caries is a continuous dynamic process. - the study of causation of a disease or an abnormal condition - Streptococcus mutans
- Lactobacilus acidophilus
- Actinomyces viscosus Streptococcus mutans is the bacteria most commonly associated with dental caries. Researchers Berkowitz and Jones (1985) have discovered that the bacteria can be transmitted from mother to infant. Kohler, B. and colleagues (1984) were doing a similar study at the time, and they found out that lower numbers of oral S. mutans in mothers slowed down the colonization of bacteria in their children's mouths. They also discovered that the earlier S. mutans colonize in a child's mouth, the higher the risk is for that child to develop caries at age 4. REFERENCES Saliva plays an important role in fighting dental caires, and certain characteristics of saliva can influence the process. SALIVARY
SALIVA A reduction or absence of saliva creates an acidic oral environment which will increase the chance of dental decay. Research has shown a significant relationship between the viscosity of saliva and dental decay. People who have thick saliva will have a higher rate of dental decay. A study concluded that a reduction in refined sugar can alter the viscosity of saliva. Normal salivary flow helps with the breakdown of food on which bacteria thrive. A reduction of salivary flow will make it easier for the bacteria to colonize. Arrangement of Teeth
- If teeth are crowded then it may make it difficult for a person to clean them properly. Characteristics of Teeth
- Pits are depressions and fissures are grooves on the biting surface of a tooth. Caries commonly occur in these areas because they easily trap food and they are tough to clean. Dental Appliances
-Dental appliances, such as braces, may make it easier for bacteria to colonize in the mouth because more food gets left behind after eating a meal. Hereditary factors
-Many people believe that dental caries are influenced by genetics, but most researchers would disagree. Genetics have a minor effect on dental caries compared to the overall environmental effects. Dental caries are considered an environmental disease because children learn oral hygiene skills and dietary habits from their parents. FLUORIDE EATING HABITS REGULAR DENTAL VISITS REDUCTION OF PLAQUE CONTROL OF ALL PRESENT CARIES
- Reduce the amount of fermentable carbohydrate intake

- Reduce between meal snacking

- Reduce frequency of drinking sugary drinks If there are caries present in the mouth, then it is important treat all the lesions and slow down the progress of the disease. It is important to try to reduce the number of bacteria in the mouth so the pH in the oral cavity is not acidic enough to demineralize teeth. - Use fluoridated toothpaste and mouthwash

- Eat foods that contain fluoride and drink fluoridated water

- Regularly visit the dentist to receive topical fluoride as gel or foam - Brush twice daily

- Floss - Visit the dentist every 6 months for a regular check up and cleaning

- Have x-rays taken once a year Berkowitz, R. J., & Jones, P. (1985). Mouth-to-mouth transmission of the bacterium Streptococcus

mutans between mother and child. Arch Oral Biol, 30, 377-379.

Dean, J. A., Avery, D. R., & McDonald, R.E. (2011). Dentistry for the Child and Adolescent (9th ed.).

Maryland Heights, MO: Elsevier Mosby

Kohler, B., Andreen, I., Jonsson, B. (1984). The earlier the colonization by streptococci, the
higher the caries prevelance at 4 years of age. Oral Microbiol Immunol, 29, 879-883.

Lenander-Lumikari, M., & Loimaranta, V. (2000). Saliva and Dental Caries. Adv Dent Res, 14, 40-47

Short, M. J., & Levin-Goldstein, D. (2002). Head, Neck, and Dental Anatomy (3rd ed.). Clifton Park, NY:


Society for General Microbiology (2008, August 11). New Bacterial Species Found In Human Mouth.

ScienceDaily. Retrieved April 18, 2013, from http://www.sciencedaily.com­

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