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1-We
now know that in a mouth there is a continuous cycle of demineralization and
remineralization in the tooth surface, so that we can consider to caries as a
dynamic process.
If the acidity on the surface of a tooth below the pH of 5.5, there will be a
release of calcium and phosphate ions, which are encompassed in the saliva. But
since saliva is a saturated solution of these ions, the possibility exists that
these super return to the surface of the tooth. If the saliva pH rises above
5.5, any injury that may affect only enamel remineralisation and "healing".
2 - The disease starts when a super long tooth surface is exposed to the acids
produced by fermentation of carbohydrates by cariogenic bacteria present
capacity in dental plaque.
3 - In enamel, crystals of calcium and phosphate are lost by dissolution in the
subsurface after the oral fluid pH falls to less than 5.5. This loss usually
occurs when the defensive mechanisms in the oral cavity are not sufficient to
protect the enamel from the harmful effects of frequent acid attacks.
4 - If the loss of calcium and phosphate crystals continues, large areas develop
micro pores. These areas are visually identified as "white spots" when the tooth
is dried or unseasoned is also displayed. If the loss of tooth structure
remains, develops caries cavity. In the roots, early carious lesions soften and
discolor the cementum and dentin (dark yellow or brown) These characteristics
are the result of the loss of organic and inorganic components of dentin and
cementum.
5 - Remember that caries is a chronic process of slow progress (although it can
have acute phases) than in its early stages is asymptomatic, the goal is to
examine a patient and find the earliest signs of this disease in the enamel and
root . If discovered early signs of demineralization, can advise the patient on
preventive care to reverse this process.
6 - It is important to dental caries as a polymicrobial infectious disease.
Carving and plugging a tooth is not the only solution to the damage caused by
the decay process and is not an effective method to treat caries infection
(Gregory et al1998) It is necessary to manage a comprehensive and preventive
treatment of dental caries, especially for Patients with high caries activity.
7 - To provide a comprehensive program of prevention and dental treatment for
patients with high caries activity, an assessment will be conducted to identify
the biochemical factors directly involved, oral hygiene habits, diet, use of
fluoride products, the microbial infection in the mouth, salivary flow, buffer
capacity of the same and host susceptibility factors to evaluate. "
8-In the absence of an effective vaccine against tooth decay today, prevention
and early diagnosis of this disease are our most valuable tools.
1 -
The difficulty of developing a vaccine against tooth decay lies:
a. In several microorganisms that are responsible for this disease (Streptococcus
mutans, Actinomyces naeslundii and Capnocytophaga gingivalis, Lactobacillus
....)
b. The location of the same: The oral cavity
Bibliography
1. Anderson DM, Langeland K, Clark GE, et al. Diagnostic Criteria for the
Treatment of caries-nduced pulpitis. Bethesda MD: Department of the Navy, Navy
Dental Research Institute, NDRI-R 81-03, March 1981.
2. Money Barrancos Editorial Panamericana Operative Dentistry Third Edition 1981
3. Bhaskar SN. Oral pathology, sixth edition, Buenos Aires, El Ateneo, cap, 5
"Injuries to hard dental tissues," 1984
4. MacGregor AB. The position and extent of acid in the Carious process. Arch
Oral Biol, 1961, 4:86
5. WA Miller and Massler M. Permeability and stainning of active and arrested
Lessions in dentine. Brit Dent J. 1962, 112; 187
6. Langeland K. Tissue response to dental caries. Endod Dent Traumatol 1987; 3:
149-71.
7. Langeland K. Tissue changes in the dental pulp. An experimental histologic
study. Oslo: Oslo University Press, 1957, 19, 71.
8. Langeland K, Rodriguez M, Dowden WE. Periodontal disease, bacteria, and
pulpal histopathology. Oral Surg Oral Med Oral Pathol 1974; 37: 257-70
9. Langeland K. Management of the inflamed pulp associated with deep Carious
lesion. J Endod 1981, 7:169-81.
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