39 Caries
CASE HISTORY
The referring veterinarian noticed caries while performing an annual periodontal debridement.
ORAL EXAMINATION – UNDER GENERAL ANAESTHETIC
In summary, examination under general anaesthesia identified the following:
THEORY REFRESHER
Caries usually affect the teeth that have true occlusal tables, namely the molar teeth.
While both periodontal disease and caries are caused by the accumulation of dental plaque on the tooth surfaces, the pathogenesis of the two diseases is completely different. Periodontal disease is a plaque-induced inflammation of the periodontium and caries is a plaque-induced destruction of the hard tissues of the tooth. Caries starts as an inorganic demineralization of the enamel. The demineralization occurs when plaque bacteria use fermentable carbohydrate (notably sugar) from the diet as a source of energy. The fermentation products are acidic and demineralize the enamel. Once the enamel has been destroyed, the process extends into the dentine. In the dentine, the process accelerates as an organic decay and will eventually involve the pulp, causing pulpitis and eventually pulp necrosis and/or periapical pathology. Dental caries stimulates the formation of secondary dentine on the surface of the pulpal wall, which is directly beneath it. If the carious lesion is progressing slowly, the deposition of secondary dentine may keep pace with its advance and prevent exposure of the dental pulp.