Dentistry Book


Dental Caries

Aka: Dental Caries, Tooth Decay, Dental Cavities
  1. Epidemiology
    1. Early childhood carries are the most common chronic condition in children <6 years old
  2. Pathophysiology
    1. Oral Bacteria present (Streptococcus mutans)
    2. Bacteria ferment dietary Carbohydrates (esp. Simple Sugars)
    3. Results in polymicrobial biofilm matrix
    4. Resulting acids are cariogenic
    5. Acids demineralize tooth enamel and dentine
  3. Risk Factors: Children
    1. Enamel defects at time of Tooth Eruption
      1. Premature Infants
      2. Low Birth Weight Infants
      3. Low socioeconomic status
    2. Increased Mutans Streptoccal colonization
      1. Increased maternal levels of Mutans Streptococcus
      2. Second hand smoke exposure
    3. Increased sugar exposure (risk increases with frequency of exposure)
      1. Sucrose and other Simple Sugar exposure
      2. Propped baby bottles
      3. Sugar liquid (e.g. juice) in sippy cup
      4. Less associated with lactose and cow's milk
      5. Sweetened pastries may be higher risk
      6. Diet sodas also increase risk due to low pH
    4. References
      1. Garcia-Closas (1997) Am J Clin Nutr 66(5): 1257-63 [PubMed]
  4. Risk Factors: Adults
    1. See child risk factors above
    2. Xerostomia (Dry Mouth)
      1. See Xerosotomia
      2. See Medication Causes of Dry Mouth
      3. Saliva helps remineralize teeth, decreases Bacterial load, and increases oral pH
  5. Symptoms
    1. See Pulpitis
    2. Dental Erosions are initially painless
      1. Progresses from stimulation after hot or cold exposure to constant pain
  6. Signs
    1. Pain when patient bites on Tongue blade
    2. Appearance
      1. Initial
        1. Pit or fissure in dental enamel (may be detected by dental probe)
        2. Appears as chalky white deposit in enamel surface of tooth
      2. Next
        1. Brown or Black Tooth Discoloration
        2. Softening and tooth cavitation
  7. Imaging
    1. Dental XRays detect caries early
    2. Low-level lasers detect Dental Caries
  8. Management
    1. See Pulpitis for dental management
    2. Evaluate for Pulpitis complications
    3. Analgesics
      1. NSAIDs or
      2. Vicodin or similar Opioid
  9. Complications
    1. See Pulpitis
    2. Dental abscess (Periapical Abscess, Periodontal Abscess)
    3. Periodontal Cellulitis
  10. Prevention
    1. See Oral Health
    2. See Oral Health in Children
    3. See Fluoride Supplementation
      1. Tooth Brushing with fluoride toothpaste (guidelines vary by age)
      2. Mouth rinses (e.g. ACT) for adults
  11. References
    1. Douglass (2003) Am Fam Physician 67(3):511-16 [PubMed]
    2. Douglass (2004) Am Fam Physician 70(11):2113-22 [PubMed]
    3. Stephens (2018) Am Fam Physician 98(11): 654-60 [PubMed]

Dental caries (C0011334)

Definition (MEDLINEPLUS)

You call it a cavity. Your dentist calls it tooth decay or dental caries. They're all names for a hole in your tooth. The cause of tooth decay is plaque, a sticky substance in your mouth made up mostly of germs. Tooth decay starts in the outer layer, called the enamel. Without a filling, the decay can get deep into the tooth and its nerves and cause a toothache or abscess.

