4/29/2013

DEFINITION
an infectious, communicable disease resulting in
destruction of tooth structure by acid-forming bacteria

Dental caries
found in dental plaque, in the presence of sugar
The development of dental caries is a dynamic process of
demineralization of the dental hard tissues by the
products of bacterial metabolism, alternating with periods
of remineralization
drg Miftakhul Cahyati, SpPM

ORIGINAL CONCEPT RECENT CONCEPT

ETIOLOGY AGEN FACTORS

Tooth Susceptibility
Bacterial Plaque (Microorganism) Streptococcus mutans initiation of dental
caries
Carbohydrates mutans plus sucrose reduces the pH in the
plaque to a critical level of 5.0-5.5, which can
Time overcome the buffering capacity of saliva and
Oral Sugar Clearance result in demineralization of enamel

Host (Saliva Flow & Ph)

Lactobacillus progression of dental caries
Social Economic & Demografic lactobacillus counts are significantly higher in
patients with open caries lesions

1
 4/29/2013

Dental Caries: Formation of a cavity

Initial attachment of S. mutans to tooth pellicle is
mediated by antigen I/II (adhesin) and Glycosyl
transferase (GTF).

Sucrose is broken down into fructose and glucose

by glucosyltransferases (GTFs).

Fructose and glucose are both metabolized,

resulting in lactic acid accumulation.

Glucose is stored as a glucan polymer (dextran).

S. mutans accumulates as glucosyltansferases

(GTFs) adhere to glucans produced by other
bacteria in plaque.

TYPES OF DENTAL CARIES

Black classification of caries class
I , II , III , IV , V and VI
Rampant caries
Recurrent caries
Arrested caries
Root or cemental caries
Baby bottle caries

Cervical caries Nursing bottle caries

2
 4/29/2013

Rampant caries Arrested caries

A. Active caries
.
B. Arrested caries

Classification by Black

Linking diagnosis to clinical management

3
4/29/2013