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dental caries (tooth decay)

Pathology: - localized, progressive destruction of a tooth (or teeth) - starts at the external surface, generally the enamel, with demineralization of the tooth by organic acids produced by bacteria (in plaque), followed by destruction of the protein matrix, bacterial invasion & cavitation. - stained pits & fissures - dental caries in elderly: [2] a) generally at the root surface b) painless Complications: - pulp cavities: - rare, painful - pulpitis occurs with erosion extending down to the pulp cavity - can effect root of tooth or result in periodontitis - Ludwig's angina - dental caries linked to increased risk of ischemic stroke especially among African Americans (RR=1.4) [6] Management: - fluoride toothpaste [3] - pulpitis is treated by removal of dental cavity & dental filling - periodontitis is treated with a root canal

Related

pulp cavity

General

tooth disease; odontogenic disease

References

  1. Stedman's Medical Dictionary 27th ed, Williams & Wilkins, Baltimore, 1999
  2. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004 - Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
  3. American Dental Association Council on Scientific Affairs. Fluoride toothpaste use for young children. J Am Dent Assoc 2014 Feb; 145:190 PMID: 24487611 http://jada.ada.org/content/145/2/190
  4. U.S. Preventive Services Task Force. May 2014 Prevention of Dental Caries in Children from Birth Through Age 5 Years. http://www.uspreventiveservicestaskforce.org/uspstf12/dentalprek/dentchfinalrs.htm
  5. American Academy of Pediatrics Maintaining and Improving the Oral Health of Young Children. Pediatrics. Nov 24, 2014 PMID: 25422016 http://pediatrics.aappublications.org/content/early/2014/11/18/peds.2014-2984.full.pdf+html
  6. Sen S, Logue L, Logue M et al Dental Caries, Race and Incident Ischemic Stroke, Coronary Heart Disease, and Death. Stroke 2023. Nov 29 PMID: 38018831 https://www.ahajournals.org/doi/10.1161/STROKEAHA.123.042528