“The mouth is the gateway to the rest of the body, a mirror of our overall well-being.”

Areas for Development of Caries

• Pit and fissure caries occurs primarily on the occlusal surfaces and buccal and lingual grooves of posterior teeth, as well as in lingual pits of the maxillary incisors.
• Smooth surface caries occurs on intact enamel other than pits and fissures.
• Root surface caries occurs on any surface of the root.
• Secondary, or recurrent, caries occurs on the tooth surrounding a restoration.

Stages of Caries Development

• It usually takes a period of time, from months to years, for a carious lesion to develop.
• It is an ongoing process, characterized by alternating periods of demineralization and remineralization.
• Demineralization is the dissolving of the calcium and phosphate from the hydroxyapatite crystals.
• Remineralization is the calcium and phosphate being redeposited in previously demineralized areas.
• It is possible to have the processes of demineralization and remineralization occur without any loss of tooth structure.

Stages of Caries Development-cont’d

• Incipient lesion develops in the earliest stages when caries begins to demineralize the enamel.
• Overt, or frank, lesion is characterized by cavitation (the development of a cavity or hole in the tooth).
• Rampant: The time between the onset of the incipient lesion and the development of the cavity is rapid and there are multiple lesions throughout the mouth.

Fig. 13-4 A, The earliest sign of decay is decalcification (Courtesy Dr. John Featherstone, University of California, San Francisco, School of Dentistry.)

Fig. 13-4 B, Dental caries (Courtesy Dr. Frank Hodges, Santa Rosa, CA.)

Fig. 13-4 C, Dental caries (Courtesy Dr. Frank Hodges, Santa Rosa, CA.)

Fig. 13-5 Severely decayed molar on a child