Materiały źródłowe

• #1 Dental Caries – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551699/

  Dental caries is a common chronic infectious resulting from tooth-adherent cariogenic bacteria, primarily Streptococcus mutans, which metabolize sugars to produce acid, demineralizing the tooth structure over time. […] Dental caries is a prevalent chronic infectious disease resulting from tooth-adherent cariogenic bacteria that metabolize sugars to produce acid, which, over time, demineralizes tooth structure. […] Dental caries occurs when the biofilm microbiota that normally resides in the oral cavity in homeostasis change to an acidogenic, aciduric, and cariogenic population due to the frequent consumption of sugars. […] Therefore, dental caries is considered a dietary-microbial disease that requires a cariogenic biofilm and regular exposure to fermentable carbohydrates (glucose, fructose, maltose, and sucrose) from the diet.

• #1 Dental Caries – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551699/

  The ecological plaque hypothesis believes that dental caries is not caused by a specific type of microorganism acting alone but is the result of a shift in the microbiota of the dental biofilm towards more cariogenic species. […] Fermentable carbohydrates are metabolized by the biofilm bacteria that produce organic acids, primarily lactic acid. These end products of bacterial metabolism accumulate in the fluid phase of the biofilm, causing a pH drop and demineralization of the surface layer of the tooth. […] If the acidic conditions perpetuate, the pH drops will continue, reaching a point when the rate of mineral loss in the subsurface is higher than the surface, resulting in a subsurface lesion. […] A carious tissue consists of four different zones histologically, among which three zones are visible clinically.

• #1 The Evolving Microbiome of Dental Caries

  https://www.mdpi.com/2076-2607/12/1/121

  The development of a caries-associated microbiome was subsequently described using an ecological plaque hypothesis. This concept was based, in part, on chemostat studies and the growth of a mixture of nine oral bacteria pulsed with glucose at different pHs over time. The experimental findings indicated that when a healthy resting oral pH of 7.0 was maintained, Streptococcus gordonii, which is acidogenic but not very acid-tolerant, dominated the community. When the acidity of the medium was not controlled in the experiment, however, the pH dropped to 4.5 and the acid-tolerant species S. mutans, Lactobacillus casei, and Veillonella dispar dominated the community. According to this model, the metabolism of all acid-producing species in the nine-species cocktail lowered the environmental pH, but only the acid-tolerant species could survive. Thus, the oral biofilm under acid stress undergoes a selective succession that favors acid-tolerant species. In accordance with the ecological plaque hypothesis, it is dietary carbohydrates, particularly sucrose, that are the drivers of acid production in tooth-associated microbial communities.

• #1 The Caries Process & Fluoride’s Mechanism of Action | A-Z Fundamentals of Dentifrice | Continuing Education Course on dentalcare.com

  https://www.dentalcare.com/en-us/ce-courses/ce670/caries-process-and-fluorides-mechanism-of-action

  Dental caries is an infectious disease caused by the complex interaction of cariogenic (caries-causing) bacteria with carbohydrates (i.e., sugars) on the tooth surface over time. […] The acids lower the pH in the plaque biofilm. […] When the pH drops below a critical level (approximately 5.5 for enamel, and 6.2 for dentin), it causes the dissolution of tooth mineral (hydroxyapatite) in a process called demineralization. […] Caries is simply the result of a series of demineralization/remineralization cycles where, over time, demineralization conditions prevail. […] One of the most effective methods to prevent caries is by promoting remineralization and slowing down demineralization. […] When fluoride is present in oral fluids (i.e., saliva), fluorapatite, rather than hydroxyapatite, forms during the remineralization process.

• #1 The Caries Process & Fluoride’s Mechanism of Action | A-Z Fundamentals of Dentifrice | Continuing Education Course on dentalcare.com

  https://www.dentalcare.com/en-us/ce-courses/ce670/caries-process-and-fluorides-mechanism-of-action

  Fluorapatite is inherently less soluble than hydroxyapatite, even under acidic conditions. […] When hydroxyapatite dissolves under cariogenic (acidic) conditions, if fluoride is present, then fluorapatite will form. […] Because fluorapatite is less soluble than hydroxyapatite, it is also more resistant to subsequent demineralization when acid challenged. […] Under cariogenic conditions, carbohydrates are converted to acids by bacteria in the plaque biofilm. […] When the pH drops below 5.5, the biofilm fluid becomes undersaturated with phosphate ion and enamel dissolves to restore balance. […] When fluoride (F) is present, fluorapatite is incorporated into demineralized enamel and subsequent demineralization is inhibited. […] With fluoride treatment, a noncavitated lesion can be remineralized with fluorapatite and have greater resistance to subsequent demineralization than hydroxyapatite. […] Even when available at very low concentrations, fluoride is effective as an anticaries agent.

• #1 Section 6: Pathophysiology of Caries Process and Influences on Caries Development

  https://www.txhealthsteps.com/static/warehouse/1076-2011-May-4-06vdu11301voz18o4925/section_6.html

  Caries develops when there is a susceptible tooth exposed to pathogenic flora (bacteria) in the presence of substrate (the surface on which an organism grows). Under these conditions, the bacteria metabolize substrate to form acid, which decalcifies teeth. […] As shown in Figure 1, caries can occur if oral flora contains acid-producing bacteria, such as Streptococcus mutans. […] The human oral cavity has little cariogenic potential until it is infected by pathogenic organisms. Streptococcus mutans is currently considered the principal caries-causing bacteria, but Streptococcus sobrinus may also be involved. […] Cariogenic bacteria are transmitted from the mother, sibling, playmate, or primary caregiver, all of whom harbor these bacteria, to the infant at or before the eruption of the first tooth.

• #1 The Disease: 2 Etiology and Pathogenesis of Caries | Pocket Dentistry

  https://pocketdentistry.com/part-1-caries-science-6/

  The demineralization-remineralization balance in caries etiology. […] Caries is profoundly influenced by exposure to fluoride, which reduces demineralization and enhances remineralization. […] The aims of this chapter are to outline the relevant biological and chemical factors, and to describe their interactions in caries initiation and progression. […] In his chemo-parasitic theory (1890), Miller postulated that caries was caused by acids produced in the mouth by bacteria metabolizing dietary carbohydrate in food particles retained between the teeth. […] The hypothesis that caries is caused by infection with S. mutans or the mutans streptococci, is known as the specific plaque hypothesis. […] However, S. mutans usually makes up only a very small proportion of the plaque flora, is not always detectable in plaque associated with caries, and can occur in plaque without caries developing.

• #1 The Evolving Microbiome of Dental Caries

  https://www.mdpi.com/2076-2607/12/1/121

  Dental caries is a significant oral and public health problem worldwide, especially in low-income populations. The risk of dental caries increases with frequent intake of dietary carbohydrates, including sugars, leading to increased acidity and disruption of the symbiotic diverse and complex microbial community of health. Excess acid production leads to a dysbiotic shift in the bacterial biofilm composition, demineralization of tooth structure, and cavities. Highly acidic and acid-tolerant species associated with caries include Streptococcus mutans, Lactobacillus, Actinomyces, Bifidobacterium, and Scardovia species. The differences in microbiotas depend on tooth site, extent of carious lesions, and rate of disease progression. Metagenomics and metatranscriptomics not only reveal the structure and genetic potential of the caries-associated microbiome, but, more importantly, capture the genetic makeup of the metabolically active microbiome in lesion sites. Due to its multifactorial nature, caries has been difficult to prevent. The use of topical fluoride has had a significant impact on reducing caries in clinical settings, but the approach is costly; the results are less sustainable for high-caries-risk individuals, especially children. Developing treatment regimens that specifically target S. mutans and other acidogenic bacteria, such as using nanoparticles, show promise in altering the cariogenic microbiome, thereby combatting the disease.

