Teeth caries

Start with the ranked list of needs such as those obtained after the previous lesson (Figure 6-2 see also Appendix 6-1). We have given this as a mind map to keep it short. Note that all the regulations have a rank 5 (essential) you must obey these. Some needs in the map are a bit cryptic because we had to keep them short. Tartar is a calcified deposit on your teeth caries is the dental name for holes or cavities. Simulates water is short for bmshing with paste simulates drinking water with a suitable fluoride content . 

Armstrong WG The composition of organic films formed on human teeth. Caries Res 1967 1 89-103. 

Vitamin Dj has m.p. 115-117°C and D, m.p. 82 83 "C. Both vitamins, which have almost identical actions, are used for the prevention and cure of infantile rickets they are essential for the normal development of teeth, and are used for treating osteomalacia and dental caries. They are necessary for the absorption of Ca and P from the gut. 

Fluoridation of potable water suppHes for the prevention of dental caries is one of the principal uses for sodium fluoride (see Water, municipal WATER treatment). Use rate for this appHcation is on the order of 0.7 to 1.0 mg/L of water as fluoride or 1.5 to 2.2 mg/L as NaF (2). NaF is also appHed topically to teeth as a 2% solution (see Dentifrices). Other uses are as a flux for deoxidiziag (degassiag) rimmed steel (qv), and ia the resmelting of aluminum. NaF is also used ia the manufacture of vitreous enamels, ia pickling stainless steel, ia wood preservation compounds, caseia glues, ia the manufacture of coated papers, ia heat-treating salts, and as a component of laundry sours. 

Another important use for the glass polyalkenoate cement is in preventive dentistry where it can be used to fill and seal naturally occurring pits and fissures in molar teeth which are sites for the initiation of caries (McLean Wilson, 1974, 1977b Komatsu, 1981 Wilson McLean, 1988). Its adhesive quality and ability to act as a long-term fluoridereleasing gel make it particularly suitable for this purpose. Special formulations for this application have been placed on the market. 

Jenkins, G. N. (1965). The equilibrium between plaque and enamel in relation to dental caries. In Wolstenholme, G. E. W. O Connor, M. (eds.) Caries Resistant Teeth, pp. 192-210. London Churchill. 

It is superior to the zinc phosphate cement for bonding orthodontic bands to teeth (Clark, Phillips Norman, 1977). It has greater durability and there is less decalcification in adjacent tooth enamel. This latter beneficial effect must arise from the release of fluoride which is absorbed by the enamel, so protecting it in a clinical situation where caries-produdng debris and plaque accumulate. 

Selenium, which at present does not appear to be essential to man, apparently can be either beneficial or harmful to man, depending on very small differences in the concentrations. 13 Molybdenum can also be a boon or a detriment to health. It helps stabilize enamel and prevent caries in teeth, but also causes osteoporosis, a weakening of the bones.13... 

The simplest interpretation of these results is that a rat which was to exhibit no dental decay had genetically determined nutritional requirements such that, from the time the original egg was fertilized to the end of the experiment, it was supplied with enough of all the elements required to promote growth, development, and maintenance of healthy teeth. On the other hand, the rat that was to show extensive dental decay probably had genetically determined nutritional requirements such that deficiencies did develop, particularly on the caries-inducing diet. 

The importance of nutrition in the dental caries problem is reviewed in 90 pages by Shaw.22 Although we have indicated that metabolic peculiarities in the area of mineral metabolism seem "most likely to be pertinent" to the dental caries problem (p. 218), it does not follow that interest should be restricted to this field. Because teeth are organic structures produced as the result of metabolic processes, there is not a single vitamin, amino acid, or other nutrient factor which may not be implicated in the disease. Probably many different deficiencies are involved in the production of the sum total of all caries existing in all individuals. Much evidence, of course, has been found to indicate the importance of calcium, phosphorus, and vitamin D, but other items may also be very important. 

Dentin caries is inversely correlated with oral hygiene (Axelsson et ah, 1994 0gaard et ah, 1994) and fluoride intake (Frencken et ah, 1991). It can be expected that an improved oral status will decrease the incidence of dentin caries, but will increase root surface caries because the elderly are more dentate. A higher number of teeth retained, however, is associated with fewer root surface caries (Vehkalahti and Paunio, 1994). 

Thylstrup A, Featherstone JDB and Fredebo L (1983) Surface morphology and dynamics of early enamel caries development. In Demineralisation and remineralisation of the teeth (eds. Leach SA and Edgar WM) pp. 165-184. IRL Press, Oxford UK. 

