LESSON 3: ETIOLOGY OF DENTAL CARIES Flashcards
What is the meaning of the word ‘Etiology’?
Cause
What are the theories involved in the Early Theories?
- Exogenous Theories
- Endogenous Theories
There is a presence of tooth worm that makes a hole through the teeth and hide beneath its surface. It drinks blood and feeds on the roots of the jaws.
Legend of Worm
YEAR: Legend of Worm
5000 B.C. (Sumerian Text)
Caries are caused by chemical disintegration of the tooth. The putrefaction of protein led to formation of ammonia which was subsequently oxidized to nitric acid.
Chemical Theory or Acid Theory
Who opined that caries are caused by chemical disintegration of the tooth?
Robertson, 1835
According to them, filamentous microorganisms caused decomposition of the teeth. (Parasitic or Septic Theory)
Erdl and Ficinus, 1843
Who recognized the first organic matrix in enamel?
Ficinus
What are the 3 EXOGENOUS THEORIES?
- Legend of Worm
- Chemical/Acid Theory
- Parasitic or Septic Theory
(Uminom ng Chemical yung Parasitic Worm)
What are the 2 ENDOGENOUS THEORIES?
- Humoral Theory
- Vital Theory
(VITAL ang HUMOR para long life. tangina niyo wag niyo tawanan ./.)
What are the four humors or elemental liquids of the body?
- Blood
- Phlegm
- Black Bile
- Yellow Bile
Imbalance in this 4 humors determine the person’s physical and mental constitution.
Humoral Theory
The Vital Theory is proposed by?
Hippocrates, Celsus, Galen, and Auicenna in 18th Century
Tooth decay originated like bone gangrene from within the tooth itself.
Vital theory
What are the 3 NEW THEORIES?
- Chemico-Parasitic Theory by Miller, 1890
- Proteolytic Theory
- Proteolysis-Chelation Theory by Schatz, 1955
Caries is caused by acids produced by oral bacteria following fermentation of sugar.
Chemico-Parasitic Theory
Two stages of Chemico-Parasitic Theory
- Preliminary Stage - Decalcification of E, Destruction of D
- Subsequent Stage - Dissolution of the softened residue of E & D
Theory which says that the organic portion of the tooth serves as pathways for advancing microorganisms causing demineralization of the teeth and therefore dental caries.
Proteolytic Theory
(Heider and Bodecker, 1878
Abbot, 1879)
Who suggested that the initial lesion of the carious process is due to the proteolytic enzymes attacking the lamellae, rod sheaths, tufts and wall of tubules.
Gottleib, 1944
(Proteolytic Theory)
Proteolytic organisms that causes the yellow pigmentation characteristic of caries.
Staphylococcus
Who proposed that the first step in carious process is the breakdown of dental cuticle (protective layer of enamel)
Pincus, 1949
Nasmyth’s membrane and enamel proteins are acted upon by sulfatase enzymes producing sulfuric acid. This acid plus the calcium of hydroxyapatite crystals destroys the inorganic component of enamel.
Proteolytic Theory (Pincus, 1949)
This theory states that dental caries is a bacterial destruction of organic components of enamel and the breakdown products if these components have chelating properties dissolving the minerals in enamel.
Proteolysis-Chelation Theory (Schatz, 1955)
There is simultaneous microbial medegradation of organic component by proteolysis and dissolution of inorganic part by chelation (namumuti yung surface).
Proteolysis-Chelation Theory (Schatz, 1955)
What are the etiologic factors in dental caries?
- The Host (Teeth, Saliva)
- Microflora
- Substrate (Diet)
- Time
Factors changing the economic implication of treatment of dental caries:
- Economic status of population
- Increasing educational status
- Growing number of dental graduates
- Insurance programs
- Commercial Pressure
- Governmental Influences
Factors of Dental Caries as an Infectious Disease:
- Susceptible Tooth Surface
- Cariogenic Bacteria
- Dietary Fermentable Carbohydrates (Esp. Sucrose)
Composition of Enamel
96% Inorganic
4% Organic
Composition of Dentin
65% Inorganic
35% Organic
Cementum
45-50% Inorganic
50-55% Organic
What is the feature predisposed to the the development of dental caries?
Presence of narrow occlusal fissure/buccal and lingual pits
When this is malaligned, out of position, rotated or otherwise not normally situated, teeth may be difficult to clean and tend to favor the accumulation of food and debris which subsequently lead to dental caries.
Tooth Position
Factors that affect the saliva as a host:
- Composition
- PH
- Quantity
- Viscosity
- Antibacterial Factors
What are the other host factors aside from the teeth and saliva?
- Age
- Socioeconomic Status
What are the microflora of the teeth?
- Streptococcus Mutans
- Lactobacilli
- Actinomyces
Increased _______(diet) increases carious activity.
Carbohydrates
Role of Microorganism in Dental Caries
Prerequisite of Dental Caries Initiation
The oral cavity is generally a warm place, at a body temperature (___°C) encouraging the growth of bacteria
37°C
Transmission of Streptococcus Mutans
Vertical Transmission
Soft, non-mineralized, bacterial deposit which forms on a teeth that are not adequately cleaned.
Dental Plaque
Important component of dental plaque
Acquired Pellicle
Microbial in dental plaque
- Streptococci
- Actinomycetes
- Veillonella
Chief etiological agent of dental caries
Streptococcus Mutans
Caries Process
- Caries of Enamel (Smooth Surface Caries & Pits and Fissures Caries)
- Caries of Dentin
- Caries of Cementum
Stages of Tooth Decay
- Stage 1 - Healthy Tooth
- Stage 2 - The acid dissolves the enamel, making a small hole.
- Stage 3 - The decay reaches the dentin and travels much faster. (Painful)
- Stage 4 - The decay has reached the pulp, causing an abscess. (Very painful)
