"දත් දිරායාම" හි සංශෝධන අතර වෙනස්කම්

If left untreated, the [[disease]] can lead to [[pain]], [[tooth loss]], [[infection]], and, in severe cases, [[death]].<ref>[http://www.mayoclinic.com/health/cavities/DS00896/DSECTION=7 Cavities/tooth decay], hosted on the Mayo Clinic website. Page accessed May 25, 2008.</ref> Today, caries remains one of the most common diseases throughout the world. Cariology is the study of dental caries.

 

 

Tooth decay is caused by specific types of [[acid]]-producing [[bacteria]] which cause damage in the presence of [[fermentation (food)|fermentable]] [[carbohydrate]]s such as [[sucrose]], [[fructose]], and [[glucose]].<ref name="Hardie1982">{{cite journal |author=Hardie JM |title=The microbiology of dental caries |journal=Dent Update |volume=9 |issue=4 |pages=199–200, 202–4, 206–8 |year=1982 |month=May |pmid=6959931 }}</ref><ref name="holloway1983">{{cite journal |author=Holloway PJ |title=The role of sugar in the etiology of dental caries |journal=J Dent |volume=11 |issue=3 |pages=189–213 |year=1983 |month=September |doi=10.1016/0300-5712(83)90182-3}}

 

== History ==

 

There is a long history of dental caries. Over a million years ago, [[hominid]]s such as [[Australopithecus]] suffered from cavities.<ref name="uicanthropology">[http://www.uic.edu/classes/osci/osci590/11_1Epidemiology.htm Epidemiology of Dental Disease], hosted on the University of Illinois at Chicago website. Page accessed January 9, 2007.</ref> The largest increases in the prevalence of caries have been associated with dietary changes.<ref name="uicanthropology"/><ref name="suddickhistorical">{{cite journal |author=Suddick RP, Harris NO |title=Historical perspectives of oral biology: a series |journal=Crit Rev Oral Biol Med. |volume=1 |issue=2 |pages=135–51 |year=1990 |pmid=2129621 |url=http://crobm.iadrjournals.org/cgi/reprint/1/2/135.pdf}}</ref>

Caries can be classified by location, etiology, rate of progression, and affected hard tissues.<ref name="sonis139">{{cite book |author=Sonis, Stephen T. |title=Dental Secrets |publisher=Hanley & Belfus |location=Philadelphia |year=2003 |pages=130 |isbn=1-56053-573-3 |edition=3rd}}</ref> These classification can be used to characterize a particular case of tooth decay in order to more accurately represent the condition to others and also indicate the severity of tooth destruction.

 

 

=== Location ===

 

 

 

==== Pit and fissure caries ====

There are three types of smooth-surface caries. Proximal caries, also called interproximal caries, form on the smooth surfaces between adjacent teeth. Root caries form on the root surfaces of teeth. The third type of smooth-surface caries occur on any other smooth tooth surface.

 

 

 

Root caries, which are sometimes described as a category of smooth-surfaces caries, are the third most common type of caries and usually occur when the root surfaces have been exposed due to [[gingiva]]l recession. When the gingiva is healthy, root caries is unlikely to develop because the root surfaces are not as accessible to [[bacteria]]l [[Dental plaque|plaque]]. The root surface is more vulnerable to the demineralization process than enamel because [[cementum]] begins to demineralize at 6.7 [[pH]], which is higher than enamel's critical pH.<ref name="banting19">Banting, D.W. "[http://www.nidcr.nih.gov/NR/rdonlyres/5A4386A8-E750-43E9-8450-651F4789D09A/0/David_Banting.pdf The Diagnosis of Root Caries]." Presentation to the National Institute of Health Consensus Development Conference on Diagnosis and Management of Dental Caries Throughout Life, in pdf format, hosted on the [[National Institute of Dental and Craniofacial Research]], p. 19. Page accessed August 15, 2006.</ref> Regardless, it is easier to arrest the progression of root caries than enamel caries because roots have a greater reuptake of fluoride than enamel. Root caries are most likely to be found on facial surfaces, then interproximal surfaces, then lingual surfaces. Mandibular molars are the most common location to find root caries, followed by mandibular premolars, maxillary anteriors, maxillary posteriors, and mandibular anteriors.

