Microbiology and Clinical Implications of Dental Caries – A Review
Sachidananda Mallya P, Shrikara Mallya
Abstract
Dental caries is a chronic infection caused by normal oral microbial flora. Even though there are several types of bacteria in the oral cavity, only a certain species of bacteria can initiate dental caries and periodontal infection. The bacteria which are most frequently associated with dental caries were Streptococcus mutans, Lactobacillus and Actinomycetes. These are gram positive bacteria which are acidogenic and aciduric. Lactobacillus is not the caries initiator but plays an important role in the progression of caries. The prerequisite in the aetiology of dental caries are cariogenic bacteria, fermentable carbohydrates, a susceptible tooth, the host and the time. The caries lesion is the result of demineralization of enamel and or dentin by acids produced by aciduric bacteria as they metabolize dietary carbohydrates. The consequences of these infections can vary according to immunological resistance of the patient as well as the resistance of some microorganisms to the most common antimicrobial agents. Factors to be taken into consideration in the treatment are the patient's history, microbial virulence factors, and maintaining or suppression of aetiological factors. Severe dental caries may cause chronic inflammatory response in the endothelial coronary cells through bacterial invasion and also can induce atherosclerosis which can increase the risk factor for the development of chronic heart disease. Organisms causing dental caries have been implicated as causative agents for bacterial endocarditis. Systemic antibiotics showed potential efficacy in the prevention or treatment of dental caries. The present review spotlights the current knowledge on the microbiology and clinical implications of dental caries.