Untitled

Tooth

Tooth Composition  

According to Armstrong, Malherbe and Ockerse study of Sound & Carious teeth composition –

                                             No difference were found in calcium, phosphorous, magnesium and carbonate content of enamel But Significant differences in fluoride content of enamel is observed.

According to Malherbe and Ockerse study-

    from sound teeth -Fluoride content of enamel is 410 ppm & dentin is 873 ppm.

   In carious teeth – Fluride content of enamel is 139 ppm & dentin is 223 ppm.

   Armstrong further stated that the enamel of sound teeth contained 0.0111 ± 0.0020 percent fluoride  while that of carious teeth contained only 0.0069 ± 0.0011 per cent fluoride.

   According to Brudevold & associate – Surface enamel is more resistant to caries than sub surface enamel. Surface enamel is more highly mineralized tends to accumulate greater quantities of                     fluoride, zinc, lead and iron than the underlying subsurface enamel. The surface enamel is lower in carbon dioxide, dissolves at a slow rate in acids, contains less water and has more organic material than    subsurface enamel. These factors apparently contribute to caries resistance and partly responsible for slower disintegration of surface enamel than the underlying subsurface enamel in initial carious lesions.

Morphological characteristics of the Tooth

    Enamel Hypoplasia predisposes to the development of dental caries. More sever the tooth affected more extensive will be the caries.

    Morphologic features like presence of deep narrow occlusal fissures or buccal or lingual pits. Such fissures & pits tend to trap food, bacteria & debris.

    Due to Morphologic chararacteristics the rate of caries progress may be influenced, But initiation of caries is affected very little.

Tooth Position

     Teeth which are malaligned, out of position, rotated or otherwise not normally situated may be difficult to cleanse and tend to favor the accumulation of food & debris. In such cases the   caries prevalence is much more than the normal person.

The Saliva factor

Composition of saliva

        The concentration of inorganic calcium & phosphorous in saliva is inversely proportional to rate of saliva flow. According to karshan report calcium & phosphorous content of saliva is low in caries active person.

       Saliva of caries immune persons exhibit a greater ammonia content than saliva from person with caries.

       In 1934 Grove & Grove reported that the ammonia nitrogen of saliva from caries Susceptibles ranged from none to 8.0mg/100ml. ; while ammonia nitrogen in saliva from the caries immune ranged from 4.0 to 10.0 mg/100ml.

 

pH of the saliva

        it is much more debated topic some says there is no direct correlation but saliva pH can control the plaque pH which directly affects the bacterial growth in plaque. But it is a still debatable topic.

Quantity of saliva 

        Theoretically at least, influence caries incidence. This is evident in case of salivary gland aplasia where xerostomia like condition shows the lack of saliva with rampant caries.

Resting saliva- certain amount of saliva is constantly being secreted by salivary gland this constituted amount of saliva is known as resting saliva.

·         Stimulated or Activated saliva also have an effect on caries prevalence.

·         Rate of saliva flow is also a constituting factor in caries prevalence.

·         Viscosity of saliva also affect the caries prevalence.

   Antibacterial property of saliva

Van Kesteren and associates found that the saliva probably contains at least two antibacterial substances. One of which resembles lysozyme. the other being distinctly different.

Diet

Physical nature of diet- Soft refined food cling to the tooth surface if instead of soft food fibrous or hard substance are used  then there is less chance of food clinging. Also the food which require more mastication is good for the oral health.

Carbohydrate content of the diet –Univesally accepted truth about tooth is carbohydrate rich diet is important factor in dental caries.

Vitamin content of the diet- Enamel hypoplasia is observed in vitamin D deficiency. Vitamin K have the enzyme inhibiting activity. So considered as a anticaries agent. Fluorine content of the diet is also the main contributing factor in patients.

Vitamin B6 (Pyridoxine) is hypothetical basis proposed as an anticaries agent on hypothetical ground that it selectively alters the oral flora by promoting the growth of non cariogenic organisms which suppress the cariogenic forms. 

Systemic factors

                                  Heredity is the main systemic factor. In the conditions where tooth enamel or dentin shows hypomaturation or faulty matrix formation Like Amelogenesis imperfecta such teeth are more prone to dental caries. In some diseases of bone & joints like Osteogenesis imperfect teeth hypoplasia is observed such teeth are more prone to caries.

General Oral hygiene & hygiene maintenance

Important factor to control the caries.

  For Best Oral Hygiene -

·         Once a day flossing is necessary

·         Twice a day brushing is mandatory.

·         Massage your gums properly after each brushing.

·         Irrigate & clean your mouth after each meal.

·         Avoid sticky & refined food, use fibrous & vitamin rich food. ”mastication is mechanical cleansing of teeth”.

·         Visit your dentist regularly or scheduled interval for oral prophylaxis.