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Dental caries
Dental caries

Dental caries

Introduction

Dental caries are caused by bacteria of the dental plaque which feed on sugary food substrates producing acid as by-products which dissolve the minerals of the tooth surface.

Pathophysiology

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Signs and symptoms

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Diagnostic criteria

• Early stage–asymptomatic
• Intermediate stage: black/brown spot which may be visible on any surface of tooth
• Cavities developing on tooth surface
• Pain/toothache elicited by hot, cold or sweet foods/drinks
• Late stage: pain may be spontaneous, intermittent, sharp and severe, even interfering with sleep.
• Tenderness on percussion of the tooth

Investigation

Periapical x-ray of tooth/teeth may need to be done especially to confirm extent of caries for treatment decision e.g. the caries contained in the dentine can be distinguished from pulpal caries.

Treatment

Non-pharmacological

    Lesion with cavitation but confined to dentine–filling/restoration of teeth with suitable filling materials (e.g. amalgam, composite, glass ionomer)

    Lesion involving the pulp (with or without periapical abscess), perform advanced tooth restoration by endodontic treatment wherever possible otherwise tooth extraction is done

Pharmacological

    Analgesics: for toothache
    • Paracetamol (PO) 1gm 8 hourly for 3 days
    OR
    • Ibuprofen (PO) 400 mg 8 hourly for at least 3 days
    OR
    • Diclofenac (PO) 50 mg 8 hourly for at least 3 days

Prevention

    • Proper counseling to avoid frequent use of sugary foods and drinks
    • Use fluoridated toothpaste to brush teeth at least twice a day
    • Provide preventive measures to early lesions presenting as a spot on enamel without cavitation and softening

Updated on,

4 Novemba 2020 06:16:38

References

1.STG

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