Dr ANURAG KASHYAP Aesthetic and implant dentist - 098155 28949

Caries and Prevention

What is tooth decay ?
Tooth decay is an infectious disease of bacterial origin and causes demineralization and destruction of hard dental tissues, enamel, dentin, cement. Etiology of the decay is the formation of acids during the fermentation of food which is collected on teeth. If the mineral loss is greater than the remineralization ( source of mineral are saliva, fluorinated pastes ) hard tissues of the tooth can be destroyed – there is a formation of caries lesion which should be treated immediately after. Caries should be excavated ( preparation ) and to fill the cavity ( obturation ). Today dentists have a large selection of filling materials. The choice depends on the size and stage of caries 
Classification of caries

- On the occlusal surface -fissures and pits 
- In the interproximal surface , between two adjacent teeth 
- Cervical caries 
- Root surface – cement caries 

- Primary 
- Secondary - around the edges of existing restorations and under the restorations ( residual caries) which is caused by incomplete excavation

- Stage of white spot - reversible by remineralization and fluoride application

- Surface enamel caries 
Caries media – caries has affected the dentin ,is sensitive to sweet and cold 
Deep caries – there can be micro communication with the pulp 
Deep caries with pulp involvement

Depending on age : 
- Early childhood caries 
- Adult's caries 

Prevention : 
1. Nutrition - Avoid foods and drinks with high level of sugar ( sweets , pasta, sodas, sugary drinks, etc. . ) . 
2 . Fluoride -Regular cleaning with a brush and paste, and the use of interdental floss ( or brush ) ; 
3 . Oral Hygiene 

How to treat tooth decay? 
Treatment of dental caries and its complications depends on the stage of destruction. 

Restorations that look like natural teeth 
The most widely used filling materials are composites .They are made of glass or quartz resin. The advantages are that dentists can choose the color of the composite , which suit with the color of natural tooth. Although all composites may be stained with time. Composites are ideal for small to medium-sized cavities and teeth that have been subjected to large occlusal forces , such as the molar teeth . 
Fillings that release fluoride 
Some of the new opportunities to fill are glass ionomer cements. They are made of acrylic acids and fine glass particles . Restorations can be selected in a color that is identical to that of the adjacent natural tooth. Glass ionomers are unique because they release fluoride , which is involved in prevention .Dentists recommend these restorations in areas near the gum or fillings between the teeth . 

Inlays / onlays 
The inlays and onlays restorations are used for obturation of molar teeth with small to moderate destruction or fractured teeth that are not damaged enough to require a crown. This allows dentists to conserve more natural tooth structure . Advantages are resistance ( up to 30 years ).Inlays and onlays improve the strength of tooth up to 75 percent , and prevents the need for additional treatment in the future. Inlays is like a restoration. Onlays are more expensive because they extend over a large chewing surface . 
During the treatment, the dentist removes the old obturation under local anesthesia and takes the impression of the tooth .The impression is sent to laboratory. Inlay can be made of porcelain , gold or composite .On the next visit the dentist fix the inlay . It takes two visits to complete the treatment. 

Low price restoration 
For many years, dentists have used amalgam to fill cavities. The amalgam is made of silver , mercury and copper. This material is extremely resistant .The disadvantage of amalgam is the gray color. Restorations can be temporarily sensitive from heat and cold.

Fillings of gold 
Gold is very resistant to corrosion and discoloration .It is used for inlays, crowns and bridges. 


Bonding is a procedure in which the dentist places the composite material and shine with visible blue light. This provide the best connection with the composite material and the tooth. Bonding is used in operative dentistry , cosmetic , pedodontics, orthodontics . 

When is it appropriate?

To restore fractured teeth and teeth with chipped edges 
To improve the aesthetics of teeth discoloration 
To close gaps between teeth – diastemas and tremas 
To increase the size of teeth 
To change the shape of teeth 

What is the procedure?

Preparation is minimal .The anesthesia is not necessary unless the tooth has a decay. Dentists use shade guide to choose the color of the composite material,which is common to the natural tooth or the desired color change . 
Bond procedure-after etching and conditioning of the tooth,the surface is prepared for the next step. In the next step the dentist shapes the composite material and in the end he polishes it.

Time for bonding-Bonding takes 30 to 60 minutes per tooth . 
Tea, coffee , tobacco, red wine and other substances can discolor the composite material . You should not drink these liquids for 48 hours after the procedure. 
Advantages: Bonding is among the cheapest procedures in cosmetic dentistry. For one visit bonding can be done .The procedure is minimal invasive. 

Bonding is suitable for people in all ages.