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Enamel Caries

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Dental Caries

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Abstract

The earliest macroscopic evidence of caries may be seen on an extracted tooth as a small opaque white region positioned on either one or both of the approximal surfaces. Similar opacities may also be seen supragingivally on facial or lingual surfaces; these will also be visible in the mouth if the tooth surface is clean and dry. The approxi-mal surface will show a small oval flattened area of interdental attrition, the contact point. The small carious lesion is seen as an opaque white region, usually positioned at the cervical margin of the interdental facet. This ‘white spot’ lesion contrasts with the translucency of adjacent sound enamel (figure 6.1), and is best demonstrated when the specimen is dried thoroughly.

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Further reading

  • Schmidt, W. J. and Keil, A. (1971). Polarizing Microscopy of Dental Tissues, 1st Eng. edn (Eds Poole, D. F. G. and Darling, A. I.), Pergamon Press, Oxford

    Google Scholar 

  • Stack, M. V. and Fearnhead, R. W. (1965). Tooth Enamel, Wright, Bristol

    Google Scholar 

References

  1. Darling, A. I. (1959). The pathology and prevention of caries. British Dental Journal, 107, 287–96

    Google Scholar 

  2. Marthaler, T. M. and Germann, M. (1970). Radiographic and visual appearance of small smooth surface caries lesions studies on extracted teeth. Caries Research, 4, 224–42

    Article  Google Scholar 

  3. Gwinnett, A. J. (1971). A comparison of proximal carious lesions as seen by clinical radiography, contact microradiography and light microscopy. Journal of the American Dental Association, 83, 1078–80

    Article  Google Scholar 

  4. Silverstone, L. M. (1978). Preventive Dentistry, Update Books, London

    Book  Google Scholar 

  5. Dwyer, D. M., Berman, D. S. and Silverstone, L. M. (1973). A study of approximal carious lesions in primary molars. Journal of the International Association of Dentistry for Children, 4, 41–6

    Google Scholar 

  6. Mortimer, K. V. (1964). The histological features of caries in human dental enamel. Ph.D. Thesis, Univ. of Bristol

    Google Scholar 

  7. Darling, A. I. (1956). Studies of the early lesion of enamel caries with transmitted light, polarized light and microradiography. British Dental Journal, 101, 289–97 and 329–41

    Google Scholar 

  8. Darling, A. I. (1958). Studies of the early lesion of enamel caries with transmitted light, polarized light and microradiography. Its nature, mode of spread, points of entry and its relation to enamel structure. British Dental Journal, 105, 119–35

    Google Scholar 

  9. Darling, A. I. (1963). Resistance of the enamel to dental caries. Journal of Dental Research, 42, 488–96

    Article  Google Scholar 

  10. Gustafson, G. (1957). The histopathology of caries of human dental enamel, with special reference to the division of the lesion into zones. Acta Odontologica Scandinavica, 15, 13–55

    Article  Google Scholar 

  11. Soni, N. N. and Brudevold, F. (1959). Microradiographic and polarized light studies of initial carious lesions. Journal of Dental Research, 38, 1187–94

    Article  Google Scholar 

  12. Darling, A. I., Mortimer, K. V., Poole, D. F. G. and Ollis, W. D. (1961). Molecular sieve behaviour of normal and carious human dental enamel. Archives of Oral Biology, 5, 251–73

    Article  Google Scholar 

  13. Kostlan, J. (1962). Translucent zones in the central part of the carious lesions of enamel. British Dental Journal, 113, 244–8

    Google Scholar 

  14. Carlstrom, D. (1963). Polarization microscopy of dental enamel with reference to incipient carious lesions, in Advances in Oral Biology, vol. 1, Academic Press, New York, pp. 255–96

    Google Scholar 

  15. Crabb, H. S. M. (1966). Enamel caries: observations on the histology and patterns of progress of the approximal lesion. British Dental Journal, 121, 115–29 and 167–74

    Google Scholar 

  16. Silverstone, L. M. (1966). The primary translucent zone of enamel caries and of artificial caries-like lesions. British Dental Journal, 120, 461–71

    Google Scholar 

  17. Silverstone, L. M. (1967). The histopathology of enamel lesions produced in vitro and their relation to enamel caries. Ph.D. Thesis, Univ. of Bristol

