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1、1.DefinitionDental cariesiscausedbycertainorganismoftheoralflora（菌丛）. Itisanirreversible,slowlyprogressivedecayofthehardtissuesofindividualteeth.the high incidence : 40-65% a multifactorial diseasea chronic diseasehard tissues of tooth: (enamel,cementum,dentin)an irreversible decaycharactersticdemin
2、eralization of apatites（磷灰石脱磷灰石脱矿）decomposition of organic substance（有机物分解）（有机物分解） disintegration （崩解）崩解）of tooth structures cavitation（洞腔形成）洞腔形成）The carious process 2.Four Factors theoryFour Factors Is Essential For The Initiation Of Dental Caries Namely: Cariogenic bacteria Food Host Time Cariogen
3、ic bacteria -Dental Plaque（牙菌斑）（牙菌斑）streptococcusmutans（变形链球菌）lactobacillus（乳酸杆菌）actinomyces（放线菌属） FoodRefined carbohydrates(精制碳水化合物精制碳水化合物) such as sucrose蔗糖蔗糖 provide a suitable substrate on which the cariogenic micro-organisms act to produce the acids that lead to dissolution of the hard dental t
4、issuesCaries experience is influenced by the quantity, quality and especially frequency of consumption of the refined carbohydrate Tooth morphologybacterialplaqueisanessentialprecursorofcaries,sitesonthetoothsurfacewhichfavourpalqueretentionandstagnationareparticularlypronetodecaySalivaundernormalco
5、nditions,thetoothiscontinuallybathedinsaliva.ItiscapableofremineralizingtheearlycariouslesionbecauseitissupersaturatedwithCaandP.whensalivarybufferingcapacityhasbeenlost,alowPhenvironmentisencouragedandpersistslongerFluorideparticularinterestwasthediscoveryoftheassociationbetweenfluorideconcentratio
6、ninwatersuppliesandprevalenceofdentalcariesinchildren Host TimeCertain time is needed for the carious process Tetra-factor hypothesis microorganismsHost & toothsubstratetimecariesThe four circle diagrammatically represent the parameters involved in the carious process. All four factors must be actin
7、g concurrently (overlapping of the circles) for caries to occur.Cariesrequiresasusceptiblehost,acariogenicoralfloraandasuitablesubstratethatmustbepresentforasufficientlengthoftime3.Classification superficial caries :enamel/cementumintermediate caries :superficialdentindeep caries :dentinsuperficial
8、cariesLesioninsideenamelNofeelingColorchangeintermediate cariesLesioninsidesuperficialdentinSusceptibletocold,hot,sour,sweetColorchange(brown)Cavitydeep cariesDentinlesionMoresusceptibletocold,hot,sour,sweetColorchange(brownblack)Deepercavitysuperficial caries intermediate caries deep cariesOther cl
9、assificationAcute cariesChronic caries1.varietiesforColor , form , hardness oftooth2.Therearethreegeneralareasontoothsurfaceswheredecaystarts:1)pitsandfissuresofmolarsandbicuspids,2)buccalandlabialsurfacesnearthegingivalline,3)proximalsurfacesthatlieintheareasbetweenthecontactpointandthegum.4.clinic
10、al characteristics 5.Diagnosis1.mainlymadeby：Clinicalcharacteristics2.DetectionThemajorexaminationmaterialsinclude-mouthmirror:lookexplorer/probe:explorationnipper:percussion,radiographs,etc.radiographtodistinguishcariesfrom6.Treatment(1)chemicaltherapy:75%NaF,10%AgNO3(2)plugging-recoveryofformandfunction:cavitypreparation:resistanceform,retentionformcavityfilling:ZOE,ZOP,silveramalgamcavitypreparationfillingcheckingonceayear7.preventionpreventionpitandfissuresealing
