Dental caries is a transmissible infectious disease caused by several bacteria, amongst which Streptococcus mutans seems to play a major role. Genetic, biological, environmental and behavioral factors seem to play a major role in the development and the progression of the disorder. Dental caries is caused due to several factors. The Presence of certain bacteria in the mouth along with cariogenic carbohydrates plays a very important role in the initiation and progression of dental caries. It is one of the most frequent disorders that affect man after a common cold.

The condition may not be life-threatening, but the process is irreversible, often progressing to several sequlae involving the neighboring tissues present in the oral cavity and leading to a lot of spcyholical distress. The treatment costs of this condition are also very high. Some of the measures that may be required to help manage or prevent dental caries include application of APF gel, pit and fissure sealants, restorations, better oral hygiene practices, diet modifications, increased use of fluorides, etc (Leme Et al, 2006, Islam Et al, 2007, & Napimoga Et al, 2005). Report

Dental caries is an infectious disorder, caused by microorganisms present in the oral cavity. The entire process of dental caries depends on the virulence of the plaque present. Plaque is biofilm containing microorganisms, along with fermentable carbohydrates. One of carbohydrates that are most cariogenic is sucrose. It enables production of intracellular as well as extracellular carbohydrates. When the oral cavity contains high levels of deposits in the mouth, the microorganisms present convert carbohydrates into acidic substances required to reduce the pH of the oral cavity.

The presence of the extracellular fermentable carbohydrates enables changes in the contents of the plaque to bacteria that is more cariogenic in nature. When the plaque contains high levels of sucrose, the levels of several substances such as calcium, fluoride and phosphate ions automatically decreases, thus potentially bringing about increased demineralization and decreased demineralization in the oral cavity. These factors play a very important role in the development of dental caries.

It was found that certain bacteria known as lactobacillus was 200 times higher in plaque formed in the presence of sugar, than in the plaque formed in the absence of sugar. The rate of enamel demineralization was higher when plaque was formed in the presence of sugar, than in its absence. The level of certain cariogenic bacteria such as Streptococcus mutans and lactobacillus was increased when plaque was formed in the presence of sugar, and the level of not so cariogenic bacteria automatically decreased when sugar was present.

When carbohydrates were consumed frequently, the teeth was exposed for greater period of time to plaque which had a pH below the critical pH required for demineralization. Due to this the enamel would undergo demineralization resulting in the formation of dental caries. Streptococcus mutans is an organism unique to the oral cavity and can survive anywhere in the mouth. Several carbohydrate substances such as sucrose, glucose, lactose, etc, can be potentially fermented by Streptococcus mutans resulting in the production acids that could demineralise the tooth substance (Leme Et al, 2006).

Initially dental caries appears as a white lesion or a white spot on the tooth. The lesion becomes bigger and gradually gets infected with more number of bacteria. It appears brownish or black in color. The infection progresses to cavitations, followed by involvement of the pulp and progression onto the periapical region. Usually, the process of dental caries is painless. During the later stages of the disease, the tooth becomes slightly sensitive. Pain may begin during the final stages of the disease when the pulp and the periapical regions are involved (Islam Et al, 2007).

The dentist may choose several measures in order to manage dental caries. As the primary cause of dental caries is poor oral hygiene and neglect, better oral hygiene practices are advised. Refined foods containing high amounts of sugar would increase the chances of developing dental caries. Fresh fruit juices and starchy foods have been recommended instead of sugary food stuff. When foods are chewed more thoroughly, the chances of them being broken down into smaller particles and being swallowed down are greater, thus reducing the chances of developing dental caries.

Fibrous food stuff such as apples, sugar cane, etc, is recommended as they have a higher self-cleansing mechanism. The presence of fluorides in the diet can help convert calcium hydroxyapatite into fluoridated hydroxyapatite which can resist demineralization processes better. The tooth material becomes less soluble in a low pH medium. The metabolism of several bacteria is also decreased by fluoride. Several antimicrobial agents such as chlorhexidine help to lower the bacterial count in the mouth, thus helping to lower the occurrence of dental caries.

Chlorhexidine helps to destroy the bacterial cell wall and in the process coagulates the contents of the cell. Often cholorhexidine is prescribed as a mouthwash or mouth rinse to help prevent the development of caries. Studies conducted by McClure et al have demonstrated that certain antibiotics such as penicillin and ampicillin help to lower the Streptococcus mutans count in the mouth. The Stems of S. persica and A. indica plant have been particularly useful in removing the plaque and the lowering the bacterial count.

A vaccine that helps protect the teeth from antibody IgA released into the saliva is under experimental studies. However, preliminary studies have demonstrated that they may have an adverse effect on the human heart. Traditionally, dentists would fill up a tooth with a restorative substance such as a Silver Amalgam restoration, Composite resin material, Glass Ionomer cement, etc. Application of APF gel to the tooth at frequent intervals help to protect the smooth surfaces from developing caries to a certain extent. Pit and fissure sealant application can also lower caries incidences to various extents.

If the dental caries has progressed to a great extent to involve the pulp and the periapical tissues, then in such cases root canal treatment has been recommended. Conclusion Dental caries is one of the most common diseases that have been affecting man since ancient times. However, the disorder can be prevented and treated if certain measures are followed such as oral hygiene practices, diet modification, frequent dental checkups, etc. As the dental caries process is multi-factorial in nature, a number of interventions are needed in order to treat it. Streptococcus mutans is the single most common causative organism for dental caries.