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Tooth decay
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{{Short description|Deformation of teeth due to acids produced by bacteria}} {{For|caries of bone|Osteolysis}} {{cs1 config|name-list-style=vanc}} {{Infobox medical condition | name = Tooth decay | synonyms = Dental cavities, dental caries, cavities, caries | image = Dental Caries Cavity 2.JPG | caption = Destruction of a tooth by dental caries and disease | image_size = 300 | field = [[Dentistry]] | pronounce = Caries {{IPAc-en|ˈ|k|ɛər|iː|z}} | symptoms = Pain, tooth loss, difficulty eating<ref name=Lau2014/><ref name=WHO2012/> | complications = [[periodontal disease|Inflammation around the tooth]], [[tooth loss]], infection or [[dental abscess|abscess]] formation<ref name=Lau2014/><ref name=Taber2013/> | onset = | duration = Long term | causes = Bacteria producing acid from food debris<ref name=Peads2014/> | risks = Diet high in simple sugar, [[diabetes mellitus]], [[Sjögren syndrome]], medications that decrease saliva<ref name=Peads2014/> | diagnosis = | differential = | prevention = Low-[[simple sugar|sugar]] diet, tooth brushing, [[fluoride]], [[dental flossing|flossing]]<ref name=WHO2012/><ref name=Oli2017/> | treatment = | medication = [[Paracetamol]] (acetaminophen), [[ibuprofen]]<ref name=Silk2014/> | frequency = 3.6 billion (2016)<ref name=WHO2016Epi/> | deaths = }} <!-- Definition --> '''Tooth decay''', also known as '''caries''',<ref name="caries" group="lower-alpha">The word 'caries' is a [[mass noun]], and is not a plural of 'carie'.''</ref> is the breakdown of [[teeth]] due to acids produced by [[bacteria]].<ref name="Silk2014">{{cite journal|last1=Silk|first1=H|title=Diseases of the mouth|journal=Primary Care: Clinics in Office Practice|date=March 2014|volume=41|issue=1|pages=75–90|pmid=24439882|doi=10.1016/j.pop.2013.10.011|s2cid=9127595}}</ref> The resulting cavities may be a number of different colors, from yellow to black.<ref name="Lau2014">{{cite journal|last1=Laudenbach|first1=JM|last2=Simon|first2=Z|title=Common Dental and Periodontal Diseases: Evaluation and Management|journal=The Medical Clinics of North America|date=November 2014|volume=98|issue=6|pages=1239–1260|pmid=25443675|doi=10.1016/j.mcna.2014.08.002}}</ref> Symptoms may include pain and difficulty eating.<ref name=Lau2014/><ref name=WHO2012/> Complications may include [[periodontal disease|inflammation of the tissue around the tooth]], [[tooth loss]] and infection or [[dental abscess|abscess]] formation.<ref name=Lau2014/><ref name=Taber2013/> [[Tooth regeneration]] is an ongoing [[Stem-cell therapy|stem cell–based]] field of study that aims to find methods to reverse the effects of decay; current methods are based on easing symptoms. <!-- Cause --> The cause of cavities is acid from bacteria dissolving the [[hard tissue]]s of the teeth ([[Tooth enamel|enamel]], [[dentin]] and [[cementum]]).<ref name=Peads2014/> The [[acid]] is produced by the bacteria when they break down food debris or sugar on the tooth surface.<ref name=Peads2014/> [[Simple sugar]]s in food are these bacteria's primary energy source and thus a diet high in simple sugar is a risk factor.<ref name=Peads2014/> If [[Remineralisation of teeth|mineral breakdown]] is greater than buildup from sources such as [[saliva]], caries results.<ref name=Peads2014/> Risk factors include conditions that result in less saliva, such as [[diabetes mellitus]], [[Sjögren syndrome]] and some medications.<ref name=Peads2014/> Medications that decrease saliva production include [[antihistamines]] and [[antidepressant]]s.<ref name="Peads2014">{{cite journal|last1=SECTION ON ORAL|first1=HEALTH|last2=SECTION ON ORAL|first2=HEALTH|title=Maintaining and improving the oral health of young children|journal=Pediatrics|date=December 2014|volume=134|issue=6|pages=1224–9|pmid=25422016|doi=10.1542/peds.2014-2984|s2cid=32580232|doi-access=free}}</ref> Dental caries are also associated with [[poverty]], poor [[oral hygiene|cleaning of the mouth]], and receding [[gums]] resulting in exposure of the roots of the teeth.