Dental caries

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 DENTAL CARIES
Dental caries also known as tooth decay is an infection, caused by bacteria that result in demineralization and destruction of the hard tissues of the tooth.
 CAUSSES /RISK FACTORS 
• Streptococus mutans
• Lacto bacilli
• Frequent intake of sugary food
• Dry mouth
• Dental arrangement
• Trapped food between the teeth
• Deficiency of mineral
• Mouth neglect/poor oral hygiene
• Susceptibility of the teeth to decay
• Numerous and exaggerated deep grooves of the teeth

PATHOPHYSIOLOGY
The various causes of dental crisis lead to demineralization [the acid dissolves the calcium salt of the teeth] exceeding saliva and remineralization factors such as calcium and fluoridated tooth pesters, which progressively breakdown the hard tissue beginning with small holes and large holes of cavities in the teeth. Advanced decay leads to tooth aches and bad breathe. The unchecked decay spread to the dentine, when the blood vessels around the tooth and nerves are exposed, they become infected and an abscess is formed within or around the tooth resulting in soreness, pain and the face swells up

CLINICAL MANIFESTATION
• Soreness
• Pain
• Swollen face
• Fever
• Offensive breath
• Holes in the teeth

DIAGNOSTIC EVALUATION 
Blood analysis to isolate the causative organisms
History of various symptoms
Physical examination reveals cavities in the teeth

MANAGEMENT/NURSING CARE
• Fluoridation;  this may be achieved by having a dentist apply a concentrated gel or solution to the teeth, adding fluoride  to home water supplies, using fluoridated tooth paste, sodium fluoride tablet, drops or lozengers
• Dentist sometimes apply a special coating to fill and seal areas prone to caries from exposure to cariogenic processes
• Diet; Reduce intake of sugar and eat less of cariogenic food such as fruits, vegetables and nuts
• Oral care; teeth should gently be cleaned daily. This is to breakup bacteria plaque around the teeth
• Denture care; if there are dentures [artificial teeth], brush them daily and remove and soak in water at night. Rinse mouth with warm water after meals, chew slowly
• Education on discharge; use antiplaque mouth rinse ,avoid alcohol and tobacco product, avoid sweet or sugar and use soft tooth brush

NURSING DIAGNOSIS
• Acute Pain related to pressure exerted on the nerves around the teeth evidenced by patient verbalization
• Hyperthermia related to infection process evidenced by temperature of 38 degree Celsius



 COMPLICATIONS 
• Halithosis [foul smelling breath]
• Sepsis

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