The World Health Organisation (WHO) defines caries as "a localised pathological process of external origin that begins after tooth eruption, leading to a softening of the hard tissue of the tooth and progresses to the formation of a cavity".
That is, a disease of teeth present in the mouth characterised by a 'hole' in the tooth, which is estimated to affect 95% of adults in Western countries.
Etymology
The word caries comes from Latin and means 'degradation or decay', reflecting its activity of progressively destroying the affected tooth, softening it and, if not remedied, even affecting its nerve.
Origin
Caries is a disease of multifactorial origin, caused by:
- Demineralisation caused by acids generated by bacteria in the oral environment
- Lack of hygiene due to poor brushing or lack of brushing
- Reduced flossing
- High consumption of sugars and acids contained in food and beverages.
- Genetic factors that determine, among others, the pH of our saliva.
Where is it produced?
To understand caries and its progression, a general understanding of dental anatomy is necessary.
The tooth has three distinct layers, the outermost being the enamel, followed by the dentine and the pulp, which is what is commonly known as the 'nerve'.
Enamelis a very hard tissue due to its high mineral content, in fact it is the most mineralised tissue in our organism, providing the tooth with a hard surface that allows chewing as well as protecting the underlying tissues. It is bluish-white in colour and is semi-translucent. It has neither blood vascularisation nor nerve endings.
DentineDentine: is a mineralised tissue (although less so than enamel) that makes up most of the volume of the tooth, providing the shape and rigidity necessary for its function during chewing to be effective. It has a pale yellow colour and, as enamel is semi-translucent, dentine is responsible for the colour of the tooth.
It contains the dentinal tubules, which are responsible for tooth sensitivity.
PulpPulp: is the non-mineralised component of the tooth. It is found in the central part of the tooth, in an area known as the pulp chamber. It is where the blood vessels and nerves that make the tooth vital are found.
How is it progressing?
- Caries starts due to demineralisation caused by acids generated by bacteria in the enamel and gets deeper and deeper.
This phase is asymptomatici.e. it does not cause discomfort and passes completely unnoticed. unnoticed by the patientThe enamel has no nerve endings, as mentioned above.
- When it reaches the dentine, as it is very extensive, if the caries is in surface can also happen unnoticed, but, according to is progressing is appearing sensitivity to cold and sweet things although this also depends on the patient's pain threshold. The deeper the caries is at the dentine level, the longer and more intense the sensitivity will be.
At the moment a cavity appears in the tooth. Up to this stage the problem is solved with a filling.
- When caries reaches pulpa pain spontaneous, intense and continuous which is intensified at night or when lying down. This is because the pulp becomes inflamed and as it increases in size, it presses on the nerve complex of the tooth, an acute process known as pulpitis.
In addition, a sensitivity augmented in the heat. Treatment is usually endodontics or root canal treatment plus reconstruction of the tooth.
- If treatment is not carried out at this stage, the caries continues its destruction and a necrosis pulp, i.e. a death of the pulp due to bacterial irritation. In this state, no There is neither sensitivity to cold and heat.
For all these reasons, one of the most important reasons to go for regular check-ups with your dentist is the early diagnosis of caries, thus preventing future problems with your teeth, so that if it is recognised in time it can be solved easily and quickly.