<ref name=Silk2014/><ref>{{cite journal|last1=Schwendicke|first1=F|last2=Dörfer|first2=CE|last3=Schlattmann|first3=P|last4=Page|first4=LF|last5=Thomson|first5=WM|last6=Paris|first6=S|title=Socioeconomic Inequality and Caries: A Systematic Review and Meta-Analysis|journal=Journal of Dental Research|date=January 2015|volume=94|issue=1|pages=10–18|pmid=25394849|doi=10.1177/0022034514557546|s2cid=24227334}}</ref> <!-- Prevention and treatment --> Prevention of dental caries includes regular cleaning of the teeth, a diet low in sugar, and small amounts of [[fluoride]].<ref name=WHO2012/><ref name=Peads2014/> [[Brushing one's teeth|Brushing]] one's teeth twice per day, and [[flossing]] between the teeth once a day is recommended.<ref name="Peads2014"/><ref name=Silk2014/> Fluoride may be acquired from [[water fluoridation|water]], [[salt]] or [[toothpaste]] among other sources.<ref name=WHO2012/> Treating a mother's dental caries may decrease the risk in her children by decreasing the number of certain bacteria she may spread to them.<ref name=Peads2014/> [[Screening (medicine)|Screening]] can result in earlier detection.<ref name=Silk2014/> Depending on the extent of destruction, various treatments can be used to [[dental restoration|restore]] the tooth to proper function, or the [[dental extraction|tooth may be removed]].<ref name=Silk2014/> There is no known method to [[regeneration (biology)|grow back]] large amounts of tooth.<ref>{{cite journal|last1=Otsu|first1=K|last2=Kumakami-Sakano|first2=M|last3=Fujiwara|first3=N|last4=Kikuchi|first4=K|last5=Keller|first5=L|last6=Lesot|first6=H|last7=Harada|first7=H|title=Stem cell sources for tooth regeneration: current status and future prospects|journal=Frontiers in Physiology|year=2014|volume=5|pages=36|pmid=24550845|doi=10.3389/fphys.2014.00036|pmc=3912331|doi-access=free}}</ref> The availability of treatment is often poor in the developing world.<ref name=WHO2012/> [[Paracetamol]] (acetaminophen) or [[ibuprofen]] may be taken for pain.<ref name=Silk2014/> <!-- Epidemiology --> Worldwide, approximately 3.6 billion people (48% of the population) have dental caries in their [[permanent teeth]] as of 2016.<ref name="WHO2016Epi">{{Cite web|url=https://www.who.int/news-room/fact-sheets/detail/oral-health|title=Oral health|publisher=World Health Organization|language=en|access-date=2019-09-14|archive-date=2019-10-17|archive-url=https://web.archive.org/web/20191017233214/https://www.who.int/news-room/fact-sheets/detail/oral-health|url-status=live}}</ref> The [[World Health Organization]] estimates that nearly all adults have dental caries at some point in time.<ref name="WHO2012">{{cite web|title=Oral health Fact sheet N°318|url=https://www.who.int/mediacentre/factsheets/fs318/en/|publisher=World Health Organization|access-date=10 December 2014|date=April 2012|url-status=dead|archive-url=https://web.archive.org/web/20141208132427/http://www.who.int/mediacentre/factsheets/fs318/en/|archive-date=8 December 2014}}</ref> In [[baby teeth]] it affects about 620 million people or 9% of the population.<ref name="Lancet2012Epi">{{cite journal|last=Vos|first=T|title=Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010|journal=The Lancet|date=Dec 15, 2012|volume=380|issue=9859|pages=2163–96|pmid=23245607|pmc=6350784|doi=10.1016/S0140-6736(12)61729-2}}</ref> They have become more common in both children and adults in recent years.<ref>{{cite journal|last1=Bagramian|first1=RA|last2=Garcia-Godoy|first2=F|last3=Volpe|first3=AR|title=The global increase in dental caries. A pending public health crisis|journal=American Journal of Dentistry|date=February 2009|volume=22|issue=1|pages=3–8|pmid=19281105}}</ref> The disease is most common in the developed world due to greater simple sugar consumption, but less common in the developing world.<ref name=Silk2014/> Caries is [[Latin]] for "rottenness".<ref name="Taber2013">{{cite book|title=Taber's cyclopedic medical dictionary|date=2013|publisher=F.A. Davis Co.|location=Philadelphia|isbn=978-0-8036-3909-6|page=401|edition=Ed. 22, illustrated in full color|url=https://books.google.com/books?id=VdY-AAAAQBAJ&pg=PA401|url-status=live|archive-url=https://web.archive.org/web/20150713035028/https://books.google.com/books?id=VdY-AAAAQBAJ&pg=PA401|archive-date=2015-07-13}}</ref> {{TOC limit|3}}
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