II. Epidemiology
- Early childhood carries are the most common chronic condition in children <6 years old
III. Pathophysiology
- Oral Bacteria present (Streptococcus mutans)
- Bacteria ferment dietary Carbohydrates (esp. Simple Sugars)
- Results in polymicrobial biofilm matrix
- Resulting acids are cariogenic
- Acids demineralize tooth enamel and dentine
IV. Risk Factors: Children
- Enamel defects at time of Tooth Eruption
- Premature Infants
- Low Birth Weight Infants
- Low socioeconomic status
- Increased Mutans Streptoccal colonization
- Increased maternal levels of Mutans Streptococcus
- Second hand smoke exposure
- Increased sugar exposure (risk increases with frequency of exposure)
- Sucrose and other Simple Sugar exposure
- Propped baby bottles
- Sugar liquid (e.g. juice) in sippy cup
- Less associated with lactose and cow's milk
- Sweetened pastries may be higher risk
- Diet sodas also increase risk due to low pH
- References
V. Risk Factors: Adults
- See child risk factors above
-
Xerostomia (Dry Mouth)
- See Xerosotomia
- See Medication Causes of Dry Mouth
- Saliva helps remineralize teeth, decreases Bacterial load, and increases oral pH
VI. Symptoms
- See Pulpitis
-
Dental Erosions are initially painless
- Progresses from stimulation after hot or cold exposure to constant pain
VII. Signs
- Pain when patient bites on Tongue blade
- Appearance
- Initial
- Pit or fissure in dental enamel (may be detected by dental probe)
- Appears as chalky white deposit in enamel surface of tooth
- Next
- Brown or Black Tooth Discoloration
- Softening and tooth cavitation
- Initial
VIII. Imaging
- Dental XRays detect caries early
- Low-level lasers detect Dental Caries
IX. Management
X. Complications
- See Pulpitis
- Dental abscess (Periapical Abscess, Periodontal Abscess)
- Periodontal Cellulitis
XI. Prevention
- See Oral Health
- See Oral Health in Children
- See Fluoride Supplementation
- Tooth Brushing with fluoride toothpaste (guidelines vary by age)
- Mouth rinses (e.g. ACT) for adults