Theories of Dental Caries

THEORIES OF DENTAL
CARIES
Rubab Haider
Final year BDS
FMH college of MED and Dentistry
Lahore.
DENTAL CARIES
--Progressive bacterial damage to

teeth exposed to saliva.
--one of the most major causes of
all diseases and major cause of
tooth loss.
--ultimate effect-to breakdown
enamel and dentin and open a
path for bacteria to reach pulp.
Consequences-inflammation of pulp
and periapical tissues.
AETIOLOGY
 Four major factors involved in etiology:-

 Cariogenic bacteria
 Bacterial plaque
 Susceptible tooth surface
 Fermentable bacterial substrate (sugar)
THEORIES OF DENTAL
CARIES
Chemical (acid) theory

Parasitic (septic) theory
The Acidogenic theory
The Proteolytic theory
Proteolysis chelation theory
CHEMICAL (ACID)
THEORY
 In 17th and 18th century,there emerged
a concept that teeth are destroyed by
acids formed in the oral cavity by
fermentation of food particles around
the teeth..
PARASITIC (SEPTIC)
THEORY
 Microorganisms were associated with
the carious process...
ACIDOGENIC THEORY
 W.D Miller was the first well known scientist
and investigator of dental caries and
published his results in 1882.
 According to him dental decay is a
chemoparasitic process
 It is a two stage process there is
decalcification of the enamel which also
results in the destruction of the dentin. in
the second stage there is dissolution of the
softened residue of the enamel and dentin.
ACIDOGENIC THEORY
 In the first stage there is destruction is

done by the acid attack where as the
dissolution of the residue is carried by
the proteolytic action of the bacteria's
 This whole process is supported by the
presence of carbohydrates
microorganisms and dental plaque
PROTEOLYTIC
THEORY
PROTEOLYTIC THEORY
The evidence given by the acidogenic

theory was considerable but it was not
conclusive, and alternative explanation
was given in the form of proteolytic
theory.
 Workers like “Heider, Bodecker
(1878)and Abbott (1879) contributed
considerably to this theory
PROTEOLYTIC THEORY
 There has been evidence that the organic
portion of the tooth plays an important role
in the development of dental caries
 The are some enamel structure which are
made of the organic material such enamel
lamelle and enamel rods
 These structure prove to be the path ways
for the advancing microorganisms.
PROTEOLYTIC THEORY
 It has been established that enamel contains 0.56
% of organic matter of which 0.18% is keratin and
0.17 % is a soluble protein
 Microorganisms produce proteolytic enzymes,which
destroy the organic matrix of enamel,loosening the
apatite crystals….so they are eventually lost and
tissue collapses…
PROTEOLYSIS
CHELATION
THEORY
PROTEOLYSIS
CHELATION THEORY
Some of the minor flaws of the
acidogenic and the proteolytic theory
were addressed in the proteolysis
chelation theory.
 This theory was put forward by Schatz
and his co-workers in 1955.
PROTEOLYSIS
CHELATION THEORY
CHELATION
It is a process in which there is
complexion of the metal ions to form
complex substance through
coordinate covalent bond which
results in:
poorly dissociated /or
weakly ionized compound
PROTEOLYSIS
CHELATION THEORY
Example of chelation reaction:
Hemoglobin in which 4 pyrrole nuclei are linked to
iron by a similar bond
 Chelation is independent of the PH of the medium.
 The bacterial attack on the surface of the enamel
results in the breakdown of the protein ,chiefly
keratin and results in the formation of soluble
chelates with calcium which decalcify enamel even
at neutral PH..
 Mucopolysaccarides may also act as secondary
chelators.
Dental caries
Its clinical correlation
TYPES OF DENTAL
CARIES
 Gv blanks classification of caries class
I , II , III , IV , V and VI
 Rampant caries
 Recurrent caries
 Arrested caries
 Root or cemental caries
 Baby bottle caries
Pits and fissure caries
Proximal caries
Cervical caries
Rampant caries
Recurrent caries
Arrested caries
Root or cemental caries
Nursing bottle caries
THANK YOU!!!!!!!!!!!!

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THEORIES OF DENTAL

--Progressive bacterial damage to

 Four major factors involved in etiology:-

Chemical (acid) theory

 In the first stage there is destruction is

The evidence given by the acidogenic

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