    Google Scholar 

  18. Silverstone, L. M. (1968). The surface zone in caries and in caries-like lesions produced in vitro. British Dental Journal, 125, 145–57

    Google Scholar 

  19. Silverstone, L. M. (1973). Structure of carious enamel including the early lesion, in Oral Sciences Reviews: No. 3 Dental Enamel (Eds Melcher, A. H. and Zarb, G. A. ), Munksgaard, Copenhagen, pp. 100–160

    Google Scholar 

  20. Silverstone, L. M. (1970). The histopathology of early approximal caries in the enamel of primary teeth. Journal of Dentistry for Children, 37, 17–27

    Google Scholar 

  21. Wiener, O. (1912). Theory of composite bodies. Abh. sachs Ges. Wiss., 33, 507

    Google Scholar 

  22. Crabb, H. S. M. and Mortimer, K. V. (1967). Two dimensional microdensitometry. A preliminary report. British Dental Journal, 122, 337–43

    Google Scholar 

  23. Weatherell, J. A., Robinson, C. and Hallsworth, A. S. (1971). Micro-analytical studies on single sections of enamel, in Tooth Enamel, vol. 2 (Eds Stack, M. V. and Fearnhead, R. W. ), Wright, Bristol, pp. 31–8

    Google Scholar 

  24. Poole, D. F. G., Mortimer, K. V., Darling, A. I. and Ollis, W. D. (1961). Molecular sieve behaviour of dental enamel. Nature (London), 189, 998–1000

    Article  Google Scholar 

  25. Gray, J. A. and Francis, M. D. (1963). Physical chemistry of enamel dissolution, in Mechanisms of Hard Tissue Destruction, American Association for the Advancement of Science, Washington, publ. No. 75, p. 213

    Google Scholar 

  26. Silverstone, L. M. and Poole, D. F. G. (1968). Modification of the histological appearance of enamel caries after exposure to saliva and a calcifying fluid. Caries Research, 2, 87–96

    Article  Google Scholar 

  27. Silverstone, L. M. (1977). Remineralization phenomena. In Cariostatic Mechanisms of Fluoride (Eds Brown, W. E. and Konig, K. G.), Caries Research, 11 (Suppl. 1), 59–84

    Google Scholar 

  28. Mortimer, K. V. and Tranter, T. C. (1971). A scanning electron microscope study of carious enamel. Caries Research, 5, 240–63

    Article  Google Scholar 

  29. Bergman, G. and Lind, P. O. (1966). A quantitative microradiographic study of incipient enamel caries. Journal of Dental Research, 45, 1477–84

    Article  Google Scholar 

  30. Miller, J. (1958). Note on the early carious lesion in enamel. British Dental Journal, 105, 135–6

    Google Scholar 

  31. Gustafson, G. and Gustafson, A. G. (1961). Human dental enamel in polarized light and contact microradiography. Acta Odontologica Scandinavica, 19, 259–87

    Article  Google Scholar 

  32. Crabb, H. S. M. (1972). Incremental bands in microradiographs of ground sections of a carious lesion in enamel. Caries Research, 6, 169–82

    Article  Google Scholar 

  33. Thewlis, J. (1940). The Structure of Teeth as Shown by X-ray Examination, Special Report Series 238, HMSO, London

    Google Scholar 

  34. Brudevold, F. (1948). A study of the phosphate solubility of the human enamel surface. Journal of Dental Research, 27, 320–9

    Article  Google Scholar 

  35. Hals, E., Morch, T. and Sand, H. F. (1955). Effect of lactate buffers on dental enamel in vitro observed in polarizing microscope. Acta Odontologica Scandinavica, 13, 85–122

    Article  Google Scholar 

  36. Isaac, S., Brudevold, F., Smith, F.. A. and Gardner, D. E. (1958). Solubility rate and natural fluoride content of surface and subsurface enamel. Journal of Dental Research, 37, 254–63

    Article  Google Scholar 

  37. Sullivan, H. R. (1954). The formation of early carious lesions in dental enamel. Journal of Dental Research, 33, 231–44

    Article  Google Scholar 

  38. Sperber, G. H. and Buonocore, M. G. (1963). Enamel surface in white spot formation. Journal of Dental Research, 42, 724–31

    Article  Google Scholar 

  39. Fehr, F. R. von der (1967). A study of carious lesions produced in vitro in un-abraded, abraded, exposed in F-treated human enamel surfaces with emphasis on the X-ray dense outer layer. Archives of Oral Biology, 12, 797–814

    Article  Google Scholar 

  40. Stack, M. V. (1954). The organic content of chalky enamel. British Dental Journal, 96, 73–6

    Google Scholar 

  41. Rowles, S. L. and Little, K. (1955). Some observations on histological techniques. Journal of Dental Research, 34, 778 (abst.)