 

=== Etiology ===

In some instances, caries are described in other ways that might indicate the cause. "[[Early childhood caries|Baby bottle caries]]", "early childhood caries", or "[[baby bottle]] tooth decay" is a pattern of decay found in young children with their [[deciduous teeth|deciduous]] (baby) teeth. The teeth most likely affected are the maxillary anterior teeth, but all teeth can be affected.<ref>[http://www.ada.org/public/topics/decay_childhood_faq.asp ADA Early Childhood Tooth Decay (Baby Bottle Tooth Decay)]. Hosted on the American Dental Association website. Page accessed August 14, 2006.</ref> The name for this type of caries comes from the fact that the decay usually is a result of allowing children to fall asleep with [[Sweetness|sweetened]] liquids in their bottles or feeding children sweetened liquids multiple times during the day. Another pattern of decay is "rampant caries", which signifies advanced or severe decay on multiple surfaces of many teeth.<ref>[http://www.dent.ohio-state.edu/radiologycarie/classification.htm Radiographic Classification of Caries]. Hosted on the Ohio State University website. Page accessed August 14, 2006.</ref> Rampant caries may be seen in individuals with [[xerostomia]], poor oral hygiene, [[stimulant]] use (due to drug-induced dry mouth<ref>[http://www.ada.org/prof/resources/topics/methmouth.asp ADA Methamphetamine Use (METH MOUTH)]. Hosted on the American Dental Association website. Page accessed February 14, 2007.</ref>), and/or large sugar intake. If rampant caries is a result of previous radiation to the head and neck, it may be described as radiation-induced caries. Problems can also be caused by the self destruction of roots and whole [[root resorption|tooth resorption]] when new teeth erupt or later from unknown causes.

 

Depending on which hard tissues are affected, it is possible to describe caries as involving enamel, dentin, or cementum. Early in its development, caries may affect only enamel. Once the extent of decay reaches the deeper layer of dentin, "dentinal caries" is used. Since cementum is the hard tissue that covers the roots of teeth, it is not often affected by decay unless the roots of teeth are exposed to the mouth. Although the term "cementum caries" may be used to describe the decay on roots of teeth, very rarely does caries affect the cementum alone. Roots have a very thin layer of cementum over a large layer of dentin, and thus most caries affecting cementum also affects dentin.

 

 

A person experiencing caries may not be aware of the disease.<ref>[http://www.hpb.gov.sg/hpb/default.asp?pg_id=865&aid=198 Health Promotion Board: Dental Caries], affiliated with the Singapore government. Page accessed August 14, 2006.</ref> The earliest sign of a new carious lesion is the appearance of a chalky [[white]] spot on the surface of the tooth, indicating an area of demineralization of enamel. This is referred to as incipient decay. As the lesion continues to demineralize, it can turn brown but will eventually turn into a cavitation ("cavity"). Before the cavity forms, the process is reversible, but once a cavity forms, the lost tooth structure cannot be [[Regeneration (biology)|regenerated]]. A lesion which appears [[brown]] and shiny suggests dental caries was once present but the demineralization process has stopped, leaving a stain. A brown spot which is dull in appearance is probably a sign of active caries.

As the enamel and dentin are destroyed, the cavity becomes more noticeable. The affected areas of the tooth change color and become soft to the touch. Once the decay passes through enamel, the dentinal tubules, which have passages to the nerve of the tooth, become exposed and cause the tooth to [[toothache|hurt]]. The pain may worsen with exposure to heat, cold, or sweet foods and drinks.<ref name="medline"/> Dental caries can also cause [[halitosis|bad breath]] and foul tastes.<ref>[http://www.med.nyu.edu/patientcare/patients/library/article.html?ChunkIID=11496 Tooth Decay], hosted on the New York University Medical Center website. Page accessed August 14, 2006.</ref> In highly progressed cases, [[infection]] can spread from the tooth to the surrounding [[soft tissue]]s. Complications such as [[cavernous sinus thrombosis]] and [[Ludwig's angina]] can be life-threatening.<ref>[http://www.webmd.com/a-to-z-guides/cavernous-sinus-thrombosis Cavernous Sinus Thrombosis], hosted on WebMD. Page accessed May 25, 2008.</ref><ref>{{MedlinePlus|001047|Ludwig's Anigna]}}[</ref><ref>Hartmann, Richard W. [http://www.aafp.org/afp/990700ap/109.html Ludwig's Angina in Children], hosted on the American Academy of Family Physicians website. Page accessed May 25, 2008.</ref>

 

 

