Carie

Carie is the process of tooth decay caused by acid produced by bacteria in dental plaque. In English the condition is called dental caries or tooth decay; carie is the spelling used in some languages such as French. The disease involves demineralization of enamel and underlying dentin and pulp as it progresses.

Causes and progression: The decay is driven by biofilm bacteria, especially Streptococcus mutans and Lactobacillus, that ferment sugars to lactic acid. The acidic environment lowers mouth pH, causing minerals to leach from enamel. Recurrent cycles of demineralization and limited remineralization create lesions that may cavitate and extend into dentin.

Symptoms and diagnosis: Early caries are often asymptomatic. Visible discoloration, white-spot lesions, sensitivity, or pain may occur as decay advances. Diagnosis relies on clinical examination, dental explorers, and bitewing radiographs to detect lesions.

Treatment: Early lesions may be managed with fluoride therapy and improved oral hygiene to promote remineralization. More advanced decay requires removing decayed tissue and restoring with fillings or indirect restorations. If the pulp is affected, root canal treatment or extraction may be necessary.

Prevention: Strategies include brushing with fluoride toothpaste, flossing, fluoride varnish or rinse as advised, reducing fermentable sugar intake, and regular dental checkups. Sealants for children can help prevent new lesions on molars.

Epidemiology and public health: Dental caries is one of the most common chronic diseases worldwide, affecting people of all ages but especially children and older adults in underserved communities. Prevention programs and access to fluoridated water or dental care have reduced prevalence in many regions but disparities persist.

Etymology and terminology: The word carie derives from Latin caries, meaning decay. The condition is distinct from other forms of tooth wear such as abrasion or erosion.