• #1 Tooth decay – Wikipedia

  https://en.wikipedia.org/wiki/Tooth_decay

  Tooth decay, also known as caries, is the breakdown of teeth due to acids produced by bacteria. The cause of cavities is acid from bacteria dissolving the hard tissues of the teeth (enamel, dentin and cementum). The acid is produced by the bacteria when they break down food debris or sugar on the tooth surface. If mineral breakdown is greater than buildup from sources such as saliva, caries results. Risk factors include conditions that result in less saliva, such as diabetes mellitus, Sjgren syndrome and some medications. Dental caries are also associated with poverty, poor cleaning of the mouth, and receding gums resulting in exposure of the roots of the teeth. […] Prevention of dental caries includes regular cleaning of the teeth, a diet low in sugar, and small amounts of fluoride. The development of biofilm begins with pellicle formation. Bacteria colonize on the teeth by adhering to the pellicle-coated surface. Over time, a mature biofilm is formed, creating a cariogenic environment on the tooth surface. Dental caries result when the demineralization rate is faster than the remineralization, producing net mineral loss, which occurs when there is an ecologic shift within the dental biofilm from a balanced population of microorganisms to a population that produces acids and can survive in an acid environment.

• #1 Microbial Etiology and Prevention of Dental Caries: Exploiting Natural Products to Inhibit Cariogenic Biofilms

  https://www.mdpi.com/2076-0817/9/7/569

  The oral microbiota on teeth surface tends to form polymicrobial communities, known as dental biofilm. It is now clear that the matrix of extracellular polymers (EPS) provides a pathological habitat for cariogenic microorganisms. A large body of evidence indicates that dental caries is essentially a biofilm-induced disease, rather than an infectious disease, and the disease process begins in the biofilm that covers the surface of the tooth. Caries biofilm (biofilm that may cause caries) is an extremely active and complicated ecosystem, rich in EPS. The formation of the biofilm begins when a salivary glycoprotein film (called dental pellicle) coats a tooth surface. Gram-positive bacteria including streptococci of the mitis and mutans species (which are considered as initial colonizers of the biofilm) then form EPS, which enhance the adherence of other organisms. Emerging evidence shows that acid-producing bacterial species of the genera Veillonella, Scardovia, Lactobacillus, and Propionibacterium could be present in the dental biofilm as colonizers and may induce in cariogenic conditions in the mouth.

• #1 Dental Caries – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551699/

  The first clinical sign of the disease is a white spot, which is the expression of the enamel subsurface demineralization – the surface enamel is more mineralized. […] As the caries process progresses, the dentin also experiences mineral loss and bacterial invasion, producing tertiary dentin to protect the pulp. […] A recurrent or secondary caries is a new caries that form at the restorations margin. […] Dental caries prognosis depends on the patient’s health, maintenance of oral hygiene, and the extent and severity of dental caries. […] If dental caries progresses to the moderate stage with loss of specific tooth structure, the tooth must be filled and rebuilt.

• #1 Tooth Decay Stages: 5 Stages and How to Treat Each

  https://www.healthline.com/health/dental-and-oral-health/tooth-decay-stages

  If the process of tooth decay is allowed to continue, enamel will break down further. […] As enamel is weakened, small holes in your teeth called cavities, or dental caries, can form. Cavities will need to be filled by your dentist. […] Dentin is the tissue that lies under the enamel. Its softer than enamel, which makes it more sensitive to damage from acid. Because of this, tooth decay proceeds at a faster rate when it reaches the dentin. […] Dentin also contains tubes that lead to the nerves of the tooth. Because of this, when dentin is affected by tooth decay, you may begin experiencing sensitivity. […] The pulp is the innermost layer of your tooth. It contains the nerves and blood vessels that help to keep the tooth healthy. […] When damage to the pulp happens, it may become irritated and start to swell.

• #1 Tooth Decay Stages: 5 Stages and How to Treat Each

  https://www.healthline.com/health/dental-and-oral-health/tooth-decay-stages

  As tooth decay advances into the pulp, bacteria can invade and cause an infection. Increased inflammation in the tooth can lead to a pocket of pus forming at the bottom of your tooth, called an abscess. […] Tooth abscesses can cause severe pain that may radiate into the jaw. […] Tooth decay happens when bacteria break down sugars into acids, which damage tooth tissues. […] The treatment for tooth decay depends on what stage its in. Some examples of potential treatments include fluoride treatments, fillings, and root canals. […] There are steps that you can take to help prevent tooth decay. These include things like brushing your teeth at least twice a day, avoiding sweet foods, and making sure to visit your dentist regularly.

• #1 Microbiology of Dental Decay and Periodontal Disease – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8259/

  Dental decay is due to the irreversible solubilization of tooth mineral by acid produced by certain bacteria that adhere to the tooth surface in bacterial communities known as dental plaque. […] The tooth surface normally loses some tooth mineral from the action of the acid formed by plaque bacteria after ingestion of foods containing fermentable carbohydrates. This mineral is normally replenished by the saliva between meals. However, when fermentable foods are eaten frequently, the low pH in the plaque is sustained and a net loss of mineral from the tooth occurs. This low pH selects for aciduric organisms, such as S mutans and lactobacilli, which (especially S mutans) store polysaccharide and continue to secrete acid long after the food has been swallowed. […] These clinical studies indicated that of the 200 to 300 species which can be isolated from plaque, only S mutans, and to a lesser extent the lactobacilli, can be consistently associated with dental decay. What makes these organisms cariogenic relative to all other bacterial types found in the plaque?

• #1 Microbiology of Dental Decay and Periodontal Disease – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8259/

  In the 19th century, microbial acid production from dietary substrates was linked to the etiology of dental decay in what was called the chemoparasitic theory of decay. But researchers were not able to associate any single acidogenic species with decay, and concluded that decay was bacteriologically nonspecific and due to the increased amounts of acid formed when bacteria accumulated in plaque on the tooth surfaces. […] Sucrose fermentation produces a rapid drop in the pH, to 5.0 or lower, at the point of interface between plaque and enamel. When sucrose is ingested during meals, sufficient saliva is secreted to buffer the plaque pH and decay does not occur. […] Plaque bacteria that ferment sucrose produce acids, which in vitro lower the pH value to below 5.0. However, only S mutans of all these species reliably caused decay in germ-free animals fed a high-sucrose diet.

• #1 Section 6: Pathophysiology of Caries Process and Influences on Caries Development

  https://www.txhealthsteps.com/static/warehouse/1076-2011-May-4-06vdu11301voz18o4925/section_6.html

  The anti-cariogenic effect of fluoride is well documented. Fluoride and the frequency of ingestion of fermentable carbohydrates are the two greatest issues in the fight against dental caries. […] Frequent exposure to small amounts of fluoride each day is the best way to reduce the risk for developing tooth decay. […] When a person consumes food, cariogenic bacteria, including Streptococcus mutans and Streptococcus sobrinus, can break down carbohydrates in the mouth and produce acids that cause mineral loss in teeth. […] Acid causes demineralization of enamel. […] Frequent snacking promotes acid attack. […] The frequency of sugars and refined carbohydrate intake may be the main dietary variable in caries etiology, affecting colonization by cariogenic bacteria and the development of caries. […] The potential for ECC is related to extended and repetitive feeding times with prolonged exposure of teeth to fermentable carbohydrate without appropriate oral hygiene.

