Oral conditions

Tooth decay

The dental caries is one of the most most common diseases of the mouth. Jtogether with periodontitis, is among the leading causes of tooth loss..

Very few people in their lifetime have been fortunate enough to never visit the dentist because of a severe toothache caused by a deep cavity.

What is caries?

Caries is a disease that slowly slowly leads to the loss of enamel and and dentini.e, the hard tissues of the tooth.

Initially the enamel is damaged. At this stage, it is also it is also difficult to realize that caries is that caries is present in its initial stage.

Only the dentistthrough a careful analysis, can check for the presence of that small speck that indicates that the tooth has been damaged.


The causes of tooth decay are of two types: on the one hand, we have the exogenous factors exogenous factors and on the other endogenous factors.

Exogenous factors

Exogenous factors are those external external factors that condition and promote the formation of caries.

The main ones are microbial microbial factorswhich favor the formation of biofilm, a gelatinous layer formed by microorganisms that affect the teeth, hence the absolute importance of oral hygiene. absolute importance of oral hygiene..

Dietary factors are also crucial, especially high intakes of sugary foods and beverages. high intake of sugary foods and beverages, as these are substances that favorThese are substances that favor the proliferation of cariogenic bacteria.

Another factor that should not be underestimated is smoking. The smoking contributes significantly to the formation of plaque and tartar, favoring the formation of caries.and tartar formation, favoring the formation of caries.

Endogenous factors

Endogenous factors are those intrinsic to the intrinsic to the subjectsuch as constitutional factors characterized by a weak tooth structure.

The type of salivation is also important in the formation and development of caries.

The reduction of salivation both quantitativelyreduction of salivation, reduction of salivary production as well as qualitativelyThe reduction of salivation, alteration of pH, changes in the concentrations of the components of saliva, can be an indirect aid to the caries process.

The saliva has a cleansing function and is able to buffer acids that are formed during feeding.. It constitutes a protective barrierTherefore, if it is too weak, it cannot adequately protect the oral cavity.


Acids produced by bacteria in the presence of food debris food debris, are the main cause of the caries formation process..

Without a thorough cleaning, these acids begin to acids begin to erode the tooth enamel, causing the first lesions (first degree caries).causing the first lesions (first degree caries).

A through them, bacteria and acids reach the innermost layers of the tooth. First to the dentin, which is less resistant than enamel to the effect of acids, increasing their destructive action (second-degree caries).

The advance of caries continues uninterrupted and deeper and deeper, reaching the innermost layer of the tooth, the dental pulp, which contains blood vessels and nerves (third degree caries).reaching the innermost layer of the tooth, the dental pulp, which contains blood vessels and nerves (third degree caries).

At this time, the tooth is severely infected and if left untreated caries can also reach the bone, compromising the entire tooth structure (grade four caries).compromising the entire tooth structure (grade four caries).

Caries then develops from the outside to the inside of the tooth, with a slow and variable time course. On average the caries process evolves over a period of 6 months to 2 years, depending on the influence of various endogenous and exogenous factors.depending on the influence of various endogenous and exogenous factors.


The tissues of which the teeth are composed do not do not have the capacity for self-regeneration, for this reason it is important to go to the odentist to treat caries..

The treatments carried out depend on the type of caries depend on the type of caries and its stage of development..

The first thing the dentist will do dentist is check where the cavity is located y the general condition of the teeth that have been affected.In most cases, an x-ray will be needed.

The main objective is to try to save the tooth whenever possible, eliminating the tissue affected by the caries.

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Filling is the most commonly used method used for this purpose, y consists of treating the lesion removing the carious part with a dental drill with a dental drill and filling the cavity with a suitable material.

Depending on the amount of tooth surface involved, more advanced treatments will be required, such as the placement of a prosthetic crown to replace the natural one.

When the caries has penetrated deep into the tooth, affecting the dental pulp, it is necessary tothe dental pulp, it is necessary to devitalize the tooth. devitalize the toothIn this case, a pathway is created to the pulp chamber, which is carefully cleaned with the help of dental files and filled with an inert substance called gutta-percha. The tooth is then reconstructed with an inert substance called gutta-percha, the tooth is then reconstructed with a filling or a new crown as needed.as needed.

The most extreme solution is tooth extraction extraction of the tooth if the tooth is irreparably compromised and even more serious complications are to be avoided.


The measures to prevent caries are simple, but they must be carried out regularly:

  • Brushing your teeth teeth after every meal, at least twice a day twice a day. An excellent way to complement the use of toothbrush and toothpaste is the use of a Mouthwash and dental floss.
  • Perform check-ups at the dentist every 6 or 12 months (depending on the physiology of each person, following the dentist's recommendation). Early detection of caries greatly simplifies the treatment necessary to combat it.
  • In the case of a high propensity to develop cavities, it is possible to use dental sealantssealants, which are protective applied on the chewing surfaces of the back teeth (the most difficult to clean with a toothbrush) to close grooves and fissures (potential plaque accumulation areas). Their use is possible for both children and adults.
  • Limit the consumption of foods that can easily get stuck in the spaces between teeth in the spaces between the teeth and in the grooves of the chewing surfaces (e.g. cookies, jelly beans). and in the grooves of the chewing surfaces (e.g., cookies, jelly beans).
  • Moderate consumption of sugary foods and sugary beverages.

