What is Dental Caries?

Dental Caries, a very common Dental ailment, causes damage to the structure of Teeth. The consequences of Caries are Tooth Decay and Cavities. If caries is left undiagnosed, it can lead to loss of tooth, infection, pain and in worst cases, death. This ailment has a long historical background can be traced back to bronze, Iron and Medieval ages. Diet has been the common cause for increased prevalence of caries today. Dental Caries can be classified in a number of ways. Even though the presentation might vary, the risk factors and development among distinct types of caries remain majorly similar. It starts as a small chalky area but slowly develops into a large, brown cavitation. In some cases radiographs are frequently needed to inspect those areas of teeth which are not clearly visible. But in most cases, it can be seen directly and hence extent of damage can be concluded.

The general cause of Tooth decay is certain types of acid producing bacteria, especially of lactobacillus species, which cause damage in the presence of ferment-able carbohydrates such as glucose, fructose and Sucrose. A special mineral content of tooth causes it to be sensitive to low pH, hence high presence of lactic acid in the mouth affect teeth. Generally, a tooth is in constant state of back and forth demineralization and re mineralization between the tooth and surrounding saliva. When pH at the tooth surface drops below 5.5, demineralization proceeds faster than re-mineralization. This causes the decay. Although there are no known method to regenerate large amount of tooth structure, however, depending on the extent of tooth destruction, various treatments can be used to restore dental health. Due to such severe outcomes, Dental health organizations stress more on preventive dental measures like regular oral checkups.

According to an estimate, 90% of school going children around the globe and many adults have experienced dental caries. This dental disease is more prevalent in Asian and Latin American countries and least in African countries. In united states, dental caries is the most common childhood disease, being at least five times more common than asthma. This is due to bad eating habits. In Adults, between 29% and 59% of adults over the age of fifty experience caries. In some developed countries, the count of caries diseased persons have fallen down, and this decline is usually attributed to increasingly better oral hygiene practices and preventive measures such as fluoride treatment. Nonetheless, countries that have experienced an overall decrease in cases of tooth decay continue to have a disparity in the distribution of the disease.Among children in the United States and Europe, 60-80% of cases of dental caries occur in 20% of the population. A similarly skewed distribution of the disease is found throughout the world with some children having none or very few caries and others having a high number.Some countries, such as Australia, Nepal, and Sweden, have a low incidence of cases of dental caries among children, whereas cases are more numerous in Costa Rica and Slovakia.

Dentist's Role in Aids Epidemic

We know that the chances of contracting HIV-infection in a dental setup is very slim. However, as health care workers, dental students and dentists, we must be knowledgeable of the disease process, its oral manifestations and their management, modes of transmission, preventive strategies, and most importantly the instructions to the dental team and education to the public. There are many major authorities dealing with the ethical and legal issues related to HIV and AIDS. They are the American Dental Association (ADA) and the centers of disease control (CDC) in USA and similarly General Dental Council (GDC) and the British Dental Association (BDA) in UK. In UK, there are two guidelines to be followed in HIV discrimination, the GDC & the BDA. The GDC guidelines states that "It would be unethical for a dentist to refuse to treat a patient solely on the grounds that the person was HIV Positive".

Regarding the patient confidentiality, according to BDA, "Any information obtained in the course of consultation and treatment is confidential, including personal health information. Practitioners should ensure that their staff are aware of the absolute duty of confidentiality and behave accordingly". It is also advisable to seek the permission from the HIV infected patient for each release of their HIV related information. There are three possible transmission routes for HIV in a dental practice. They are (1) From a Dentist deliberately to a patient, (2) From the Dentist to patient by accident, and (3) From an infected patient to another patient. As we all know, protection from any disease is mainly through immunization, but unfortunately an AIDS vaccine is still at large. Preventive Strategies in a Dental Clinic should be carried out by means of universal precautions, through cleaning and disposal of blood, saliva or tissues from all patients. Accidental needlestick injuries are relatively common in dental practise. So all the members of Dental team should be trained to avoid such injuries, though the chances of contracting HIV from a needlestick is very slim (less than 1%).

Nevertheless, Dentist's role in Aids Epidemic is quite important!

Oral Cancer - Fight it

Introduction: The disease characterized by the growth of cancerous cells in the mouth, including the lips. Oral cancer is often associated with cancers of the cavity located behind the tonsils and the back of the throat (oropharyngeal cancer). Most cases originate from the flattened cells that make up the lining of the oral cavity (squamous cell carcinomas). Oral cancers can spread into the jaw and may occur simultaneously with cancers of the larynx, esophagus, or lungs.

Causes: Several factors have been identified that increase the risk of developing oral cancer. Tobacco and alcohol use are the leading factors, with each increasing the risk sixfold. Tobacco use includes cigarettes, cigars, pipes, and chewing tobacco. Oral cancer affects men at twice the rate of women, probably because men have generally been more likely to use tobacco and alcohol. Vitamin A deficiency is also a risk factor, and some strains of human papillomavirus can infect the mouth and may increase risk of oral cancer. Exposure to ultraviolet radiation from the sun is responsible for some cancers of the lips.

Symptoms: Symptoms of oral cancer vary depending on the location of the cancer. The most common symptom is a mouth sore that does not heal. Some early visual signs include white or red patches in the mouth. White patches (leukoplakia) progress to cancer in about 5 percent of cases. The red patches (erythroplakia) bleed easily, and roughly half of them become cancerous. Other symptoms of oral or oropharyngeal cancer include lumps or swelling in the cheek, neck, or jaw, difficulty swallowing or moving the tongue or jaw, and pain in the jaw or teeth. Virtually any type of continuing mouth pain may indicate oral cancer and should be investigated by a physician.

Result: Well, you loose your teeth, you lose your money on treatment, you lose on your favorite foods and you know what? your entire Happiness is screwed!

Prevention: Oral cancer is almost completely preventable if the key risk factors of smoking and alcohol consumption are avoided. A healthy diet containing sufficient vitamin A is also recommended. Regular dental examinations may detect oral cancer early. Dentures should be removed and cleaned at night to avoid trapping cancer-causing agents against the gums.

Well, so now you decide, you wanna avoid those dirty stuff??

Preventing Dental decay

Ever met someone whose mouth stinks like drainage??? Well, don't be surprised, he or she sure has some decay in their teeth. Dental decay can be prevented very easily, by just brushing properly and using proper brushing technique. I have seen in my practice that some people brush twice a day but still they get dental decay! This is because they don't use proper brushing technique. Of course, type of tooth brush is important, especially in patients with bleeding gums and other gum problems. These patients require soft bristle tooth brush. Tooth paste also has a important role in preventing tooth decay. Now a days we see advertisements of toot paste with calcium,salt, blah blah etc, but the one with fluoride is really helpful. In patients with high risk of dental decay, fluoride prevents tooth decay.

Dental floss is as important as tooth brush as it cleans those areas where a brush cannot reach. Many people now are getting aware about the importance of floss. Dental Floss is helpful in patients with orthodontic appliance or braces and those with artificial teeth or dental prosthesis. It cleans those areas which a brush cannot reach and results in dental decay. I have seen several patients with this problem , they dont use floss and end up with a decay tooth.

Hope that was clear and crisp! post your comments if you have any questions, would love to answer them! Happy smiling!!!