Dental Diseases
Dental Caries
aka Tooth decay · Cavities
Multifactorial biofilm-mediated demineralisation of dental hard tissues by acidogenic bacteria.
§ figuresFigures (3)
Fig. 1This is a cavity inside a tooth of a 10-year-old boy from India
“Dental Caries Cavity 2” · Suyash.dwivedi · CC BY-SA 4.0 · Wikimedia Commons
Fig. 2Dental Caries
“Dental caries 3 ” · Ickyvickywiki · CC BY-SA 4.0 · Wikimedia Commons
Fig. 3Dental caries or decay involving occlusal part of the tooth.
“Dental Caries Lower Right First Molar” · Dr. Yogesh · CC BY-SA 4.0 · Wikimedia Commons
Verified open-access images only, reproduced for education under their stated licences · no AI-generated or illustrative artwork · Dental Caries figures pending faculty review.
§ overviewOverview
A dynamic disease process in which cariogenic biofilms produce organic acids that demineralise enamel, dentin and cementum.
§ etiologyEtiology
- 01Streptococcus mutans, S. sobrinus, Lactobacillus, Actinomyces
- 02Fermentable carbohydrates
§ riskRisk Factors
- 01Frequent sugar intake
- 02Hyposalivation
- 03Poor oral hygiene
- 04Deep pits & fissures
- 05Low fluoride exposure
§ epidemiologyEpidemiology
Most prevalent chronic disease globally (WHO). Affects 60–90% of school children.
§ pathogenesisPathogenesis
Keyes' triad (host + microflora + substrate) over time → repeated acid attack drops pH < 5.5 → net mineral loss.
§ clinicalClinical Features
- 01White spot lesion → brown discolouration → cavitation
- 02Sensitivity to sweet/cold
- 03Pain in advanced lesions
§ differentialDifferential Diagnosis
- 01Enamel hypoplasia
- 02Dental fluorosis
- 03Erosion / attrition / abrasion
§ radiographicRadiographic Features
- 01Bitewing: interproximal radiolucency
- 02Occlusal caries best seen clinically; radiograph shows deep lesions
§ classificationClassification
- 01G.V. Black Class I–VI
- 02ICDAS 0–6
- 03Site & size (Mount & Hume)
§ treatmentTreatment
- 01Non-cavitated: fluoride varnish, SDF, resin infiltration
- 02Cavitated: minimally invasive restoration (composite, GIC)
- 03Pulpally involved: RCT or extraction
§ prognosisPrognosis
Excellent when managed early; progressive without intervention.
§ preventionPrevention
- 01Fluoride toothpaste twice daily
- 02Pit & fissure sealants
- 03Dietary counselling
- 04Xylitol
§ vivaBDS Viva Questions
- 01Describe Keyes' triad
- 02Compare ICDAS and G.V. Black classifications
§ pearlsClinical Pearls
- 01Silver diamine fluoride arrests caries but stains lesions black.
§ mcqsMCQs — Assessment (1)
Question 1
Critical pH for enamel demineralisation is:
§ evidenceReferences & Evidence
Current Classification
WHO Classification of Tumours Online — Head and Neck
IARC / WHO · 2022
Continuously updated online edition of the WHO head and neck tumour classification.
Evidence summary
Highest level of evidence linked to this page: WHO / Official Classification.
- L1 · Classification — 1
- L6 · Textbook — 3
1 linked source was published from 2024 onwards. Where guidance is limited or contested, rely on the higher-level sources above rather than this summary. Educational use only — not a substitute for clinical judgement.
Content last reviewed
September 2026
Evidence last reviewed
September 2026
Next scheduled review
September 2027
Review status
EVIDENCE REVIEWED
Search latest PubMed evidence
Last literature search: 7 September 2026
Current Classification
IARC / WHO. IARC · 2022
Continuously updated online edition of the WHO head and neck tumour classification.
Histopathology References
Barnes L. CRC Press · 2008
Detailed histopathological reference for head and neck diagnostic criteria.
Textbook References
Neville BW, Damm DD, Allen CM et al.. Elsevier · 2024
Standard reference textbook of oral and maxillofacial pathology used throughout this atlas.
Rajendran R, Sivapathasundharam B. Elsevier · 2020
Undergraduate and postgraduate oral pathology textbook widely used in BDS and FCPS curricula.
Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.