• #1 The Physiology of Cavities – What You Need to Know

  https://www.premierdentalohio.com/blog/the-physiology-of-cavities

  For many people, going to the dentist is a frustrating process. They dread hearing the words, You have a cavity. […] This post aims to help you understand the physiology behind cavities. We believe you can have a positive impact on your own oral health by comprehending the cavity process. […] Cavities are an infectious disease, caused by the multiplication and spread of bacteria. Being an infectious disease, it is also a transmissible disease. We transfer bacteria from one mouth to another by kissing and sharing eating utensils. […] There are a few different strains of bacteria known to cause cavities, the most notable being Streptococcus mutans. These bacteria form large colonies within dental plaque (that soft whitish stuff that collects on your teeth). […] There are four essential ingredients in the cavity process: Teeth, Bacteria, Sugar, and Time. […] Bad cavity-causing bacteria stick to a tooth via dental plaque. Those bacteria eat sugar and produce acid. The acid, when it has enough time to work, softens and weakens the enamel.

• #1 How probiotics, prebiotics, synbiotics, and postbiotics prevent dental caries: an oral microbiota perspective | npj Biofilms and Microbiomes

  https://www.nature.com/articles/s41522-024-00488-7

  The close association between *S. mutans* and dental caries has been confirmed. […] Therefore, further elucidating the pathogenic mechanisms of *S. mutans* is essential for the development of effective strategies for caries prevention and treatment. […] The initial step involves the adhesion of some primitive colonizing microorganisms to the dental enamel. The second step involves the production of EPS by the microorganisms, forming a biofilm. In the third step, acidogenic and acid-tolerant microbial communities, mainly dominated by *S. mutans*, establish a highly acidic microenvironment, leading to demineralization of the dental enamel. […] The ability of *S. mutans* to exert its pathogenicity is largely attributed to the production of EPS. […] EPS contributes to the formation of highly organized chemical and physical barriers within the biofilm matrix, facilitating microbial adherence to non-living surfaces, resisting fluid shear stresses, evading host immune responses, tolerating antimicrobial agents, and ultimately establishing and maintaining acidic microenvironment in the oral cavity that favors the development of dental caries-associated biofilm communities.

• #1 How probiotics, prebiotics, synbiotics, and postbiotics prevent dental caries: an oral microbiota perspective | npj Biofilms and Microbiomes

  https://www.nature.com/articles/s41522-024-00488-7

  The acid-producing activity of *S. mutans* is not only a critical factor contributing to its pathogenicity but also a crucial characteristic leading to dental caries. […] *S. mutans* employs some acid-resistant mechanisms to cope with the stress of increasing acid production. […] The QS system regulates virulence and biofilm formation by releasing, sensing, and interacting with diffusion molecules based on cell density in the surrounding environment. […] Although plaque is a natural occurrence in teeth from an evolutionary, biological, and nutritional perspective, an imbalance in the microbiome of the oral pathological biofilm can lead to the development of dental caries. […] The mechanism through which probiotics can prevent dental caries is similar to that found in the gastrointestinal tract.

• #1

  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4841a1.htm

  Fluoride’s caries-preventive properties initially were attributed to changes in enamel during tooth development because of the association between fluoride and cosmetic changes in enamel and a belief that fluoride incorporated into enamel during tooth development would result in a more acid-resistant mineral. […] However, laboratory and epidemiologic research suggests that fluoride prevents dental caries predominately after eruption of the tooth into the mouth, and its actions primarily are topical for both adults and children. […] These mechanisms include 1) inhibition of demineralization, 2) enhancement of remineralization, and 3) inhibition of bacterial activity in dental plaque. […] Enamel and dentin are composed of mineral crystals (primarily calcium and phosphate) embedded in an organic protein/lipid matrix.

• #1

  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4841a1.htm

  Dental mineral is dissolved readily by acid produced by cariogenic bacteria when they metabolize fermentable carbohydrates. […] Fluoride present in solution at low levels, which becomes concentrated in dental plaque, can substantially inhibit dissolution of tooth mineral by acid. […] Fluoride enhances remineralization by adsorbing to the tooth surface and attracting calcium ions present in saliva. […] Fluoride also acts to bring the calcium and phosphate ions together and is included in the chemical reaction that takes place, producing a crystal surface that is much less soluble in acid than the original tooth mineral. […] Fluoride from topical sources such as fluoridated drinking water is taken up by cariogenic bacteria when they produce acid. […] Once inside the cells, fluoride interferes with enzyme activity of the bacteria and the control of intracellular pH. […] This reduces bacterial acid production, which directly reduces the dissolution rate of tooth mineral.

• #1 Tooth decay | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/Tooth-decay

  Tooth decay is a common diet-related disease. […] It is caused by the bacteria in your mouth turning sugar into energy and producing acid that damages the teeth. […] Tooth decay can start as a white or dark spot on your tooth and develop into a hole or cavity. […] Further mineral loss may lead to the cavity going into the centre of the tooth (the pulp), which may lead to toothache. […] When turning the sugar to energy, the bacteria in your mouth create acid as a waste product. This acid dissolves the crystals of your teeth and causes mineral loss, weakening the tooth. […] If the amount of acid from the bacteria on your teeth outweighs the protective effect of your saliva, then tooth decay will occur. […] Saliva is a powerful natural defence against tooth decay. It can wash sugar out of your mouth into the stomach, stop the damaging effect of acid made by bacteria, fight bacteria and reverse the early stages of tooth decay by repairing tooth mineral.

• #1 15: Dental Caries | Pocket Dentistry

  https://pocketdentistry.com/15-dental-caries/

  The main etiological agent in occlusal and pit and fissure caries is the S. mutans. Deep dentinal caries is commonly associated with lactobacilli, certain gram-positive anaerobes and filaments such as Eubacterium and Actinomyces. […] The role of diet in the causation of dental caries has been extensively studied. […] It is a well-known fact that food with high refined carbohydrate content has the greatest potential to give rise to carious lesions. […] The type of carbohydrate (monosaccharide, disaccharide or polysaccharide), frequency of intake and the time for which the ingested food remains stagnant in the oral cavity or on the tooth surface determine the incidence and severity of the carious lesions. […] Salivary IgA prevents S. mutans from adhering to the tooth surface. […] The IgG antibodies acting as opsonins, facilitate phagocytosis and the death of S. mutans by the action of macrophages and neutrophil leukocytes.

• #1 Tooth decay | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/Tooth-decay

  A reduced flow of saliva (dry mouth) can increase your risk of tooth decay. […] Early tooth decay is reversible. Saliva can deposit mineral back onto the tooth surface, and improvements in your diet and oral hygiene make a big difference. […] Your dentist can treat early areas of tooth decay with fluoride or other products to help with this process. […] Regular visits to the dentist (every 6 to 12 months) are important so that decay can be identified at this early stage when a filling can be avoided. […] When tooth decay gets worse, a hole may have formed that may need a filling. […] Early detection and treatment help preserve tooth strength and prevent bacteria from damaging its centre.

• #1 Cavities and tooth decay – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cavities/symptoms-causes/syc-20352892

  Cavities are decayed areas of your teeth that become tiny openings or holes. […] Cavities are areas in the hard surface of your teeth that are damaged. These areas of tooth decay become tiny openings or holes that can lead to a serious toothache, infection and tooth loss. […] If cavities aren’t treated, they get larger and affect deeper layers of your teeth. Regular dental visits and good brushing and flossing habits are the best ways to protect your teeth from cavities. […] Tooth decay causes cavities. This is a process that occurs over time. […] The acids from bacteria remove minerals in your tooth’s hard, outer enamel. This erosion causes tiny openings or holes in the enamel the first stage of cavities. […] As tooth decay happens, the bacteria and acid move through your teeth to the inner tooth material (pulp) that contains nerves and blood vessels. The pulp becomes swollen and irritated from the bacteria. […] Cavities and tooth decay can have serious and lasting complications, even for children who don’t have their permanent teeth yet. […] Complications of cavities may include pain, abscess a bacterial infection that causes a pocket of pus to form in a tooth, and damage or broken teeth.

