Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
DENTAL CARIES DENTAL CARIES • Chronic, painless slowly progressive and destruction of the enamel and dentin by the acid produced by plaques bacterial that ferments carbohydrates. Acid enhanced demineralization. DENTAL CARIES • The prevention and control of dental caries. • The role of dietary factors, including minerals, vitamins trace elements, and carbohydrates on tooth formation and their relation to dental caries development have been discussed before. Protecting the teeth • One of the major to caries prevention to protect the teeth from the attack of acid which occurs as a result the fermentation of carbohydrates, these can be achieved by. 1. Fluoride • Water fluoridation, salt fluoridation, fluoride containing tablet or gels all of these found to be capable of preventing caries in population or selected subjects. • People exposed to one part of a million of fluoride or more in their drinking water had fewer cavities than those who drink fluoride – free water. • Field studying showed that fluoride reduces the incidence of caries in children by as much as 50 %. • These are means by which fluoride shows its cariestatic effect by: 1. Anti-acid 2. Remineralizations 3. Antibacterial 4. Inhibition translocation of sugar across the cell membrane into the cell. • Antacid (Resistant to acid attack). • Conversion of hydroxyapatite basic component of enamel and dentin to flouroapatite. So the flouroapatite dissolve slowly in acid and becomes more resistant to acid attack. • Remineralizations of caries lesions • Fluoride act as an enzymes inhibitor to prevent oral bacteria from converting carbohydrate to acid as a result they produce a remineralization of caries lesions by causing • calcium phosphate to precipitate from a saturated saliva. In addition deposition of a mixture of fluoride containing salt in caries lesion. • Antibacterial (bactericidal) effect. • Fluoride can acts as an antibacterial which decrease acid production by plaque bacteria by dissolving number of bacteria. • Topical application of stannous fluoride is more effective than the sodium fluoride. • Application of fluoride phosphate mixture (1:23) topically to the teeth of children decreased caries from 30 to 70 % 2. Antimicrobial agents • The relations between antibiotics and reduction of caries development have been observed in: 1. Animal supplied with antibiotics in their food and water 2. Patients receiving penicillin each day for rheumatic fever 3. Patients with chronic respiratory diseases. • Dental caries development reduced in all cases mentioned about than others who do not take antibiotic. • The cariestatic effects of large number of antibiotic have been studied including: • Penicillin, kanamycin, vancomycin, auromycin , bacitracin, chloramphenicol, streptomycin and tetracycline. Penicillin: • is the most wildly tested as a caries preventive in man and animals. • It acts in acidogenic gram positive (+) in particular streptococci bacteria that inhibit caries activity by decreasing the oral microbial flora. Vancomycin: • Is a cell wall inhibitor, act on gram positive (+) bacteria. It does not absorbed into the body, so it can be used as a topical anti-caries agent. It suppresses the levels of s. mutant on occlusal surfaces. • Generally . • Penicillin has the most cariestatic activity. • Chloramphenicol , streptomycin, and terramycin are moderately effective. • Other antibiotics have slight effect. • Complications of antibiotics used for dental caries are: control – Prolonged treatment with penicillin eradicate gram positive (+) cocci, while encourage the gram negative (-) flora (E. coli, K.pneumoniae and P. aeruginosa in the mouth and upper respiratory tract). Also encourage Candida albicans. – Oral intake of chloramphenicol and oxytetracyline can convert the intestinal flora to staphylococcus aureus which produce severe entiritis. – Development of resistant bacterial strains. Many oral and nasopharyngeal staphylococcus are resistant to penicillin. – Allergy to penicillin. 3. Topical antiseptics • Cholorohexidine • Used as a mouth rinse/mouthwash • Antimicrobial against many organism including many members of the oral flora • Studies in humans and animals showed that cholorohexidine mouth rinsing inhibit development of plaques. • • • • Cholorohexidine side effect. Bitter taste. Staining of the enamel and the tongue. Development of resistant microorganism . 4. Enzyme preparation • Enzymes that are capable of disrupting plaque have been studied. Dextranses disrupt the extracellular glucans, the important component of plaque. • Therapeutic dentrifrices: • Dentrificas were designed to maintain oral hygiene by cleansing the teeth and periodntrium by liquid paste and powder to prevent periodontal disease. 5. Immunization against caries • S. mutant produce glucans from sucrose by the effect of dextransuxcrose (glucosyltransferase). Dextransucrose is a good antigen to be used in a caries vaccine.Antibody against this enzymes will inhibit glucan preparation. • When crude enzyme is injected in the salivary gland of rats and hamsters, a local protective secretory immune response is induced (active immunization). • Caries immunization studies show that IgA antibody reveal protection against caries. • Another type of caries immunization induce the passive transfers or direct suppling to the oral cavity of antibodies to bacterial. 7. Carbohydrate restriction • Dental caries can be avoided by reducing sugar in diet or sweets between meals. • Replacement of carbohydrates by proteins and fats can reduce dental caries. • Use non-carbohydrate sweetening materials or sugars. • Substitute in food and drink , can reduce dental caries such as aspartame , this compound is 150 to 200 times sweeter than sucrose use in cold sweets, sugarless gums, drink mixes, coffee, tea. 8. Anti-carcinogenic effect of phosphate • As mentioned dental cries decreased up to 70 to 90 % when phosphate increased in diet. • Phosphate could buffer acid producers by plaque bacteria, affect bacterial metabolism. • Plaque bacteria • Modify adsorption of proteins to enamel • And alter adherence capacity of plaque bacteria.