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