• #1 About Cavities (Tooth Decay) | Oral Health | CDC

  https://www.cdc.gov/oral-health/about/cavities-tooth-decay.html

  Cavities (also called tooth decay or dental caries) are one of the most common diseases people get and live with during their lifetime. Cavities are caused by the bacteria in your mouth that stick to your teeth. You feed the bacteria every time you eat or drink. […] The bacteria produce acid which starts to dissolve the outer enamel layer of your teeth. Your saliva clears away the acid and helps to repair the enamel. If the repair isn’t fast enough, bacteria get inside your tooth and make cavities. Cavities will get bigger unless the bacteria are stopped or removed. […] Cavities cause pain and sensitivity as they get bigger, especially when close to the nerve in the middle of your tooth. If the cavity reaches your nerve it may cause an infection (abscess) that can spread in your body. It is rare, but this can cause death.

• #1 About Cavities (Tooth Decay) | Oral Health | CDC

  https://www.cdc.gov/oral-health/about/cavities-tooth-decay.html

  Cavities that are not stopped lead to tooth loss. […] Cavities in children can cause pain and may lead to problems with eating, speaking, playing, and learning. Infection from cavities can also hurt adult teeth growing underneath. […] Waiting limits the options dentists have to fix large cavities. Cavities grow and, unless stopped, lead to tooth loss.

• #2 Cavities and tooth decay – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cavities/symptoms-causes/syc-20352892

  Cavities are decayed areas of your teeth that become tiny openings or holes. […] Cavities are areas in the hard surface of your teeth that are damaged. These areas of tooth decay become tiny openings or holes that can lead to a serious toothache, infection and tooth loss. […] If cavities aren’t treated, they get larger and affect deeper layers of your teeth. Regular dental visits and good brushing and flossing habits are the best ways to protect your teeth from cavities. […] Tooth decay causes cavities. This is a process that occurs over time. […] The acids from bacteria remove minerals in your tooth’s hard, outer enamel. This erosion causes tiny openings or holes in the enamel the first stage of cavities. […] As tooth decay happens, the bacteria and acid move through your teeth to the inner tooth material (pulp) that contains nerves and blood vessels. The pulp becomes swollen and irritated from the bacteria. […] Cavities and tooth decay can have serious and lasting complications, even for children who don’t have their permanent teeth yet. […] Complications of cavities may include pain, abscess a bacterial infection that causes a pocket of pus to form in a tooth, and damage or broken teeth.

• #2 About Cavities (Tooth Decay) | Oral Health | CDC

  https://www.cdc.gov/oral-health/about/cavities-tooth-decay.html

  Cavities (also called tooth decay or dental caries) are one of the most common diseases people get and live with during their lifetime. Cavities are caused by the bacteria in your mouth that stick to your teeth. You feed the bacteria every time you eat or drink. […] The bacteria produce acid which starts to dissolve the outer enamel layer of your teeth. Your saliva clears away the acid and helps to repair the enamel. If the repair isn’t fast enough, bacteria get inside your tooth and make cavities. Cavities will get bigger unless the bacteria are stopped or removed. […] Cavities cause pain and sensitivity as they get bigger, especially when close to the nerve in the middle of your tooth. If the cavity reaches your nerve it may cause an infection (abscess) that can spread in your body. It is rare, but this can cause death.

• #2 Microbiology of Dental Decay and Periodontal Disease – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8259/

  Dental decay is due to the irreversible solubilization of tooth mineral by acid produced by certain bacteria that adhere to the tooth surface in bacterial communities known as dental plaque. […] The tooth surface normally loses some tooth mineral from the action of the acid formed by plaque bacteria after ingestion of foods containing fermentable carbohydrates. This mineral is normally replenished by the saliva between meals. However, when fermentable foods are eaten frequently, the low pH in the plaque is sustained and a net loss of mineral from the tooth occurs. This low pH selects for aciduric organisms, such as S mutans and lactobacilli, which (especially S mutans) store polysaccharide and continue to secrete acid long after the food has been swallowed. […] These clinical studies indicated that of the 200 to 300 species which can be isolated from plaque, only S mutans, and to a lesser extent the lactobacilli, can be consistently associated with dental decay. What makes these organisms cariogenic relative to all other bacterial types found in the plaque?

• #2 The Disease: 2 Etiology and Pathogenesis of Caries | Pocket Dentistry

  https://pocketdentistry.com/part-1-caries-science-6/

  A third hypothesis, the ecological plaque hypothesis, emphasizes the importance of the oral environment in determining the composition and properties of the plaque microflora. […] An increased frequency of sugar intake disrupts the homoeostasis of such a plaque because it favors growth of acidogenic, aciduric bacteria and hence promotes low-pH conditions. […] The ecological plaque hypothesis is supported by considerable evidence. […] The microflora of plaque from the approximal region is complex and dominated by Gram-positive, rod-shaped bacteria (mainly Actinomyces) and streptococci, of which the most abundant is typically S. sanguinis, with smaller proportions of other bacteria, such as Bacteroides, Neisseria, Veillonella, Fusobacterium, Rothia, and Lactobacillus. […] Changes in the plaque flora can be difficult to identify because of extensive intra- and inter-individual variation, but in caries-active people the proportion of S. sanguinis and of Actinomyces naeslundii typically fall.

• #2 Cavities – Mouth and Dental Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/mouth-and-dental-disorders/tooth-disorders/cavities

  Cavities are decayed areas in the teeth, the result of a process that gradually dissolves a tooths hard outer surface (enamel) and progresses toward the interior. […] Bacteria and debris build up on tooth surfaces, and the bacteria produce acids that cause decay. […] For tooth decay to develop, a tooth must be susceptible, acid-producing bacteria must be present, and nutrients (such as sugar) must be available for the bacteria to thrive and produce acid. A susceptible tooth has relatively little protective fluoride incorporated into the enamel or has pronounced pits, grooves, or cracks (fissures) that retain plaque. Poor oral hygiene that allows plaque and tartar to accumulate can accelerate this process. […] Acid in the diet accelerates tooth decay. (For example, soft drinks, sports drinks, and energy drinks, all of which are commonly acidic, tend to promote tooth decay.)

• #2 The Disease: 2 Etiology and Pathogenesis of Caries | Pocket Dentistry

  https://pocketdentistry.com/part-1-caries-science-6/

  As described in Chapter 1, teeth are continuously bathed in saliva, one of the main functions of which is to minimize mineral dissolution and precipitation within the mouth: both can be harmful to the teeth and other oral tissues. […] In dental caries, this homoeostasis is overcome by acid-generating metabolic processes in localized accumulations of bacteria. This in turn causes loss of mineral from the hard tissues, which destroys their integrity and eventually impairs their function. […] The progressive loss of mineral through dissolution by plaque acid (demineralization) during repeated cariogenic challenges is the primary process in dental caries. […] While the combination of two factors will produce a contribution (e.g., bacteria + tooth plaque; bacteria + diet acid), the interaction of all three is required for caries initiation.