Primary [[diagnosis]] involves inspection of all visible tooth surfaces using a good light source, [[Mouth mirror|dental mirror]] and [[explorer (dental)|explorer]]. Dental [[radiographs]] ([[X-ray]]s) may show dental caries before it is otherwise visible, particularly caries between the teeth. Large dental caries are often apparent to the naked eye, but smaller lesions can be difficult to identify. Visual and [[Tactition|tactile]] inspection along with radiographs are employed frequently among dentists, particularly to diagnose pit and fissure caries.<ref>Rosenstiel, Stephen F. [http://www.lib.umich.edu/dentlib/nihcdc/abstracts/rosenstiel.html Clinical Diagnosis of Dental Caries: A North American Perspective]. Maintained by the University of Michigan Dentistry Library, along with the National Institutes of Health, National Institute of Dental and Craniofacial Research. 2000. Page accessed August 13, 2006.</ref> Early, uncavitated caries is often diagnosed by blowing air across the suspect surface, which removes moisture and changes the optical properties of the unmineralized enamel. This produces a white 'halo' effect detectable to the naked eye.{{Fact|date=August 2008}} [[Optical fiber|Fiberoptic]] [[transillumination]], [[laser]]s and disclosing dyes have been recommended for use as an adjunct when diagnosing smaller carious lesions in pits and fissures of teeth.{{Fact|date=August 2008}}

 

 

Some dental researchers have cautioned against the use of dental explorers to find caries.<ref name=summit31/> In cases where a small area of tooth has begun demineralizing but has not yet cavitated, the [[pressure]] from the dental explorer could cause a cavity. Since the carious process is reversible before a cavity is present, it may be possible to arrest the caries with [[Fluoride therapy|fluoride]] and remineralize the tooth surface. When a cavity is present, a restoration will be needed to replace the lost tooth structure.

At times, pit and fissure caries may be difficult to detect. Bacteria can penetrate the enamel to reach dentin, but then the outer surface may remineralize, especially if fluoride is present.<ref name="HC">{{cite journal |author=Zadik Yehuda, Bechor Ron |title=Hidden Occlusal Caries - Challenge for the Dentist |journal=New York State Dental Journal |volume=74 |issue=4 |pages=46–50 |year=2008 |month=June/July |url=http://www.nysdental.org/img/current-pdf/JrnlJuneJuly2008.pdf |format=PDF|accessdate=2008-08-08}}</ref> These caries, sometimes referred to as "hidden caries", will still be visible on x-ray radiographs, but visual examination of the tooth would show the enamel intact or minimally perforated.

 

 

There are four main criteria required for caries formation: a tooth surface ([[tooth enamel|enamel]] or [[dentin]]); caries-causing [[bacteria]]; fermentable [[carbohydrate]]s (such as [[sucrose]]); and time.<ref>{{cite book |author=Southam JC, Soames JV |chapter=2. Dental Caries |title=Oral pathology |publisher=Oxford Univ. Press |location=Oxford |year=1993 |pages= |isbn=0-19-262214-5 |edition=2nd}}</ref> The caries process does not have an inevitable outcome, and different individuals will be susceptible to different degrees depending on the shape of their teeth, oral hygiene habits, and the buffering capacity of their saliva. Dental caries can occur on any surface of a tooth which is exposed to the oral cavity, but not the structures which are retained within the bone.<ref>{{cite book |author=Smith B, Pickard HM, Kidd EAM |chapter=1. Why restore teeth?|title=Pickard's manual of operative dentistry |publisher=Oxford University Press |location=Oxford [Oxfordshire] |year=1990 |pages= |isbn=0-19-261808-3 |edition=6th}}</ref>

The anatomy of teeth may affect the likelihood of caries formation. Where the deep grooves of teeth are more numerous and exaggerated, pit and fissure caries are more likely to develop. Also, caries are more likely to develop when food is trapped between teeth.

 

 

=== Bacteria ===

=== Time ===

 

 

The carious process can begin within days of a tooth erupting into the mouth if the diet is sufficiently rich in suitable carbohydrates. Evidence suggests that the introduction of fluoride treatments have slowed the process.<ref name="summit75">Summit, James B., J. William Robbins, and Richard S. Schwartz. "Fundamentals of Operative Dentistry: A Contemporary Approach." 2nd edition. Carol Stream, Illinois, Quintessence Publishing Co, Inc, 2001, p. 75. ISBN 0-86715-382-2.</ref> Proximal caries take an average of four years to pass through enamel in permanent teeth. Because the [[cementum]] enveloping the root surface is not nearly as durable as the enamel encasing the crown, root caries tends to progress much more rapidly than decay on other surfaces. The progression and loss of mineralization on the root surface is 2.5 times faster than caries in enamel. In very severe cases where oral hygiene is very poor and where the diet is very rich in fermentable carbohydrates, caries may cause cavities within months of tooth eruption. This can occur, for example, when children continuously drink sugary drinks from baby bottles. On the other hand, it may take years before the process results in a cavity being formed.{{Fact|date=August 2008}}

