Dental caries, also known as tooth decay, is the destruction of the outer surface (enamel) of a tooth. Decay results from the action of bacteria that live in plaque, which is a sticky, whitish film formed by a protein in saliva (mucin) and sugary substances in the mouth. The plaque bacteria sticking to tooth enamel use the sugar and starch from food particles in the mouth to produce acid. Tooth decay can result in tooth loss.
Thanks to the benefits of fluoride and fluoridated water, dental caries, also called dental cavities, are not as prevalent as in the years before and including the 1980s. While the majority of senior citizens a generation ago lost all their teeth, the vast majority of the elderly today have some or all of their natural teeth.
Although anyone can have a problem with tooth decay, children and senior citizens are the two high-risk groups. While both groups experience a diminishing caries rate, senior citizens are getting more cavities than children. Since older adults are keeping their teeth longer, they have become more prone to root caries, or root decay. Other high-risk groups include people who eat a lot of starchy and sugary foods, people living in areas without a fluoridated water supply, and people who already have numerous dental restorations (fillings and crowns).
| Dental caries charting: classification of cavities | |
| Classification and location | Method of examination |
| SOURCE: Alvarez, K.H. Williams & Wilkins' Dental Hygiene Handbook. Baltimore: Williams & Wilkins, 1998. | |
| Class I Cavities in pits or fissures Occlusal surfaces of premolars and molars Facial and lingual surfaces of molars Lingual surfaces of maxillary incisors |
Direct or indirect visual Exploration Radiographs are not useful |
| Class II Cavities in proximal surfaces of premolars and molars |
Early caries: by radiographs only Moderate caries not broken through from proximal to occlusal: Visual by color changes in tooth and loss of translucency Exploration from proximal Extensive caries involving occlusal: direct visual |
| Class III Cavities in proximal surfaces of incisors and canines that do not involve the incisal angle |
Early caries: by radiographs or transillumination Moderate caries not broken through to lingual or facial: Visual by tooth color change Exploration Radiograph Extensive caries: direct visual |
| Class IV Cavities in proximal surfaces of Transillumination involve the incisal angle |
Visual incisors or canines that |
| Class V Cavities in the cervical 1/3 of facial or lingual surfaces (not pit or fissure) |
Direct visual: dry surface for vision Exploration to distinguish demineralization: whether rough or hard and unbroken Areas may be sensitive to touch |
| Class VI Cavities on incisal edges of anterior teeth and cusp tips of posterior teeth |
Direct visual May be discolored |
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Author Info: Lisette Hilton, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Nursing and Allied Health, 2002 |