• #2

  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4841a1.htm

  Dental mineral is dissolved readily by acid produced by cariogenic bacteria when they metabolize fermentable carbohydrates. […] Fluoride present in solution at low levels, which becomes concentrated in dental plaque, can substantially inhibit dissolution of tooth mineral by acid. […] Fluoride enhances remineralization by adsorbing to the tooth surface and attracting calcium ions present in saliva. […] Fluoride also acts to bring the calcium and phosphate ions together and is included in the chemical reaction that takes place, producing a crystal surface that is much less soluble in acid than the original tooth mineral. […] Fluoride from topical sources such as fluoridated drinking water is taken up by cariogenic bacteria when they produce acid. […] Once inside the cells, fluoride interferes with enzyme activity of the bacteria and the control of intracellular pH. […] This reduces bacterial acid production, which directly reduces the dissolution rate of tooth mineral.

• #2 How probiotics, prebiotics, synbiotics, and postbiotics prevent dental caries: an oral microbiota perspective | npj Biofilms and Microbiomes

  https://www.nature.com/articles/s41522-024-00488-7

  Dental caries, a highly prevalent oral disease, impacts a significant portion of the global population. […] A more comprehensive perspective should involve considering the concepts of cariogenic biofilms. This review elucidates the latest research progress, mechanisms of action, challenges, and future research directions regarding probiotics, prebiotics, synbiotics, and postbiotics for the prevention and treatment of dental caries, taking into account the unique pathogenic mechanisms of dental caries. […] Dental caries arises from an imbalance in the oral microbiota resulting from a complex interplay between the host, diet, and microorganisms. […] The cariogenic bacteria exhibit varying degrees of contribution to the development of dental caries. For decades, *S. mutans* and *Streptococcus sobrinus* have been widely recognized as the major cariogenic agents.

• #2 What causes cavities and why do my kids keep getting them? | Children’s Dental Health

  https://childrensdentalhealth.com/you-ask-we-answer-what-causes-cavities-and-why-do-my-kids-keep-getting-them/

  Studies show that the earlier your child is exposed to large colonies of S.Mutans, the more they are likely to develop caries. […] Saliva is a perfect bathing tool for the teeth. […] However, if the saliva is too thick or there isn’t enough of it, then it won’t be able to do its job effectively. […] Some children have tongue-tie leading to its limited range of movement. […] When a person’s teeth are crowded or overlapping, they are naturally harder to clean and more likely to trap food in tough-to-reach spaces. […] Bacteria uses not only sugars but basically any fermentable carbohydrates and breaks it down into acids that can damage tooth surfaces. […] Medications can be contributing factors to the appearance of childhood caries. […] As we brush and floss our teeth we disturb that biofilm and decrease the number of bacteria adhering to the teeth surface ultimately creating an inhospitable environment for bacterial colonies and reducing the damage their byproducts can inflict on tooth surfaces.

• #2

  https://journals.lww.com/cocd/fulltext/2020/11030/targeting_actual_dental_caries_associated_bacteria.1.aspx

  Dental caries is known to be caused by several distinct microorganisms in a dental plaque that secretes weak acids onto the tooth surface following metabolism of carbohydrates. Mutans streptococci species, especially Streptococcus mutans and Streptococcus sanguis, are considered to be major cariogenic microorganisms (initiators). […] For decades, the sugar-fermenting acidogenic species S. mutans has been considered the main causative agent of dental caries, and most diagnostic and therapeutic strategies have been targeted toward this microorganism. […] It is now recognized that this disease results not solely due to the presence of S. mutans or any single organism in dental plaque but is rather caused by interactions of multiple acid-producing organisms with other biofilm residents. […] The low proportion detected confirms that this species is a minority and questions its importance as the main etiological agent of tooth decay.

• #2 15: Dental Caries | Pocket Dentistry

  https://pocketdentistry.com/15-dental-caries/

  The main etiological agent in occlusal and pit and fissure caries is the S. mutans. Deep dentinal caries is commonly associated with lactobacilli, certain gram-positive anaerobes and filaments such as Eubacterium and Actinomyces. […] The role of diet in the causation of dental caries has been extensively studied. […] It is a well-known fact that food with high refined carbohydrate content has the greatest potential to give rise to carious lesions. […] The type of carbohydrate (monosaccharide, disaccharide or polysaccharide), frequency of intake and the time for which the ingested food remains stagnant in the oral cavity or on the tooth surface determine the incidence and severity of the carious lesions. […] Salivary IgA prevents S. mutans from adhering to the tooth surface. […] The IgG antibodies acting as opsonins, facilitate phagocytosis and the death of S. mutans by the action of macrophages and neutrophil leukocytes.

• #2 Microbial Etiology and Prevention of Dental Caries: Exploiting Natural Products to Inhibit Cariogenic Biofilms

  https://www.mdpi.com/2076-0817/9/7/569

  The oral microbiota on teeth surface tends to form polymicrobial communities, known as dental biofilm. It is now clear that the matrix of extracellular polymers (EPS) provides a pathological habitat for cariogenic microorganisms. A large body of evidence indicates that dental caries is essentially a biofilm-induced disease, rather than an infectious disease, and the disease process begins in the biofilm that covers the surface of the tooth. Caries biofilm (biofilm that may cause caries) is an extremely active and complicated ecosystem, rich in EPS. The formation of the biofilm begins when a salivary glycoprotein film (called dental pellicle) coats a tooth surface. Gram-positive bacteria including streptococci of the mitis and mutans species (which are considered as initial colonizers of the biofilm) then form EPS, which enhance the adherence of other organisms. Emerging evidence shows that acid-producing bacterial species of the genera Veillonella, Scardovia, Lactobacillus, and Propionibacterium could be present in the dental biofilm as colonizers and may induce in cariogenic conditions in the mouth.

• #2 Dental Caries – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551699/

  The first clinical sign of the disease is a white spot, which is the expression of the enamel subsurface demineralization – the surface enamel is more mineralized. […] As the caries process progresses, the dentin also experiences mineral loss and bacterial invasion, producing tertiary dentin to protect the pulp. […] A recurrent or secondary caries is a new caries that form at the restorations margin. […] Dental caries prognosis depends on the patient’s health, maintenance of oral hygiene, and the extent and severity of dental caries. […] If dental caries progresses to the moderate stage with loss of specific tooth structure, the tooth must be filled and rebuilt.

• #2 Microbiology of Dental Decay and Periodontal Disease – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8259/

  This model predicts that a bacterial succession occurs during the progression of a carious lesion and that the flora of the advanced lesion may bear little resemblance to the flora of the incipient lesion. Thus it was necessary to sample the plaque during the initial lesion or white spot stage to find the etiologic agents of decay. […] The incipient or white spot lesion occurs when the acidogenic activity of the cariogen causes tooth mineral to be mobilized from the subsurface enamel to buffer the pH at the plaque-enamel interface. […] When the lesion progresses to the stage of cavitation, the organisms penetrate into the enamel crystals. Also, secondary cariogens, such as the lactobacilli, appear as a result of the selection for aciduric organisms in the plaque. […] This bacterial succession is illustrated in Figure 99-2, which shows the sequence of events occurring on the surface of a caries-free tooth that either becomes carious or remains caries free. […] The mechanisms by which fluoride prevents decay are multiple, and the relative contributions of each mechanism are not fully understood.

• #2 Tooth Decay Stages: 5 Stages and How to Treat Each

  https://www.healthline.com/health/dental-and-oral-health/tooth-decay-stages

  If the process of tooth decay is allowed to continue, enamel will break down further. […] As enamel is weakened, small holes in your teeth called cavities, or dental caries, can form. Cavities will need to be filled by your dentist. […] Dentin is the tissue that lies under the enamel. Its softer than enamel, which makes it more sensitive to damage from acid. Because of this, tooth decay proceeds at a faster rate when it reaches the dentin. […] Dentin also contains tubes that lead to the nerves of the tooth. Because of this, when dentin is affected by tooth decay, you may begin experiencing sensitivity. […] The pulp is the innermost layer of your tooth. It contains the nerves and blood vessels that help to keep the tooth healthy. […] When damage to the pulp happens, it may become irritated and start to swell.