    Google Scholar 

  42. Eastoe, J. E. (1966). The changing nature ofdeveloping dental enamel. British Dental Journal 121, 451–4

    Google Scholar 

  43. Johansen, E. (1962). The nature of the carious lesion. Dental Clinics of North America, 305–20

    Google Scholar 

  44. Johansen, E. (1963). Mechanisms of Hard Tissue Destruction (Ed. Sognnaes, R. F.), American Association for the Advancement of Science, Washington, No. 75, pp. 187–211

    Google Scholar 

  45. Johansen, E. (1965). Tooth Enamel (Eds Stack, M. V. and Fearnhead, R. W.), Wright, Bristol, pp. 177–81

    Google Scholar 

  46. Hardwick, J. L. and Manley, E. B. (1952). Caries of the enamel and acidogenic caries. British Dental Journal, 92, 225–36

    Google Scholar 

  47. Bhussry, B. R. (1958). Chemical and physical studies of enamel from human teeth. Journal of Dental Research, 37, 1045–53

    Article  Google Scholar 

  48. Frank, R. M. (1955). La carie dentaire au microscope electronique. Schweitz Monatsschr Zahnheilkd, 65, 635–6

    Google Scholar 

  49. Little, K. (1957). The organic components of human dental enamel. Journal of Dental Research, 36, 815 (abst.)

    Google Scholar 

  50. Little, K. (1959). Electron microscope studies on human dental enamel. Journal of the Royal Microscopical Society, 78, 58–66

    Article  Google Scholar 

  51. Little, K. (1961). The use of the electron microscope in the examination of pathological conditions affecting the connective and hard tissues. Journal of the Royal Microscopical Society, 80, 35–45

    Article  Google Scholar 

  52. Little, K. (1962). The matrix in caries resistant teeth. Journal of the Royal Microscopical Society, 80, 199–208

    Article  Google Scholar 

  53. Darling, A. I. and Mortimer, K. V. (1959). Further observations on the early lesion of enamel caries. Journal of Dental Research, 38, 1226 (abst.)

    Google Scholar 

  54. Hallsworth, A. S., Robinson, C. and Weatherell, J. A. (1972). Mineral and magnesium distribution within the approximal carious lesion of dental enamel. Caries Research, 6, 156–68

    Article  Google Scholar 

  55. Frank, R. M. (1965). Caries-Resistant Teeth (Eds Wolstenholme, G. E. W. and O’Connor, M.), Churchill, London, pp. 169–84

    Google Scholar 

  56. Plackova, A. and Stepanek, J. (1965). Die submikroskopische struktur der braunen Schmelzflecken. Deutsche Zahnarztliche Zeitschrift, 20, 925–30

    Google Scholar 

  57. Meckel, A. H. (1965). The formation and properties of organic films on teeth. Archives of Oral Biology, 10, 585–97

    Article  Google Scholar 

  58. Leach, S. A. and Saxton, C. A. (1966). An electron microscopic study of the acquired pellicle and plaque formed on the enamel of human incisors. Archives of Oral Biology, 11, 1081–94

    Article  Google Scholar 

  59. Johnson, N. W. (1967a). Transmission electron microscopy of early carious enamel. Caries Research, 1, 356–69

    Article  Google Scholar 

  60. Armstrong, W. G. (1968). Origin and nature of the acquired pellicle. Proceedings of the Royal Society of Medicine, 61, 923–30

    Google Scholar 

  61. Silverstone, L. M. and Johnson, N. W. (1971). The effect on sound human enamel of exposure to calcifying fluids in vitro. Caries Research, 5, 323–42

