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:
  • generally at the root surface
  • 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)

Management

• fluoride toothpaste
• pulpitis is treated by removal of dental cavity & dental filling
• periodontitis is treated with a root canal

More general terms

• tooth disease; odontogenic disease

Additional terms

• pulp cavity

Patient information

dental caries patient information