• #2 What Causes Cavities: Formation And Prevention | Colgate

  https://www.colgate.com/en-us/oral-health/cavities/what-causes-cavitites-formation-and-prevention

  If allowed to progress, the acid and bacteria will then begin to impact the next layer of the tooth called dentin. Dentin is made of microscopic tubules, and without the protective covering of the enamel, these tubules allow hot, cold, acidic, and sticky foods to stimulate the nerves inside the tooth, causing tooth sensitivity and pain. […] If not stopped, plaque will work through the tooth until it reaches the inner tooth material, known as the pulp. This soft tissue at the center of your tooth contains nerves, blood vessels, and connective tissues. When the bacteria infect the pulp, a tooth abscess can occur, which causes severe toothaches, extreme temperature sensitivity, pain when biting, fever, and even swelling in the face or cheeks. […] The symptoms of a cavity vary depending on size, location and how many you have. In the initial stages of decay, you may not experience symptoms. Once decay breaks through the enamel and a cavity forms, especially if it has reached the dentin or pulp you may experience the following symptoms according to the Mayo Clinic: Toothache and other pain. Tooth sensitivity. Mild to sharp pain when eating or drinking something sweet, hot or cold. Holes or pits in your teeth that you can see. Brown, black or white staining on any surface of a tooth. Pain when you bite down.

• #2 Cavities (Tooth Decay): Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10946-cavities

  When tooth decay goes untreated for too long, you can lose a large portion of your tooth and need an extraction. Advanced tooth decay can lead to a severe infection inside your tooth and under your gums (tooth abscess). […] Most people with cavities don’t experience any long-term problems. Because cavities develop slowly, it’s important to get regular dental checkups. Fluoride treatments can stop tooth decay in its early stages. Once tooth decay advances to the root, you risk losing the tooth or developing a painful abscess (infection). […] Small tooth cavities turn into large cavities over time. As decay worsens, it affects the deeper layers of your tooth. This can lead to pain, infection and ultimately, tooth loss. Early treatment is essential for long-term oral health. […] Yes, in the very early stages, you may be able to reverse cavities. Tooth enamel can repair itself. If a cavity is very small, and it hasn’t spread beyond your enamel yet, then you may be able to remineralize your tooth with fluoride treatments and improved oral hygiene.

• #2 Section 6: Pathophysiology of Caries Process and Influences on Caries Development

  https://www.txhealthsteps.com/static/warehouse/1076-2011-May-4-06vdu11301voz18o4925/section_6.html

  The anti-cariogenic effect of fluoride is well documented. Fluoride and the frequency of ingestion of fermentable carbohydrates are the two greatest issues in the fight against dental caries. […] Frequent exposure to small amounts of fluoride each day is the best way to reduce the risk for developing tooth decay. […] When a person consumes food, cariogenic bacteria, including Streptococcus mutans and Streptococcus sobrinus, can break down carbohydrates in the mouth and produce acids that cause mineral loss in teeth. […] Acid causes demineralization of enamel. […] Frequent snacking promotes acid attack. […] The frequency of sugars and refined carbohydrate intake may be the main dietary variable in caries etiology, affecting colonization by cariogenic bacteria and the development of caries. […] The potential for ECC is related to extended and repetitive feeding times with prolonged exposure of teeth to fermentable carbohydrate without appropriate oral hygiene.

• #2 Tooth decay | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/Tooth-decay

  Tooth decay is a common diet-related disease. […] It is caused by the bacteria in your mouth turning sugar into energy and producing acid that damages the teeth. […] Tooth decay can start as a white or dark spot on your tooth and develop into a hole or cavity. […] Further mineral loss may lead to the cavity going into the centre of the tooth (the pulp), which may lead to toothache. […] When turning the sugar to energy, the bacteria in your mouth create acid as a waste product. This acid dissolves the crystals of your teeth and causes mineral loss, weakening the tooth. […] If the amount of acid from the bacteria on your teeth outweighs the protective effect of your saliva, then tooth decay will occur. […] Saliva is a powerful natural defence against tooth decay. It can wash sugar out of your mouth into the stomach, stop the damaging effect of acid made by bacteria, fight bacteria and reverse the early stages of tooth decay by repairing tooth mineral.

• #2 Section 6: Pathophysiology of Caries Process and Influences on Caries Development

  https://www.txhealthsteps.com/static/warehouse/1076-2010-May-3-368d6u199b5u94p7y47o/section_6.html

  Caries develops when there is a susceptible tooth exposed to pathogenic flora (bacteria) in the presence of substrate (the surface on which an organism grows). Under these conditions, the bacteria metabolize substrate to form acid that decalcifies teeth. […] As shown in Figure 1, caries can occur if oral flora contains acid-producing bacteria, such as Streptococcus mutans. […] The human oral cavity has little cariogenic potential until it is infected by pathogenic organisms. Streptococcus mutans is currently considered the principal caries-causing bacteria, but Streptococcus sobrinus may also be involved. […] The anti-cariogenic effect of fluoride is well documented. Fluoride and frequency of ingestion of fermentable carbohydrates are the two greatest issues in the fight against dental caries.

• #2 Section 6: Pathophysiology of Caries Process and Influences on Caries Development

  https://www.txhealthsteps.com/static/warehouse/1076-2010-May-3-368d6u199b5u94p7y47o/section_6.html

  Frequent exposure to small amounts of fluoride each day is the best way to reduce the risk for developing tooth decay. Fluoride combines into the tooth structure to make enamel more resistant to acid attack. […] When a person consumes food, cariogenic bacteria, including Streptococcus mutans and Streptococcus sobrinus, can break down carbohydrates in the mouth and produce acids that cause mineral loss in teeth. […] Sucrose has been more strongly associated with caries formation than any other carbohydrate. […] Acid causes demineralization of enamel. […] Frequent snacking promotes acid attack. […] The frequency of sugars and refined carbohydrate intake may be the main dietary variable in caries etiology, affecting colonization with cariogenic bacteria and the development of caries. […] The AAPD cautions that frequent breastfeeding at night and on demand after tooth eruption may contribute to the development of early childhood caries.

• #2 10 Common Causes of Cavities | Newport Beach DentalNewport Beach DentalNewport Beach DentalNewport Beach Dental

  https://www.mynewportbeachdental.com/10-common-causes-of-cavities/

  Dental cavities are holes in the teeth caused by tooth decay. The protective enamel gets worn away, leaving the core of the tooth exposed. Once plaque builds up on your teeth as you eat, it can begin to cause tooth decay in as little as 20 minutes. […] Excessive dryness of the mouth decreases the presence of this preventative enzyme, limiting its ability to fight bacteria and leading to tooth decay. […] Grinding teeth together strips them of their enamel, which leaves them more prone to decay. […] Some people are simply more prone to tooth decay due to an inherited susceptibility. […] As your gums pull back, it exposes more of the tooth–even to the root–leaving a greater area of the tooth susceptible to decay. […] It’s true, avoiding the dentist stops him or her from catching your tooth decay early on, or noticing problem behaviors that can lead to cavities.

• #2 The Disease: 2 Etiology and Pathogenesis of Caries | Pocket Dentistry

  https://pocketdentistry.com/part-1-caries-science-6/

  During the initial stages of caries, the abundance of S. mutans, S. oralis, acidogenic actinomyces, such as A. gerencseriae, and lactobacilli increase. […] Important though they are, the effects of fluoride on crystal structure are probably much less significant than the reactions which take place between crystal surfaces of apatites and fluoride dissolved in the bathing liquid. […] The overall rate of dissolution is therefore slower than in the absence of fluoride, and the higher the concentration of fluoride in the ambient solution the greater the effect, because a greater proportion of the crystals surfaces is converted to fluorapatite.