How many types of caries are there?

Cavities are usually classified as follows:

  • Acutewhen it develops in less than one year.
  • Chronicwhen it develops slowly and steadily for a couple of years.
  • Recurrentwhen it reappears if not adequately treated.

Furthermore, according to the process of caries formation, caries are divided into different classes:

  1. Dry or arrested caries.
  2. Crown caries.
  3. Cervical caries.
  4. Cement caries or senile caries.
  5. Interdental caries.
  6. Central caries.
  7. Caries of milk teeth.

1. Dry or arrested caries

This type of caries gets its name because its progression stops in the superficial stops in the superficial layer of the tooth, i.e. of the tooth, i.e, it only attacks the enamel and does not continue its development in depth.

The damage is essentially estheticThe damage is essentially esthetic, with a dark stain, especially when it occurs on the front teeth, and is totally asymptomatic.

In these cases, the body itself is able to cope with the caries. caries preventing or slowing its progression.

2. Crown caries

This is the most common type of caries and affects the part of the tooth part of the tooth visible outside the gum, the crown, as it is the most the most exposed to the effect of bacteria from food debris..

In intermediate stages, it is a caries that is easily diagnosedvisible to the naked eye, it can usually be it can be detected in time before it begins its process towards the interior of the dental piece..

3. Cervical caries

When caries affects the neck area of the neck area of the tooth, i.e.i.e, the area closest to the gumwe speak of cervical or neck caries.

The main cause of this caries is undoubtedly the accumulation of food residues. accumulation of food residues in the gum in the grooves of the gums, product of an incorrect incorrect oral hygiene.

This is a stealthy cariogenic processnot only because it starts in a hidden area of the tooth, but also because it often leads to other pathologies. it often leads to other pathologies, such as gingivitis and periodontitis.such as gingivitis and periodontitis.

4. Cement caries or senile caries

This type of dental caries affects the root of the tooth being more frequent older people, hence the name senile caries. It can also affect those who suffer from gum recession. In these cases the gum does not adequately protect the root of the toothleaving the way free for plaque and tartar to for plaque and tartar to deposit.

Here, caries has it easy; it does not suffer much resistance from the tooth structure and it easily and quickly reaches the inside of the tooth. and quickly and easily reaches the inside of the tooth. In this case, the damage caused is irreversible and the tooth extraction is extraction of the tooth is almost inevitable.

5. Interdental caries

It is undoubtedly the most insidious most insidious cariesas it affects the affects the interstitial enamelin the space between two teeth and near the gums, eroding the enamel y deepening in the dentin and dentin and the pulp of the tooth.

The molar teeth are the most easily attacked by interdental caries due to their delayed position, their larger interdental surface and their greater difficulty to be cleaned in depth. difficulty to be cleaned in depth..

Difficult to detect with the naked eye, so the patient often comes for consultation when the damage has progressed. the damage has progressed and the pulp has also been compromised. In this case, devitalization of the decayed tooth with reconstruction of the extracted part is necessary.

6. Central caries

It is a cavity caries that is not noticeablebecause it originates originates in the interior of the toothslowly emptying it until the structure cannot withstand the pressure exerted during chewing and the tooth breaks off. tooth breaks.

A cavity, therefore, that acts in the opposite way to the others, which start from the outside and extend extend in depth.

Often, a tooth affected by central caries is destined to be extracted. It can only be can only be diagnosed by radiographs and should be treated as soon as possible, to avoid the formation of granulomas, periodontitis and abscesses, or before it also affects the bone.

7. Caries of milk teeth

Unfortunately, caries in children is becoming more and more frequent. A incorrect diet and superficial oral hygiene are the most are the most common errors that favor the appearance of caries. the appearance of caries.

Baby teeth are notoriously are notoriously more fragile than permanent teeth because they have a less complex and resistant structure.

Contrary to popular belief, decayed baby teeth should also be treated, decayed deciduous teeth should also be treated, even if they are destined to fall out and be replaced by the adult dentition.even if they are destined to fall out and be replaced by the adult dentition.

This caries, can cause damage at the periodontal levelIt can also affect the germ of the permanent teeth that are ready to erupt.

More information and references

A guide to the prevention and treatment of dental caries
Help guide

A guide to the prevention and treatment of dental caries


Frequently Asked Questions

Caries forms as a result of the action of bacteria, normally present in the oral cavity, accumulated in the the biofilm biofilm which tenaciously adheres to tooth enamel, so it is important to remove it.o It is therefore important to remove it mechanically on a daily basis, i.e. by brushing the teeth..

Aguda, when it develops in less than a year, cronic, when it develops slowly and steadily over a couple of years, and ronic, when it develops slowly and steadily over a couple of years. and recurrenwhen it reappears if not adequately treated.

He is thehe dentist who The presence of caries is usually easily detected by the dentist using special instruments to probe theas cavities produced in the enamel. in the enamel. X-rays can also be taken to check the degree of severity of the carious lesion.It is therefore important to attend regular check-up visits.

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