    Article  Google Scholar 

  62. Poole, D. F. G. and Silverstone, L. M. (1969). Observations with the scanning electron microscope on trauma-induced micro-cavities in human enamel. Archives of Oral Biology, 14, 1323–9

    Article  Google Scholar 

  63. Poole, D. F. G. and Johnson, N. W. (1967). The effects of different demineralizing agents on human enamel surfaces studies by scanning electron microscopy. Archives of Oral Biology, 12, 1621–34

    Article  Google Scholar 

  64. Meckel, A. H., Griebstein, W. J. and Neal, R. J. (1965). Structure of mature human dental enamel as observed by electron microscopy. Archives of Oral Biology, 10, 775–83

    Article  Google Scholar 

  65. Boyde, A. (1965). Tooth Enamel (Eds Stack, M. V. and Fearnhead, R. W.), Wright, Bristol, pp. 163–67

    Google Scholar 

  66. Johnson, N. W. (1967). Some aspects of the ultrastructure of early human enamel caries seen with the electron microscope. Archives of Oral Biology, 12, 1505–21

    Article  Google Scholar 

  67. Silverstone, L. M. and Poole, D. F. G. (1969). Histologic and ultra-structural features of ‘remineralized’ carious enamel. Journal of Dental Research, 48, 766–70

    Article  Google Scholar 

  68. Matsumiya, S., Takuma, S. and Tsuchikura, H. (1952). Etude au microscope electronique des surfaces dentaires lisses-carie de l’email dentaire humain. Actualites Odontologica Stomatologic, 6, 409–19

    Google Scholar 

  69. Helmcke, J. G. (1955). Electronmikroskopische strukturuntersuchungen an gesunden und pathologischen zahn. Schweitz Monatsschr Zahnheilkd, 65, 629–32

    Google Scholar 

  70. Awazawa, Y. (1964). Electron microscopy of enamel caries. Journal of the Nihon University School of Dentistry, 6, 122–38

    Article  Google Scholar 

  71. Frank, R. M. (1953). Etude de development en surface de la carie dentaire par la methode des repliques ombrees et par une technique d’usure inversee a la meule. Schweitz Monatsschr Zahnheilkd, 63, 68394

    Google Scholar 

  72. Scott, D. S. and Albright, J. T. (1954). Electron microscopy of carious enamel and dentine. Journal of Oral Surgery, 7, 64–78

    Article  Google Scholar 

  73. Vahl, J., Hohlung, H. J., Plackova, A. and Bures, H. (1966). Elektronenmikroskopische ultradunnschnittuntersuchungen an zahnen mit Schmelzflecken, herruhrend von initialer karies, artifizielles Karies und mineralisations storungen. Deutsche Zahnarztliche Zeitschrift, 21, 983–9

    Google Scholar 

  74. Takuma, S. (1955). The electron microscopy of the enamel surfaces of teeth under various abnormal conditions. Journal of Dental Research, 34, 152–63

    Article  Google Scholar 

  75. Helmcke, J. G. (1963). New results of the electron microscope on shape structure of normal and pathologically changed teeth. International Dental Journal, 13, 450–5

    Google Scholar 

  76. Hinrichsen, C. F. L. and Engel, M. B. (1966). Fine structure of partially demineralised enamel. Archives of Oral Biology, 11, 65–93

    Article  Google Scholar 

  77. Johnson, N. W. (1966). Differences in the shape of human enamel crystallites after partial destruction by caries, EDTA and various acids. Archives of Oral Biology, 11, 1421–4

    Article  Google Scholar 

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Authors
  1. L. M. Silverstone
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  2. N. W. Johnson
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  3. J. M. Hardie
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  4. R. A. D. Williams
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© 1981 L. M. Silverstone, N. W. Johnson, J. M. Hardie and R. A. D. Williams

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Silverstone, L.M., Johnson, N.W., Hardie, J.M., Williams, R.A.D. (1981). Enamel Caries. In: Dental Caries. Palgrave, London. https://doi.org/10.1007/978-1-349-16547-6_6

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  • DOI: https://doi.org/10.1007/978-1-349-16547-6_6

  • Publisher Name: Palgrave, London

  • Print ISBN: 978-0-333-21179-3

  • Online ISBN: 978-1-349-16547-6

  • eBook Packages: MedicineMedicine (R0)

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