• #2 Tooth decay | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/Tooth-decay

  A reduced flow of saliva (dry mouth) can increase your risk of tooth decay. […] Early tooth decay is reversible. Saliva can deposit mineral back onto the tooth surface, and improvements in your diet and oral hygiene make a big difference. […] Your dentist can treat early areas of tooth decay with fluoride or other products to help with this process. […] Regular visits to the dentist (every 6 to 12 months) are important so that decay can be identified at this early stage when a filling can be avoided. […] When tooth decay gets worse, a hole may have formed that may need a filling. […] Early detection and treatment help preserve tooth strength and prevent bacteria from damaging its centre.

• #2 How probiotics, prebiotics, synbiotics, and postbiotics prevent dental caries: an oral microbiota perspective | npj Biofilms and Microbiomes

  https://www.nature.com/articles/s41522-024-00488-7

  Probiotics can inhibit cariogenic microorganisms colonization in the oral cavity through co-aggregation. […] The mechanism of probiotics to prevent dental caries includes the synthesis of active metabolites, inhibition of cariogenic microbial biofilm, competitive adhesion and colonization, coaggregation with pathogens, and regulation of the immune system. […] Probiotics were first introduced by Meurman and colleagues, who found that *Lacticaseibacillus rhamnosus* GG ATCC 53103 could colonize the human mouth. […] The use of probiotics in the treatment of oral diseases has been found to restore oral microbial balance and reduce the levels of *S. mutans* in dental plaque and saliva. […] Probiotics can inhibit or remove the biofilm of oral cariogenic microorganisms. […] Probiotics activate or modulate the host immune system, thereby enhancing the immune response to cariogenic microorganisms.

• #2 What Causes Cavities: Formation And Prevention | Colgate

  https://www.colgate.com/en-us/oral-health/cavities/what-causes-cavitites-formation-and-prevention

  If cavities are left untreated, an abscess (bacterial infection that creates a pocket of pus) may form beneath the root. This can be serious. Signs may include facial swelling, pain, and fever. Sometimes pain and damage can spread outside of the tooth root to the bone. This may result in tooth loss and systemic infection. With regular checkups, you can stop decay or treat a cavity before it reaches this stage. […] If you recognize any signs of a cavity, you should make an appointment with your dentist immediately. Despite wild internet claims, you can’t get rid of a cavity on your own. A dental professional can only treat cavities, and your treatment will depend on the level of tooth decay. […] Remineralization. Your saliva contains the many minerals needed to help replace the calcium and phosphorous lost from your tooth’s enamel in the earliest stages of tooth decay, which allows the enamel to repair itself. However, you can boost remineralization with fluoride, which combines with calcium and phosphate ions to make the tooth enamel stronger and more resilient. A dental hygienist can apply a fluoride treatment at your next appointment to help reverse the early effects of tooth decay.

• #2 Dental cavities – UF Health

  https://ufhealth.org/conditions-and-treatments/dental-cavities

  Treatment of cavities can help prevent further tooth damage. […] Dentists fill teeth by removing the decayed tooth material with a drill and replacing it with a material such as composite resin, glass ionomer, or amalgam. […] A root canal is recommended if the pulp is exposed to bacteria, or if the nerve in a tooth dies from decay or injury. […] Treatment often saves the tooth. Treatment is less painful and less expensive if it is done early. […] Dental cavities can lead to: Discomfort or pain, Fractured tooth, Inability to bite down on tooth, Tooth abscess, Tooth sensitivity, Infection of the bone, Bone loss, Tooth loss. […] Oral hygiene is necessary to prevent cavities. This consists of regular professional cleaning (every 6 months), brushing at least twice a day, and flossing at least daily.

• #2 Dental cavities Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/dental-cavities

  Carbohydrates (sugars and starches) increase the risk of tooth decay. Sticky foods are more harmful than non-sticky foods because they remain on the teeth. Frequent snacking increases the time that acids are in contact with the surface of the tooth. […] Treatment of cavities can help prevent further tooth damage. […] Dentists fill teeth by removing the decayed tooth material with a drill and replacing it with a material such as composite resin, glass ionomer, or amalgam. […] A root canal is recommended if the pulp is exposed to bacteria, or if the nerve in a tooth dies from decay or injury. […] Dental cavities can lead to: Discomfort or pain, Fractured tooth, Inability to bite down on tooth, Tooth abscess, Tooth sensitivity, Infection of the bone, Bone loss, Tooth loss. […] Oral hygiene is necessary to prevent cavities. This consists of regular professional cleaning (every 6 months), brushing at least twice a day, and flossing at least daily.

• #2 Cavities – How to Tell if You Have One – Symptoms, Causes, Treatments

  https://www.webmd.com/oral-health/dental-health-cavities

  Older adults sometimes get decay around the edges of fillings. Seniors often have a lot of dental work because they didn’t get fluoride or good oral care when they were kids. Over the years, these fillings can weaken teeth and break. Bacteria gather in the gaps and cause decay. […] If you have teeth, you’re at risk for cavities. Some things can raise your chances: […] A lack of fluoride. This mineral, found in toothpaste, mouthwash, and some tap water, helps to prevent cavities and can reverse early tooth damage. […] Saliva washes away food and plaque from your teeth and helps prevent tooth decay. […] Treatment depends on how bad the cavity is. Most often, the dentist takes out the decayed portion of your tooth with a drill. […] You might need a root canal if the root or pulp of your tooth is dead or injured in a way that can’t be repaired. The dentist removes the nerve, blood vessels, and tissue along with the decayed portions of the tooth. […] You can prevent tooth decay and cavities with a few lifestyle changes: […] A cavity may seem like a minor issue, but you should take it seriously. This is also true of children who don’t have their permanent teeth yet. Cavities can cause long-term problems including: […] Tooth loss.

• #2 Dental Caries (Tooth Decay)

  https://www.dentalhealth.ie/adult-oral-health/terms/dental-caries-tooth-decay/

  Tooth decay is caused by the action of acids on the enamel surface produced when sugars (mainly sucrose) in foods or drinks react with bacteria present in the dental biofilm (plaque) on the tooth surface. The acid produced leads to a loss of calcium and phosphate from the enamel; this process is called demineralisation. […] The problem arises when sugar containing foods/drinks are taken more often than four times a day! They are then unable to restore the natural balance between attacks and tooth decay is the result. […] Tooth decay, even in children who do not yet have their permanent teeth, can have serious and lasting complications such as pain, tooth abscess, tooth loss, broken teeth, chewing problems and serious infection. […] Frequent consumption of sugars is associated with tooth decay.

• #2 The Caries Process & Fluoride’s Mechanism of Action | A-Z Fundamentals of Dentifrice | Continuing Education Course on dentalcare.com

  https://www.dentalcare.com/en-us/ce-courses/ce670/caries-process-and-fluorides-mechanism-of-action

  Dental caries is an infectious disease caused by the complex interaction of cariogenic (caries-causing) bacteria with carbohydrates (i.e., sugars) on the tooth surface over time. […] The acids lower the pH in the plaque biofilm. […] When the pH drops below a critical level (approximately 5.5 for enamel, and 6.2 for dentin), it causes the dissolution of tooth mineral (hydroxyapatite) in a process called demineralization. […] Caries is simply the result of a series of demineralization/remineralization cycles where, over time, demineralization conditions prevail. […] One of the most effective methods to prevent caries is by promoting remineralization and slowing down demineralization. […] When fluoride is present in oral fluids (i.e., saliva), fluorapatite, rather than hydroxyapatite, forms during the remineralization process.

