|SECTION I||OVERVIEW OF DENTAL DECAY (CARIOUS LESIONS)|
Tooth destruction can occur from dental decay, attrition (from tooth-to-tooth wear), abrasion (from improper toothbrushing with abrasive toothpaste), erosion (from acids), and fracture. Dental caries [CARE eez] (always plural, never a carie), known more commonly as tooth decay, is the most common cause of tooth destruction. Caries (which literally means “rotten”) results from the loss of mineralized tooth structure from enamel, dentin, and cementum. This loss of minerals is called demineralization. Caries formation on a tooth requires the following:
- BACTERIA: Specific caries-producing bacteria like Streptococcus mutans and lactobacilli must firmly adhere to the tooth in a layer called dental plaque [PLAK], which is a type of microbial biofilm.
- CARBOHYDRATES/SUGARS: Certain carbohydrates, especially sugar-containing food such as candy, honey, pastries, and especially nondiet, sugar-containing soft drinks, react with certain bacteria in dental plaque to form acids (such as lactic acid) that act upon hard tooth structure resulting in the loss of minerals.1 Caries formation is greatly influenced by the acidity of the biofilm, which, in turn, is influenced by the acidity of ingested foods and acidic beverages. Therefore, sports drinks, soda (diet and nondiet), and any drink with an acidic pH below 5.5, if frequently consumed, will increase the demineralization process. (The pH is the numerical range from 1 to 14 used to denote the amount of acidity or alkalinity: pH of 7 is neutral, lower than 7 becomes more acidic, and higher than 7 is more alkaline.)
- TIME: As enough minerals are lost over time (demineralization), a hole (or cavity) can form.
Patient education and prevention techniques taught in dental offices and presented in the media are important aspects of dental patient care. Demineralization can be reduced if a person removes dental plaque by using good oral hygiene measures like toothbrushing and flossing. Further, since acids can begin to damage a tooth every time it is exposed to snacks and acidic beverages, patients must be educated to reduce the amount and frequency of certain carbohydrates like sweets and acidic drinks in the diet. Frequent intake of carbonated, nondiet soft drinks can be especially damaging since these drinks not only contain sugar but are also mildly acidic due to the carbonation.