Synonyms in a broader sense
Carie, tooth decay
- The first stage describes the initial lesion or caries initialis. In this stage of development, only the enamel is decalcified or demineralized and no collapse of the surface can be felt. Therefore, this stage is still reversible and controllable through targeted fluoridation.
All other stages are irreversible and must be treated with measures such as a filling therapy.
- In the second phase, there is an enamel intrusion, which, however, only affects the uppermost layer of the hard tooth substance.
- If the caries spreads further, it reaches the dentin and is in the third caries stage. This stage is called enamel – dentine lesion or caries profunda. Once the dentin has been reached by the caries, it progresses much faster because the dentin is less hard and can be penetrated more easily.
- The last stage is the reaching of the pulp.
The caries has now completely penetrated through enamel and dentine and infects the pulp. The nerve and blood vessels are metabolised by the bacteria and die as a result. At this stage, pure filling therapy cannot save the tooth.
The tooth must first be treated with a root canal treatment to completely remove bacteria from the pulp and close the root canals with a root filling. The tooth can then be treated with a filling therapy and at best with a crown to restore its complete stability.
The bacteria metabolize low-molecular sugars into acids, which are waste products of the microorganisms and damage the tooth substance. The acids demineralize the enamel and decompose the hard tooth substance, resulting in a collapse of the surface.
This incipient hole is the entry portal for further bacteria and their acids, which spread further and further into the depth. Therefore, the dentist’s typical means of diagnosing caries is to carefully scan the tooth surfaces with a probe. In case of caries, a break in the surface can be felt with the probe and the probe gets stuck there. Due to the tendency to spread into the depths, the typical holes of caries known in the vernacular are created.
