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Theories &Diagnosis of Dental caries ( Lecture ( 6 Dr.Baha, H. AL-Amiedi Ph.D.Microbiology :Classification of Dental caries Dental caries can be classified with respect to the site of the lesion and diagrammatically in of lesion as Bit and fissuer -1 Smooth Surface -2 Root surface -3 Recureent caries -4 : Theories of etiology of caries : -1Early TheoriesA-Worms tooth aches caries caused by worm B-Humors : unbalance between the humors : ( blood , black bile , yellow bile ( 2-Vital Theory : origination of dental caries with in tooth it self extensive -2 penetration into the dentin & into pulp 3-Chemical Theory : chemical agents responsible for caries4-Parasitic or septic Theory : filmentous microorganisms caused decomposition of the enamel and the dentin 5-Chemo - parasitic Theory (Miller 1890) : caries is caused by acids produced -5 by oral cavity microorganisms of the mouth miller 1890 concluded that the . process was mediated by microorganisms produced acids and digestion proteins 6-Proteolytic Theory(Gottlib 1944) : it has been proposed that the organic -6 matrix or protein elements of enamel are the initial pathway of invasion by oral cavity microorganisms 7-Proteolysis – chelation Theory : this theory considers dental caries to be -7 bacterial destruction of teeth where the initial attack essentially on organic component of enamel and the end products of proteolysis acts as a chelating.agent :(Bacterial caries susceptibility test(synder test Many attepts have been made to develop sutable diagnosis test for the determination of caries susceptibility of an individual. most of these tests have been based on differences in type of bacteria present in the microflora of caries & whether these microflora of caries are .capable of producing acid when incubated with sugar, usually glucose There have have been number of modifications of this test in 1965 Grainger introduced a swab for the buccal surface of teeth, the placing in semifluid synder type medium& incubating at 37 C for 96 hr .Test reading by color comparison to standard test Reading of synder modification test Diffusion acid color change to from yellow top down one fourth + or less of tube, from top down ++ color change to yellow, one half of tube from top down +++ color change to yellow, three fourths of tube , from top down ++++ _ color change to yellow, entire tube No color change The current approach to diagnose The current approach to diagnose dental caries Naked eyes-1 Mechanical probing-2 X-ray-3 The current approach to treat dental caries Surgical repair Fluoride treatment Mechanical removal “Gross” Visual Examination