Dental caries is an infectious and transmissible disease intiated by a heterogeneous group of gram-positive bacteria present in the biofilm that forms on teeth soon after eruption. This complex community of bacteria, termed dental plaque, contains Streptococcus mutans, which is a necessary agent for the production of dental caries. S. mutans has been shown to be transmissible from parents or caregivers to infants at the time of tooth eruption. The dental health of direct caregivers thus becomes an important factor in the prevention of dental caries.
Dental caries disease is usually classified by four different factors:
(1) according to anatomic site of the lesion,
(2) according to the severity or rate of progession of the lesion,
(3) according to age patterns at which lesions predominate, and
(4) according to therapies that can induce decay.
Caries can occur in teeth of persons of any age, but when the disease occurs in children younger than 3 years, the condition is termed early childhood caries. Previously, most descriptions of early childhood caries focused on the period of nursing, giving rise to the term nursing bottle caries. It is now recognized that early childhood caries can be present in the absence of bottle- or breast-feeding and conversely does not always result from inappropriate bottle- or breast-feeding practices, indicating that other host susceptibility factors are involved.
Regardless of age or circumstance, all carious lesions must be eradicated by some means. Failure to do so eventually leads to invasion of the pulp chamber of the tooth with inflammation, pain, swelling, and exudation. Since the tooth pulp is encased within a rigid structure, necrosis of the tissue within the pulp chamber occurs because of the increased pressure, which prevents blood flow. An ensuing buildup of toxic products in this space will force extension of the process into the tissue surrounding the root apices, forming an abscess within the bone. Cellulitis with acute pain Continue reading »