=== Other risk factors ===

 

 

The use of [[tobacco]] may also increase the risk for caries formation. Some brands of [[Dipping tobacco|smokeless tobacco]] contain high sugar content, increasing susceptibility to caries.<ref name="neville347">Neville, B.W., Douglas Damm, Carl Allen, Jerry Bouquot. "''Oral & Maxillofacial Pathology.''" 2nd edition, 2002, p. 347. ISBN 0-7216-9003-3.</ref> Tobacco use is a significant risk factor for periodontal disease, which can cause the [[gingiva]] to [[Receding gums|recede]].<ref>[http://www.perio.org/consumer/smoking.htm Tobacco Use Increases the Risk of Gum Disease], hosted on the [http://www.perio.org/index.html American Academy of Periodontology]. Page accessed January 9, 2007.</ref> As the gingiva loses attachment to the teeth, the root surface becomes more visible in the mouth. If this occurs, root caries is a concern since the cementum covering the roots of teeth is more easily demineralized by acids than enamel.<ref name="banting19">Banting, D.W. "[http://www.nidcr.nih.gov/NR/rdonlyres/5A4386A8-E750-43E9-8450-651F4789D09A/0/David_Banting.pdf The Diagnosis of Root Caries]." Presentation to the National Institute of Health Consensus Development Conference on Diagnosis and Management of Dental Caries Throughout Life, in pdf format, hosted on the National Institute of Dental and Craniofacial Research, p. 19. Page accessed August 15, 2006.</ref> Currently, there is not enough evidence to support a causal relationship between smoking and coronal caries, but evidence does suggest a relationship between smoking and root-surface caries.<ref>[http://www.cdc.gov/tobacco/sgr/sgr_2004/pdf/executivesummary.pdf Executive Summary] of U.S. Surgeon General's report titled, "The Health Consequences of Smoking: A Report of the Surgeon General," hosted on the [http://www.cdc.gov CDC] website, p. 12. Page accessed January 9, 2007.</ref>

== Pathophysiology ==

 

 

 

Enamel is a highly mineralized acellular [[Tissue (biology)|tissue]], and caries act upon it through a chemical process brought on by the acidic environment produced by bacteria. As the bacteria consume the sugar and use it for their own energy, they produce lactic acid. The effects of this process include the demineralization of crystals in the enamel, caused by acids, over time until the bacteria physically penetrate the dentin. [[Enamel rod]]s, which are the basic unit of the enamel structure, run perpendicularly from the surface of the tooth to the dentin. Since demineralization of enamel by caries generally follows the direction of the enamel rods, the different triangular patterns between pit and fissure and smooth-surface caries develop in the enamel because the orientation of enamel rods are different in the two areas of the tooth

As the enamel loses minerals <!--- Is this an acceptable way to put it? --->, and dental caries progress, they develop several distinct zones, visible under a light microscope. From the deepest layer of the enamel to the enamel surface, the identified areas are the: translucent zone, dark zones, body of the lesion, and surface zone.<ref>{{cite journal |author=Darling AI |title=Resistance of the Enamel to Dental Caries |journal=J Dent Res. |volume=42 |issue=1 |pages=488–96 |year=1963 |url=http://jdr.iadrjournals.org/cgi/reprint/42/1/488.pdf}}</ref> The translucent zone is the first visible sign of caries and coincides with a 1-2% loss of minerals.<ref name="robinson">{{cite journal |author=Robinson C, Shore RC, Brookes SJ, Strafford S, Wood SR, Kirkham J |title=The chemistry of enamel caries |journal=Crit Rev Oral Biol Med. |volume=11 |issue=4 |pages=481–95 |year=2000 |pmid=11132767 |url=http://crobm.iadrjournals.org/cgi/reprint/11/4/481.pdf}}</ref> A slight remineralization of enamel occurs in the dark zone, which serves as an example of how the development of dental caries is an active process with alternating changes.<ref name="cate417">Cate, A.R. Ten. "''Oral Histology: development, structure, and function.''" 5th edition, 1998, p. 417. ISBN 0-8151-2952-1.</ref> The area of greatest demineralization and destruction is in the body of the lesion itself. The surface zone remains relatively mineralized and is present until the loss of tooth structure results in a cavitation.