To help prevent cavities

  • Brush your teeth every day with a fluoride toothpaste
  • Clean between your teeth every day with floss or another type of between-the-teeth cleaner
  • Snack smart - limit sugary snacks
  • See your dentist or oral health professional regularly
Definition (MSH) Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp.
Definition (NCI_CTCAE) A disorder characterized by the decay of a tooth, in which it becomes softened, discolored and/or porous.
Definition (NCI) The decay of a tooth, in which it becomes softened, discolored, and/or porous.
Definition (CSP) localized destruction of calcified tissue initiated on the tooth surface by decalcification of the enamel of the teeth, followed by enzymatic lysis of organic structures, leading to cavity formation that, if left untreated penetrates the enamel and dentin and may reach the pulp.
Concepts Disease or Syndrome (T047)
MSH D003731
ICD9 521.00, 521.0
ICD10 K02, K02.9
SnomedCT 196307002, 155632007, 80967001
English Caries, Dental, Dental Caries, TOOTH CARIES, Decay, Dental, Dental Decay, DENTAL CARIES, Cavity, Dental caries, unspecified, Caries, Carious teeth, DENT CARIES, DECAY DENT, CARIES DENT, DENT DECAY, carious teeth (physical finding), carious teeth, cavities of teeth, caries was observed, Caries dental, Tooth caries NOS, Decay dental, Dental caries NOS, Dental Caries [Disease/Finding], saprodontia, Dental cavities, tooth cavity, decayed teeth, dental cavity, dental decay, tooth caries, cavity, dental cavities, tooth decay, Tooth Decay, Cavities, caries, dental caries, dental caries (diagnosis), Dental caries NOS (disorder), Carious lesion, Cavity NOS, Dental cavity, Dental decay, Teeth decayed, Tooth decay, Tooth decayed, Tooth caries, Saprodontia, Dental caries (disorder), Dental caries, caries; dental, dental; caries, Dental caries, NOS, Dental cavity, NOS
French CARIE DENTAIRE, Caries dentaires SAI, Cavité, Cavité SAI, Carie dentaire, Caries dentaires, Carie, Dent cariée, Taches achromiques des dents
Spanish CARIES DENTAL, caries dental (trastorno), caries dental, Cavidad, Deterioro dental, Caries en diente NEOM, Caries en diente, Cavitación dental, Caries NEOM, caries dentales (trastorno), caries dentarias, cavidad dental, caries dentales, caries dentaria, SAI (trastorno), caries dentaria, SAI, saprodoncia, Caries dental, Caries Dentales, Caries Dental
German ZAHNKARIES, Kavitaet, Zahnkavitaet, Cavity NNB, Zahnverfall, Zahnkaries NNB, KARIES, Zahnkaries, nicht naeher bezeichnet, Karies, Karies, Zahn-, Zahnkaries, Zahnfäule
Italian Carie dentarie, Carie dentale, Deterioramento dei denti, Cavità, Cavità non specificata, Carie dentaria NAS, Cavità dentale, Deterioramento dentale, Carie dentaria
Dutch tandcariës NAO, cariës, tandbederf, gaatje in tand, holte NAO, cariës dentaal, holte, cariës; tanden, tanden; cariës, Tandcariës, niet gespecificeerd, tandcariës, Tandcariës, Caries dentium, Tandwolf, Cariës, tand-
Portuguese Cavidade, Cavidade NE, Cárie dentária NE, Cavidade dentária, CARIES DENTARIAS, Cárie dentária, Cárie Dentária, Cáries Dentárias, Dente Cariado
Japanese 齲窩, 空洞, 齲歯NOS, 空洞NOS, クウドウNOS, ウシNOS, ウシ, クウドウ, ウカ, ウ蝕, 齲蝕症, むしば, 虫歯, 歯の白斑, 齲歯, 齲蝕, むし歯, う歯, う蝕
Swedish Karies
Czech zubní kaz, Zubní kaz, Zubní kavita, Kavita NOS, Karies, Zubní kaz NOS, Kavita, Caries dentis
Finnish Karies
Korean 치아우식증, 상세불명의 치아우식증
Polish Próchnica zębów
Hungarian Üreg, Fogszúvasodás, Fogcaries k.m.n., Fog szúvasodása, Dentalis caries, Fog caries, Dentalis üreg, Dentalis fogszúvasodás, Szúvas fog, Üreg k.m.n.
Norwegian Hull i tennene, Karies, Tannråte
Derived from the NIH UMLS (Unified Medical Language System)

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