Dental caries: a dynamic disease process

Abstract

Dental caries is a transmissible bacterial disease process caused by acids from bacterial metabolism diffusing into enamel and dentine and dissolving the mineral. The bacteria responsible produce organic acids as a by-product of their metabolism of fermentable carbohydrates. The caries process is a continuum resulting from many cycles of demineralization and remineralization. Demineralization begins at the atomic level at the crystal surface inside the enamel or dentine and can continue unless halted with the end-point being cavitation. There are many possibilities to intervene in this continuing process to arrest or reverse the progress of the lesion. Remineralization is the natural repair process for non-cavitated lesions, and relies on calcium and phosphate ions assisted by fluoride to rebuild a new surface on existing crystal remnants in subsurface lesions remaining after demineralization. These remineralized crystals are acid resistant, being much less soluble than the original mineral.

Saliva A review of its role in maintaining oral health and preventing dental disease

“…3 The pH of dental plaque is a key factor in the balance between acid demineralisation of the teeth and the remineralisation of the initial caries lesion. Plaque pH falls each time acid accumulates in the plaque due to bacterial acid production following the consumption of fermentable carbohydrates -mainly sugars -in foods and drinks.…”

Evaluation of efficacy of different surface treatment protocols by laser fluorescence: an invitro study

“…Dental caries is a dynamic progressive disease of tooth with varying phases of demineralization and remineralization. Thus, the thrust in caries management has moved away from restorative phase to detecting caries at an early non-cavitated stage and risk assessment to determine appropriate preventive, intervention and recall frequency [1][2][3].…”

Original Research. Evaluation of Dental Erosion in a Group of Romanian Children Diagnosed with Gastroesophageal Reflux Disease

“…If the enamel is exposed to a durable acidic attack, demineralization will occur, the enamel will lose its integrity, and enamel cavity will be formed. 15 From a nutritional point of view, we can try to reduce the effect of acidic foods by reducing the intake of high quantities of carbohydrates: white bread, pasta, sugary drinks such as coffee, tea and juices. 16 Demineralization and remineralization of the enamel depend on the salivary buffer capacity and volume.…”