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What are cavities? What causes cavities in the tooth? – Part 3

• Tooth decay is generally known as cavities or even a cavity.
• It is deemed as an infection that is bacterial in origin.
• It causes demineralization and destruction of the hard tissues.

Causes for Cavities

1. Teeth Problems
• There are certain diseases and disorders affecting teeth.
• This will leave a person to have higher chances for cavities.
• Amelogenesis imperfecta occurs between 1 in 718 and 1 in 14,000 individuals.
• It is a disease in the location where the enamel is not fully form or forms in insufficient amounts and may slump a tooth.
• In both the cases, teeth might be left more vulnerable to decay.
• This is because the enamel struggles to protect your tooth.
• In many people, disorders or diseases affecting teeth usually are not the principal reason for dental caries.
• Ninety-six percent of tooth enamel consists of minerals.
• These minerals, especially hydroxyapatite, will become soluble when they come across acidic environments.
• Enamel actually starts to demineralize for a pH of 5.5.
• Dentin and cementum tend to be vulnerable to caries than enamel.
• This is simply because they have minimal mineral content.
• Hence, when root surfaces of teeth get exposed due to gingival recession or periodontal disease, teeth are affected by caries.
• Even in proper oral environment, the tooth is subject to caries.
• The research for linking malocclusion or crowding on the tooth decay is weak.
• However, the anatomy of teeth may affect the possibilities of caries formation.
• Pits and fissure caries develop in a location where the deep grooves of teeth will be more numerous and exaggerated.
• Also, caries are more likely to develop when meals is trapped between teeth.

2. Bacteria
• The mouth posesses a wide variety of oral bacteria.
• One or two specific varieties of bacteria are considered to cause tooth decay.
• Streptococcus mutans and Lactobacilli are the most notable.
• These organisms can produce high degrees of lactic acid following fermentation of dietary sugars.
• They are proofed against the adverse reactions of low pH, properties required for cariogenic bacteria.
• Since, the cementum of root surfaces are demineralized easily when compared to the enamel surfaces, bacteria of wider could cause root caries.
These include:
– Lactobacillus acidophilus
– Actinomyces spp.,
– Nocardia spp.,
– Streptococcus mutans
• Bacteria collect across the teeth and gums in the sticky, creamy-coloured mass called plaque, which may serve as a biofilm.
• Some sites collect plaque additionally than others.
• This is like the sites with a low rate of salivary flow.
• The occlusal surfaces grooves of molar and premolar teeth allow plaque bacteria to enter in its microscopic retention sites.
• These are same as approximal sites.
• Below or above the gingival, the plaque accumulates slowly.
• This is also known as supra- or sub-gingival plaque respectively.
• These bacterial strains include S. mutans.
• It can also enter through premasticated food intake.

3. Ferment-able carbohydrates
• Bacteria in a person’s mouth convert glucose, fructose, and many commonly sucrose into acids. Eg: lactic acid
• This takes place through a glycolytic process called fermentation.
• These acids might result in demineralization, which can be the dissolution of that mineral content.
• The operation is dynamic.
• Remineralization can also occur in the event the acid is neutralized by saliva or mouthwash.
• Fluoride toothpaste or dental varnish may aid remineralization.
• If demineralization continues as time passes, enough mineral content could possibly be lost.
• This leads to the soft organic material that is left to disintegrate, forming a cavity or hole.
• The impact such sugars have on the progress of cavity is referred to as cariogenicity.
• Sucrose, although a bound glucose and fructose unit, is certainly more cariogenic over a mixture of equal areas of glucose and fructose.
• This is due to the bacteria utilizing the action within the saccharide bond between your glucose and fructose subunits.
• S.mutans adheres on the biofilm about the tooth by converting sucrose into an extremely adhesive substance called dextran polysaccharide through the enzyme dextransucranase.

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