 

 

Unlike enamel, the dentin reacts to the progression of dental caries. <!--- It was unclear in the preceding section that enamel '*does not* react to the progression of caries ---> After [[tooth development|tooth formation]], the [[ameloblast]]s, which produce enamel, are destroyed once [[amelogenesis|enamel formation]] is complete and thus cannot later regenerate enamel after its destruction. On the other hand, dentin is [[dentinogenesis|produced]] continuously throughout life by [[odontoblast]]s, which reside at the border between the pulp and dentin. Since odontoblasts are present, a stimulus, such as caries, can trigger a biologic response. These defense mechanisms include the formation of sclerotic and tertiary dentin.<ref>"[http://www.usc.edu/hsc/dental/PTHL312abc/312b/09/Reader/reader_set.html Teeth & Jaws: Caries, Pulp, & Periapical Conditions]," hosted on the [http://www.usc.edu/hsc/dental/ University of Southern California School of Dentistry] website. Page accessed June 22, 2007.</ref>

In dentin from the deepest layer to the enamel, the distinct areas affected by caries are the translucent zone, the zone of bacterial penetration, and the zone of destruction.<ref name="kidd"/> The translucent zone represents the advancing front of the carious process and is where the initial demineralization begins. The zones of bacterial penetration and destruction are the locations of invading bacteria and ultimately the [[decomposition]] of dentin.

 

==== Sclerotic dentin ====

 

In the case of reparative dentin, other cells are needed to assume the role of the destroyed odontoblasts. [[Growth factor]]s, especially [[TGF beta|TGF-β]],<ref name="transdentinal"/> are thought to initiate the production of reparative dentin by [[fibroblast]]s and [[Mesenchymal stem cell|mesenchymal]] cells of the pulp.<ref name="summit14">Summit, James B., J. William Robbins, and Richard S. Schwartz. "Fundamentals of Operative Dentistry: A Contemporary Approach." 2nd edition. Carol Stream, Illinois, Quintessence Publishing Co, Inc, 2001, p. 14. ISBN 0-86715-382-2.</ref> Reparative dentin is produced at an average of 1.5&nbsp;μm/day, but can be increased to 3.5&nbsp;μm/day. The resulting dentin contains irregularly-shaped dentinal tubules which may not line up with existing dentinal tubules. This diminishes the ability for dental caries to progress within the dentinal tubules.

 

 

{{Seealso|Dental restoration|Tooth extraction}}

Destroyed tooth structure does not fully regenerate, although remineralization of very small carious lesions may occur if dental hygiene is kept at optimal level.<ref name="medline"/> For the small lesions, topical fluoride is sometimes used to encourage remineralization. For larger lesions, the progression of dental caries can be stopped by treatment. The goal of treatment is to preserve tooth structures and prevent further destruction of the tooth.

Restorative materials include dental [[amalgam (dentistry)|amalgam]], [[Dental composite|composite]] [[resin]], [[porcelain]], and [[gold (element)|gold]].<ref name="DCPPtx">"[http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=dcp2.section.5402 Aspects of Treatment of Cavities and of Caries Disease]" from the Disease Control Priorities Project. Page accessed August 15, 2006.</ref> Composite resin and porcelain can be made to match the color of a patient's natural teeth and are thus used more frequently when aesthetics are a concern. Composite restorations are not as strong as dental amalgam and gold; some dentists consider the latter as the only advisable restoration for posterior areas where chewing forces are great.<ref>[http://www.ada.org/public/topics/fillings.asp Oral Health Topics: Dental Filling Options], hosted on the American Dental Association website. Page accessed August 16, 2006.</ref> When the decay is too extensive, there may not be enough tooth structure remaining to allow a restorative material to be placed within the tooth. Thus, a [[Crown (dentistry)|crown]] may be needed. This restoration appears similar to a cap and is fitted over the remainder of the natural crown of the tooth. Crowns are often made of gold, porcelain, or porcelain fused to metal.

