A Lecture Note On Histopathology Of Dental Caries

Histopathology of Dental Caries

• Dental caries or tooth decay is one of the most common of all disorders, second only to common cold. 
• Dental caries has afflicted more humans longer than any other disease. It was first appeared about 14000 years ago. From that time to the present, dental caries affected almost all human populations, at all socioeconomic levels, and at all ages.
• The first study about dental caries was published in 1870 and has continued uninterrupted to the present.
• Every year $20 billion is spent in USA for prevention of dental caries.
• Some isolated populations like Eskimos, some African natives, and inhabitants of rural India are “immune” to dental caries because they are not exposed to western food habits.
• The word ‘caries’ is derived from the Latin word ‘rot’.
• In 1982 Dr. Louw calculated that it would take 470 dentists, working all year long , to restore the carious lesions in 12-year old ‘colored’ children in South Africa.

è It is the most prevalent disease affecting the human race,

è  Practically spread all over the world,

è  Affects both sexes and all races, all socio-economic strata and people of all ages,

è  Starts soon after teeth erupt into the oral cavity

è  It is a paradox that teeth are the hardest tissue in the body but can be easily destroyed relatively rapidly in vivo.

What is Dental Caries?

It is a microbial disease of the calcified tissues of the teeth, characterized by demineralization of the inorganic portion and destruction of the organic substance of the tooth.

CARIES OF ENAMEL

Smooth surface Caries:

Due to plaque formation on enamel. The earliest manifestation of incipient caries (early caries) of enamel is usually seen beneath dental plaque as areas of decalcification (white spots).

The first change seen histologically is the loss of inter-rod substance of enamel with increased prominence of the rods.

        -this is followed by the loss of mucopolysaccharides in the organic substance.

        -presence of transverse striations of the enamel rods,

        - accentuated incremental lines of Retzius

as it goes deeper, the caries forms a triangular pattern or cone shaped lesion with the apex towards DEJ and base towards the tooth surface. Finally there is loss of enamel structure, which gets roughened due to demineralization, and disintegration of enamel prisms.

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