• #2 Reports of the Death of Dental Cavities Are Greatly Exaggerated | Office for Science and Society – McGill University

  https://www.mcgill.ca/oss/article/medical-critical-thinking-technology/reports-death-dental-cavities-are-greatly-exaggerated

  Our understanding of dental caries, however, has greatly advanced in the interim. We went from calling caries an infectious disease that was specifically caused by S. mutansmuch like how the influenza virus causes the fluto gaining a more ecological perspective on the disease. S. mutans is not the only acid-producing oral bacterium that can cause caries: in fact, it forms less than 2% of all the bacteria that cause caries, and a little over one in seven people with caries do not have S. mutans in their mouth. There is even a scientific paper on dental caries literally titled Beyond Streptococcus mutans! […] Even if you could reliably stop S. mutans from producing acid, you could not guarantee the absence of future dental caries. The reason why S. mutans became the Big Bad of the 1970s dentistry world is because researchers were stuck studying the mouth bacteria they could grow in the laboratory, and S. mutans grows well in the conditions scientists were selecting back then. But now, with DNA technology, scientists have been able to detect 800 different species of bacteria in the human mouth.

• #2 Caries as a Non-Communicable Disease

  https://www.colgateprofessional.com/dentist-resources/caries/caries-non-communicable-disease

  Viewing caries as an NCD affecting the microbiota can also help to reframe our clinical approach in various ways. […] As the main driver of the dysbiosis that supports dental caries, sugar intake should be addressed as a priority in caries prevention and management. Limiting consumption of sugars reduces the “fuel” available to cariogenic bacteria and therefore reduces their acidic metabolic by-products. […] Fluoride is known to inhibit the demineralization process, support remineralization, and interrupts the metabolism of cariogenic bacteria species by forming rich, durable calcium fluoride reservoirs in the biofilm matrix. These reservoirs release calcium and fluoride during acid attacks, contributing to inhibition of demineralization and supporting remineralization.

• #3 The Evolving Microbiome of Dental Caries

  https://www.mdpi.com/2076-2607/12/1/121

  Dental caries is a significant oral and public health problem worldwide, especially in low-income populations. The risk of dental caries increases with frequent intake of dietary carbohydrates, including sugars, leading to increased acidity and disruption of the symbiotic diverse and complex microbial community of health. Excess acid production leads to a dysbiotic shift in the bacterial biofilm composition, demineralization of tooth structure, and cavities. Highly acidic and acid-tolerant species associated with caries include Streptococcus mutans, Lactobacillus, Actinomyces, Bifidobacterium, and Scardovia species. The differences in microbiotas depend on tooth site, extent of carious lesions, and rate of disease progression. Metagenomics and metatranscriptomics not only reveal the structure and genetic potential of the caries-associated microbiome, but, more importantly, capture the genetic makeup of the metabolically active microbiome in lesion sites. Due to its multifactorial nature, caries has been difficult to prevent. The use of topical fluoride has had a significant impact on reducing caries in clinical settings, but the approach is costly; the results are less sustainable for high-caries-risk individuals, especially children. Developing treatment regimens that specifically target S. mutans and other acidogenic bacteria, such as using nanoparticles, show promise in altering the cariogenic microbiome, thereby combatting the disease.

• #3

  https://www.who.int/news-room/fact-sheets/detail/sugars-and-dental-caries

  Dental caries (also known as tooth decay or dental cavities) is the most common noncommunicable disease worldwide. […] Free sugars are the essential dietary factor in the development of dental caries. Dental caries develops when bacteria in the mouth metabolize sugars to produce acid that demineralizes the hard tissues of the teeth (enamel and dentine). […] Dental caries develops over time; loss of tooth substance (enamel and dentine) is caused by acid production resulting from bacterial metabolism of sugars. Early stages are often without symptoms, but advanced stages of dental caries may lead to pain, infections and abscesses, or even sepsis. […] Addressing the cause (i.e. free sugars) is therefore essential in preventing and reducing dental caries.

• #3 The Disease: 2 Etiology and Pathogenesis of Caries | Pocket Dentistry

  https://pocketdentistry.com/part-1-caries-science-6/

  A third hypothesis, the ecological plaque hypothesis, emphasizes the importance of the oral environment in determining the composition and properties of the plaque microflora. […] An increased frequency of sugar intake disrupts the homoeostasis of such a plaque because it favors growth of acidogenic, aciduric bacteria and hence promotes low-pH conditions. […] The ecological plaque hypothesis is supported by considerable evidence. […] The microflora of plaque from the approximal region is complex and dominated by Gram-positive, rod-shaped bacteria (mainly Actinomyces) and streptococci, of which the most abundant is typically S. sanguinis, with smaller proportions of other bacteria, such as Bacteroides, Neisseria, Veillonella, Fusobacterium, Rothia, and Lactobacillus. […] Changes in the plaque flora can be difficult to identify because of extensive intra- and inter-individual variation, but in caries-active people the proportion of S. sanguinis and of Actinomyces naeslundii typically fall.

• #3 Caries – Dental Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dental-disorders/common-dental-disorders/caries

  Caries is tooth decay, commonly called cavities. […] The etiology of caries is best described as multifactorial and dynamic. Many caries result from buildup of plaque, or dental biofilm, that accumulates in the mouth each day. Certain bacteria in dental plaque are able to ferment carbohydrates, producing acids that can result in demineralization of hard tooth structure. […] A tooth surface is more susceptible to caries when it is poorly calcified, has low fluoride exposure, and/or is in an acidic environment. Typically, decalcification begins when the pH at the tooth falls below 5.5. This occurs when lactic acid-producing bacteria colonize the area or when people drink soft drinks, sports drinks, or energy drinks, all of which commonly have pH values below 5.5. […] Untreated caries leads to tooth destruction, infections, and the need for extractions and replacement prostheses.

• #3 Section 6: Pathophysiology of Caries Process and Influences on Caries Development

  https://www.txhealthsteps.com/static/warehouse/1076-2010-May-3-368d6u199b5u94p7y47o/section_6.html

  Frequent exposure to small amounts of fluoride each day is the best way to reduce the risk for developing tooth decay. Fluoride combines into the tooth structure to make enamel more resistant to acid attack. […] When a person consumes food, cariogenic bacteria, including Streptococcus mutans and Streptococcus sobrinus, can break down carbohydrates in the mouth and produce acids that cause mineral loss in teeth. […] Sucrose has been more strongly associated with caries formation than any other carbohydrate. […] Acid causes demineralization of enamel. […] Frequent snacking promotes acid attack. […] The frequency of sugars and refined carbohydrate intake may be the main dietary variable in caries etiology, affecting colonization with cariogenic bacteria and the development of caries. […] The AAPD cautions that frequent breastfeeding at night and on demand after tooth eruption may contribute to the development of early childhood caries.

• #3 What Are Cavities? | Comprehensive Guide | Colgate

  https://www.colgate.com/en-us/oral-health/cavities/what-are-cavities

  Adults are especially at risk for cavities if they suffer from dry mouth, a condition due to a lack of saliva. Dry mouth may be caused by illness, medications, radiation therapy and chemotherapy, and may be either temporary (days to months) or permanent, depending on its cause. […] Now that you know what a cavity is, what causes cavities and the factors that contribute to tooth decay, you can help prevent cavities before they start. Practice good oral hygiene and see your dentist for regular checkups to keep your mouth healthy and cavity-free.

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