Cárie Dental
Prevalence: Affects 60-90% of school-aged children and the vast majority of adults globally
Overview
A doença infecciosa mais prevalente no mundo
Etiology and Risk Factors
The caries process requires the simultaneous presence of four factors: a susceptible host (tooth), cariogenic bacteria, fermentable carbohydrates, and sufficient time.
Streptococcus mutans is the primary cariogenic organism. It produces lactic acid from dietary sugars, adheres strongly to tooth surfaces via glucan synthesis, and survives in acidic environments.
Lactobacillus species play a significant role in caries progression once cavitation occurs. Other acidogenic species include Streptococcus sobrinus and various Actinomyces species.
Dietary factors are central: frequency of fermentable carbohydrate intake is more important than total amount. Sucrose is particularly cariogenic as it serves as a substrate for glucan synthesis.
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Pathogenesis
Cariogenic bacteria metabolize fermentable carbohydrates to produce organic acids, primarily lactic acid, which lower the pH of dental plaque below the critical pH of 5.5.
Classification
Stage 1 — Initial Caries (White Spot Lesion)
Demineralization of the subsurface enamel without visible cavitation.
Stage 2 — Enamel Caries
Cavitation confined to enamel.
Clinical Manifestations
Early caries may be asymptomatic, detected only by clinical examination or radiography.
Diagnosis
Clinical examination using a blunt explorer and dental mirror to detect surface changes, discoloration, and cavitation.
Treatment Protocol
Stage 1: Non-Cavitated Lesions
Remineralization and preventive therapy
Prognosis
Prognosis depends on the stage at diagnosis and effectiveness of preventive measures.
Prevention
- Twice-daily tooth brushing with fluoride toothpaste (1000-1500 ppm for adults)
- Interdental cleaning (flossing or interdental brushes) once daily
Interactive Quiz
Test your understanding of Cárie Dental.
Q1.
3D Pathology Description
Demonstrate progressive demineralization from enamel surface through dentin tubules toward pulp chamber. Show bacterial biofilm layer, acid diffusion front, and remineralization zones.