Caries and Cavities in Dentistry

Teeth damaged by caries

Teeth damaged by caries

Caries is the term for "rotten" or "foulness" in Latin.

In dentistry, caries is a tooth disease caused by bacteria. Our bodies are occupied by numerous germs, and the settlement thereof usually starts immediately after birth because of our parents and our environment.

Not all bacteria are harmful though. For example, the flora in our intestinal tract is crucial for our survival; this is called symbiotic bacteria. Other substances simply settle in niches; these are called commensal bacteria - we do not benefit from them directly. However, settlement of such niches by commensal germs, for example in the skin, prevents these areas from being inhabited by other harmful entities.

Sometimes, bacteria and hosts struggle for dominance. Doctors call such germs opportunists. If the host is damaged by bacterial dominance – meaning they are winning the fight – these germs are called pathogens - of which we have a lot of in our mouths. Some live in essential niches and prevent other aggressive germs from settling, while other germs simply live alongside us. This means that we have symbiotic and commensal bacteria in our mouths. However, the bacteria flora can change instantly due to changes in life circumstances.

Commensal bacteria can suddenly turn into pathogenic germs. In fact, this is what happens with caries. People suffer from caries when certain factors come together. The most important aspects are: certain host factors, plaque, time. Host factors encompass all the factors relating to the host, such as tooth anatomy, saliva composition and cleaning habits.

Plaque is a layer on the teeth consisting of saliva parts, germs and carbohydrates, and it forms when the teeth are not cleaned properly. When all these factors come together – bad cleaning habits, plaque and time – they lead to the formation of caries. We will now use the animation to take a little tour into the plaque. There are bacteria that are specialized in just holding on to the teeth. Other entities transport nutrients by forming transport tubes.

Streptococcus mutant bacteria, for example, produce nutrients from organic acids, which then attack the structure of the teeth by removing existing minerals from the tooth substance. Plaque is therefore like a little city. The formation of mature plaque usually takes about 24 hours. This is the time it takes originally commensal and symbiotic germs to turn pathogenic. Unorganized, mouth bacteria is not harmful. Only mature plaque can cause caries and periodontitis.

Therefore, it is very important to remove plaque efficiently with the help of a toothbrush, dental water jets and dental floss. By doing so, these germs are deprived of their habitat. Without a habitat, they cannot cause any more harm. Within the plaque, the bacterial products disintegrate the enamel of your teeth. However, as soon as caries reach the dentin – depicted in yellow – the dentin is occupied by the bacterial infestation. This is because the dentin contains proteins that supply the germs with a food source. Even when plaque is removed thoroughly, the decay process cannot be stopped. They develop their own dynamic. There will be more about this in the video entitled "Initial Caries".

Toothache and decay usually only occurs when caries have reached the tooth nerves, marked here in red. In this case, an oral root treatment is necessary because the tooth nerve has been infected by bacteria. If the root treatment is done incorrectly, it can lead to bone inflammation, even after many years. Patients frequently refer to this as the disease focus, or the location where the disease or infection originated. A root tip resection or even a tooth extraction are possible consequences. You can see what a good root treatment looks like in the video entitled "Root Canal Treatment".

Now the common caries is more easily understandable. Common caries usually refers to bridges, crowns, partial prosthesis and sometimes even total prosthesis by the age of 50. Here you see various x-rays of patients from different doctors’ offices. Do you see that all these patients, probably just like you, only have bad teeth in the corner areas? On all those pictures, even a non-expert can tell that people get fillings, crowns and bridges (the bright spots on the x-rays) in the corner teeth areas first. Why is this so?

Unfortunately, often times, people only brush their teeth superficially because their minds are on other things and they get fooled by the fresh feeling coming from the toothpaste. This process leads us to clean the front properly but the side teeth areas have cleaning deficits. This is not without consequence: Hidden layers, especially in the gaps between teeth later lead to the destruction of the dental enamel, decay, caries and even gum inflammation or periodontosis. This is why we create fillings on the sides first. Compiled with bad dental work and a lack of information, this will lead to most people having bad teeth (or even no teeth) in the side regions by age 50. The frontal teeth are overly strained and by age 60, a total prosthesis will likely be unavoidable for a typical individual.

Regular oral hygiene, quality medical work and information prevent the new formation of dental caries and the loss of your teeth. You have something to smile about, all the way into old age with!

Click here to see the video: Initial Caries


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