�� 2500 B.C.—Chinese—little white worms with black spots on heads caused decay
�� 350 B.C Aristotle, et. al., figs and sweets caused decay
�� 1819—Livei Parmly linked bacteria to decay created by a combination of lodged food and an “active poison which causes teeth to corrode.”
• 1840—John Tomes—heat and moisture caused decomposition in the mouth
�� 1881—Miles & Underwood—germs secreted acid that led to decay
�� 1889—W.D. Miller— chemico-parasitic theory— carbohydrate retention + acidogenic bacteria
1938—H. Trendley Dean links fluoride to caries reduction
�� 1955—Crest develops first fluoridated toothpaste
�� 1990s—water fluoridation ...view middle of the document...
�� Streptococcus mutans has long since been the primary culprit and the most prolific among the organisms in the bacterial plaque that can lead to the development of caries, along with Streptococcus sobrinus.
�� Lactobacillus (casei, fermentum, and plantarum) is also capable of producing (lactic) acid that leads to the demineralization of the tooth surface.
Causal Factors: The Host
�� Tooth-Teeth become susceptible to decay when exposed to the cariogenic
microorganisms in the mouth.
�� Saliva- serves as a buffer in the oral cavity; when the pH drops to a low level
in the presence of plaque, it remains low causing an acid to develop which breaks
down the enamel, thereby causing demineralization.
Causal Factors: The Host(2)
�� The main buffering agent in saliva is sodium bicarbonate.
�� It helps to keep the saliva neutralized, otherwise the oral cavity would be a
constant acidic environment, much like that of the bulimic patient or someone with acid
�� In the previous cases, gastric juices invade the oral cavity, making it difficult for teeth to remain intact if conditions are left untreated.
Causal Factors: The Host(3)
�� The immune response- The individual’s ability to resist disease.
�� When resistance is low, the host becomes susceptible to disease, any disease and caries is no exception.
�� Systemic conditions invade the body and it cannot withstand the stress from a bacterial invasion. Essentially, prevention is the key.
�� Reduce stress levels, eat a variety of healthy foods and seek frequent dental care to avoid problems.
Causal Factors: The Environment
�� Dietary concerns become a factor when discussing dental caries.
�� When assessing the needs of the patient, the dental professional must consider the diet of an individual.
�� If a patient is presented with multiple carious lesions, one should not simply assume that neglect or ignorance is the cause.
�� Ask questions to find out what the patient consumes on a regular basis that may be highly cariogenic, such as sugary foods, hard candy, soda pop, and even antacid tablets & cough drops.
Other Contributing Factors
�� Systemic conditions- can limit or inhibit healing time. May also prohibit the patient from performing home care or getting to dental office.
�� Age- people are living longer, keeping their teeth longer—exposes teeth to the acidic oral environment longer as well.
�� Leads to increased caries risk, particularly root caries due to natural progression of gingival recession as part of the aging process, along with other dental problems such as attrition and toothbrush abrasion.
Contributing Factors (2)
�� Medications- some dry out the mouth, decreasing salivary flow.
�� Chemotherapy or radiation therapy patients often times need fluoride supplements or a salivary substitute to reduce caries risk.
�� The elderly have many nutritional deficiencies resulting in a high caries risk. Many are confined...