 

 

In certain cases, root canal therapy may be necessary for the restoration of a tooth.<ref>[http://www.agd.org/consumer/topics/rootcanaltherapy/main.asp What is a Root Canal?], hosted by the Academy of General Dentistry. Page accessed August 16, 2006.</ref> [[Root canal]] therapy, also called "endodontic therapy", is recommended if the pulp in a tooth dies from infection by decay-causing bacteria or from trauma. During a root canal, the pulp of the tooth, including the nerve and vascular tissues, is removed along with decayed portions of the tooth. The canals are instrumented with endodontic files to clean and shape them, and they are then usually filled with a rubber-like material called [[gutta percha]].<ref>[http://www.aae.org/patients/faqs/rootcanals.htm FAQs About Root Canal Treatment], hosted on the American Association of Endodontists website. Page accessed August 16, 2006.</ref> The tooth is filled and a crown can be placed. Upon completion of a root canal, the tooth is now non-vital, as it is devoid of any living tissue.

An [[Extraction (dental)|extraction]] can also serve as treatment for dental caries. The removal of the decayed tooth is performed if the tooth is too far destroyed from the decay process to effectively restore the tooth. Extractions are sometimes considered if the tooth lacks an opposing tooth or will probably cause further problems in the future, as may be the case for [[wisdom teeth]].<ref>[http://www.aaoms.org/public/Pamphlets/WisdomTeeth.pdf Wisdom Teeth], packet in pdf format hosted by the American Association of Oral and Maxillofacial Surgeons. Page accessed August 16, 2006.</ref> Extractions may also be preferred by patients unable or unwilling to undergo the expense or difficulties in restoring the tooth.

 

 

 

=== Oral hygiene ===

However chewing gum does not absorb saliva and is not able to effectively force saliva and any dental agents inside pits and fissures in chewing surfaces where over 80% of cavities occur. Chewing raw vegetable fibre like celery after eating forces saliva inside pits and fissures to dilute carbohydrate like sugar, neutralise acid and remineralise deminealised tooth.

 

 

=== Other preventive measures ===

Furthermore, recent research shows that low intensity [[laser]] radiation of [[argon]] ion lasers may prevent the susceptibility for enamel caries and white spot lesions.<ref>{{cite journal |author=Westerman GH, Hicks MJ, Flaitz CM, Powell GL |title=In vitro caries formation in primary tooth enamel: role of argon laser irradiation and remineralizing solution treatment |journal=J Am Dent Assoc |volume=137 |issue=5 |pages=638–44 |year=2006 |month=May |pmid=16739544 |url=http://jada.ada.org/cgi/pmidlookup?view=long&pmid=16739544 |day=01}}</ref> Also, as bacteria are a major factor contributing to poor oral health, there is currently research to find a [[Caries vaccine|vaccine for dental caries]]. As of 2004, such a vaccine has been successfully tested on animals,<ref>[http://www.wired.com/medtech/health/news/2004/05/63510 New Drill for Tomorrow's Dentists]. WIRED Magazine, May, 2004. Page accessed May 24, 2007.</ref> and is in clinical trials for humans as of May 2006.<ref>{{ cite web |url=http://www.planetbiotechnology.com/products.html |title=Planet Biotechnology:Products |publisher=Planet Biotechnology}}</ref>

 

* [[Feline odontoclastic resorptive lesion]]

* [[Erosion (dental)|Dental erosion]]

* [[Oral microbiology]]

 

{{reflist|2}}

 

<div class="references-small">

{{col-begin}}

</div>

 

*[http://www.animated-teeth.com/tooth_decay/t2_tooth_decay_caries.htm What causes cavities; an indepth look]

*[http://www.lib.uiowa.edu/hardin/md/toothdecaypictures.html Links to tooth decay pictures (Hardin MD/Univ of Iowa)]

 

{{Tooth disease}}

 

[[ප්‍රවර්ගය:ශල්‍ය වෛද්‍යවේය]]

[[ප්‍රවර්ගය:සෞඛ්‍යය]]

 

[[ar:تسوس سني]]

[[ay:Laka k'ama]]

[[bg:Кариес]]

[[ca:Càries dental]]

[[de:Zahnkaries]]

[[el:Τερηδόνα]]

[[eo:Kario]]

[[fa:پوسیدگی دندان]]

[[fr:Carie dentaire]]

[[hr:Karijes]]

[[id:Karies gigi]]

[[it:Carie dentaria]]

[[lt:Dantų ėduonis]]

[[ml:ദന്തക്ഷയം]]

[[nl:Cariës]]

[[no:Karies]]

[[pl:Próchnica zębów]]

[[pt:Cárie dentária]]

[[qu:Kiru ismu]]

[[ru:Кариес зубов]]

[[sk:Zubný kaz]]

[[sr:Каријес]]

[[sv:Karies]]

[[vi:Sâu răng]]