1. Pathology
1.1. Enamel Caries
1.1.1. Macroscopic
1.1.1.1. Slowly progression ( brown spot)
1.1.1.2. Opaque chalky white hard area
1.1.2. Microscopic
1.1.2.1. Phase of initiation
1.1.2.1.1. translucent zone
1.1.2.1.2. dark zone
1.1.2.1.3. body of lesion
1.1.2.1.4. surface zone
1.1.2.2. Phase of bacterial invasion
1.1.2.3. Phase of destruction
1.1.2.4. Phase of secondary enamel caries
1.2. Dentin Caries
1.2.1. Macroscopic
1.2.1.1. Conical-shaped
1.2.2. Microscopic
1.2.2.1. Uninfected dentinal lesion
1.2.2.1.1. Zone of fatty degeneration
1.2.2.1.2. Zone of hypermineralization
1.2.2.1.3. Zone of hypomineralization
1.2.2.2. Infected dentinal lesion
1.2.2.2.1. Zone of Bacterial invasion
1.2.2.3. Area of dentinal destruction
2. Expiremnts
2.1. turku study
2.1.1. Explains the different rate of caries by various sugars
2.2. vipeholm experiment
2.2.1. investigate the effect of amount, frequency of intake, texture of CHO
2.3. Hopewood house experiment
2.3.1. different diet affect dental caries activity
2.4. miller's experiment
2.4.1. bacteria produced acids that lead to demineralization of enamel and dentin
2.5. orland's experiment
2.5.1. Not all bacteria produce dental caries
2.5.2. Streptococcus mutans is more cariogenic than lactobacilli
2.6. Stephan's experiment
2.6.1. importance of acid production in dental caries
3. Balance
3.1. Demineralization
3.1.1. Acid producing Bacteria
3.1.2. Sub-normal saliva flow
3.1.3. Frequent fermentable Carbohydrates intake
3.1.4. Poor oral hygiene
3.2. Remineralization
3.2.1. Adequate Saliva Flow
3.2.2. Flouride calcium,phosphate
3.2.3. Antibacterials
3.2.4. Oral Care
4. Theories
4.1. Proteolytic theory
4.2. Miller's chemo parasitic theory (most acceptable theory)
4.3. Proteolysis chelation theory
5. Etiology
5.1. Host Factors (saliva & susceptible tooth)
5.2. Cariogenic Bacteria
5.3. Time
5.4. Fermentable Carbohydrate
5.4.1. types
5.4.1.1. Monosaccharides
5.4.1.2. disaccharide
5.4.1.3. polysaccharides
5.4.2. frequency
5.4.2.1. Increase periods of CHO in oral cavity
5.4.2.2. Increase periods of micro-organism activity producing acid
5.4.2.3. Increase periods of acid demineralisation to tooth structure
5.4.2.4. Cleansing effect of other fibrous food elements is absent
5.4.3. Total Amount
5.4.3.1. CHO intake increases Caries Activity and vice versa
5.4.4. Texture
5.4.4.1. Sticky CHO is more cariogenic
6. Dental Plaque
6.1. Mechanism of Formation
6.1.1. formation of an acquired enamel pellicle
6.1.2. colonization of cell free pellicle by bacteria
6.1.2.1. initiation
6.1.2.2. formation
6.1.2.3. establishment
6.2. factors affecting plaque formation
6.2.1. Anatomy and position of tooth
6.2.2. Presence of appliances
6.2.3. Structure of tooth surface
6.2.4. Friction from the diet and masticatory movements
6.2.5. Oral hygiene measures
6.2.6. Composition of the diet
6.3. Composition
6.3.1. micro-organism
6.3.2. amorphous matrix
6.3.3. proteins
6.3.4. carbohydrate
6.3.5. inorganic content
6.4. Role of Plaque Matrix
6.4.1. Act as diffusion-limiting membrane
6.4.2. Contrubutes to adhesiveness, bulk & resistance to washing saliva