Heme and iron. Aside from bacterial heme, the host him/herself may contribute to heme- and iron-derived pigmentations. Heme and iron compounds may originate from either the pulp or the oral cavity. Pulp-derived discolorations are known, for example, from traumatic teeth (Stanley et al., 1978). The pulp underlying caries lesions may become... 

Food pigments. Well-described are footh discolorations associated with the consumption of coffee, fea, wine, and betel nuts. This discoloration by food and beverages has been mimicked in vitro with caries lesions (Kidd et al., 1990) and sound teeth (Chan et al., 1981). 

In the course of dentin caries, both demineralization and reactions with the organic matrix take place. Matrix reactions include proteolysis and covalent modifications. From the introduction (Chapter 2) and the review on discoloration in caries (Chapter 3), it becomes clear that there are still few reports on the effect of matrix modifications on dentin caries. In Chapters 2, 4, and 5, the investigations were aimed at filling the information gap concerning the effect of reactions of dentin matrix on caries. To this end, degradation and modification of dentin were studied in demineralized specimens in vitro. In addition, specimens placed in dentures in situ and caries lesions in extracted teeth were analysed for modifications. 

A widespread form of dental disease, caries, is caused by acids that dissolve the mineral part of the teeth by neutralizing the negatively charged counter-ions in apatite (see A). Acids occur in food, or are produced by microorganisms that live on the surfaces of the teeth (e. g.. Streptococcus mutans). 

The most important form of protection against caries involves avoiding sweet substances (foods containing saccharose, glucose, and fructose). Small children in particular should not have very sweet drinks freely available to them. Regular removal of plaque by cleaning the teeth and hardening of the dental enamel by fluoridization are also important. Fluoride has a protective effect because fluoroapatite (see A) is particularly resistant to acids. 

Fluoride is the salt, such as sodium fluoride, of the element fluorine. It is readily absorbed by the intestine and is incorporated into bone or tooth enamel. When incorporated into teeth, fluoride strengthens the outer layers of enamel, thus reducing dental caries. It is generally accepted that addition of fluoride to the drinking water (approximately 1 ppm) is beneficial for the reduction in childhood dental caries. 

When fluoride therapy was first used it was widely assumed that its effect was systemic. In particular, it was assumed to become incorporated into the tooth during development, forming the less acid-soluble fluorapatite rather than hydro-xypatite [18,19]. There was evidence to support this view. For example, studies showed that incidence of caries was lower in areas with fluoridated water and that fluoride concentration was higher in the surface of teeth of subjects in high fluoride areas [20,21]. However, over the last three decades or so, there has been a shift in our understanding, and it is now known that the principal effects of fluoride take place after eruption of the tooth [22],... 

Although not the most important effect of fluoride, the effect on hypersensitivity is further evidence of generally beneficial role of this element. More important is its effect of caries. The rest of the chapter is concerned with the ways in which fluoride can be delivered to the teeth of individuals in various populations and how its positive effects are harnessed to promote improved oral health. 

In general, moderate and severe fluorosis is rare. However, mild fluorosis has been detected at significant levels, for example, in 26% of subjects in one recent study [93]. However, the mildness of the fluorosis detected is associated with only very slight changes in the appearance of the teeth, which suggests that, even at these levels, it is not a major public health problem. Nonetheless, it is appropriate to ensure that parents or guardians of children continue to receive sound advice on safe levels of fluoride for those in their care to be exposed to and, since the cariostatic effect of fluoride is known to occur well after enamel formation during tooth development, treatment to reduce caries should concentrate on those measures that carry the lowest possible risks of fluorosis [91]. 

A variety of materials are employed in the repair of teeth damaged by caries. The main ones are amalgams, composite resins and glass-ionomers (conventional and resin-modified). Table 6 shows the proportion of these materials used in the United Kingdom, based on a comprehensive survey of 9000 restorations placed. 

O. Fejerskov, K.W. Stephen, A. Richards, R. Speirs, Combined effect of systemic and topical fluoride treatments on human deciduous teeth—Case studies. Caries Res. 21 (1987) 452 59. 

F. Brudevold, H.G. McCann, P. Gron, Caries resistance as related to the chemistry of enamel, in G.E.W. Wolstenholm, M. O Conner (Eds.), Caries Resistant Teeth, Ciba Foundation Symposium, Churchill, London, 1965. 

I. Zipkin, F.J. McClure, Complex fluorides, caries reduction and fluoride retention in bones and teeth of white rats. Public Health Rep. 66 (1951) 1523-1532. 

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