CARIES DISEASE: PATHOGENESIS, MODERN TREATMENT METHODS AND PREVENTIVE MEASURES

Аннотация

This article provides a comprehensive overview of the pathogenesis of dental caries, its modern treatment methods, and current preventive strategies. It emphasizes the multifactorial nature of caries as a dynamic process involving microbial activity, host susceptibility, dietary factors, and time. The paper discusses both invasive and non-invasive management options, such as remineralization techniques, minimal intervention dentistry, bioactive materials, and photodynamic therapy. Preventive approaches—including fluoride application, dietary control, oral hygiene education, and risk-based strategies—are examined for their effectiveness in reducing the incidence and severity of caries. The article underscores the importance of personalized dental care and early detection as key components in minimizing the global burden of this widespread disease. Kеywоrds: Dental caries; pathogenesis; remineralization; bioactive materials; prevention; oral health; fluoride; minimal intervention; photodynamic therapy. INTRОDUСTIОN Dental caries remains one of the most prevalent chronic diseases affecting human populations worldwide. It affects individuals of all ages, socioeconomic statuses, and geographic locations, posing a significant public health burden. Despite major advancements in dental care and awareness campaigns, the global incidence of dental caries continues to be high, particularly in developing regions and among disadvantaged populations [1]. Caries is not merely a cosmetic issue but a complex disease that, if left untreated, can lead to pain, infection, tooth loss, and systemic health complications. Understanding the multifactorial pathogenesis of dental caries, along with modern approaches to its treatment and prevention, is essential for improving individual oral health and reducing healthcare costs on a national scale. MАTЕRIАLS АND MЕTHОDS The pathogenesis of dental caries involves the interaction between host factors, dietary habits, oral microbiota, and time. Caries begins when acid-producing bacteria in the dental biofilm metabolize fermentable carbohydrates, primarily sucrose, leading to acid production. These acids gradually demineralize the enamel and dentin, initiating the formation of carious lesions [2]. https://scientific-jl.com/ped 2 5 Volume-87, Issue-1, August -2025 “PEDAGOGS” international research journal ISSN: 2181-3027_SJIF: 5.449 Streptococcus mutans and Lactobacillus species are considered the primary pathogens responsible for initiating and progressing carious lesions. However, caries is increasingly understood as a polymicrobial disease, where a diverse microbial community contributes to the imbalance between demineralization and remineralization processes. The pH of the oral environment, frequency of sugar intake, saliva flow and composition, enamel quality, and immune responses are all critical host factors that influence the development and progression of caries. The disease follows a dynamic process, with periods of demineralization and remineralization occurring continuously. If this balance tips in favor of demineralization and is sustained over time, irreversible damage occurs, forming cavities that require professional intervention. Caries may begin as a non-cavitated white spot lesion and progress through enamel into dentin and eventually into the pulp, resulting in pain and potential systemic infection if left untreated. RЕSULTS АND DISСUSSIОN Contemporary treatment strategies for dental caries have evolved from traditional “drill and fill” approaches to more conservative, minimally invasive, and patient- centered care. The core philosophy now emphasizes preserving tooth structure and restoring the natural balance of the oral environment [3]. In the early stages of caries, non-invasive remineralization treatments are often preferred. These include the use of topical fluorides, such as fluoride varnishes and gels, as well as calcium phosphate compounds like CPP-ACP (casein phosphopeptide- amorphous calcium phosphate). These agents enhance remineralization of early enamel lesions and prevent progression. Silver diamine fluoride (SDF) has emerged as a powerful non-invasive option that both halts caries progression and provides antibacterial action. It is particularly effective in pediatric and geriatric populations where traditional restorative treatments may be challenging. When restoration is necessary, techniques such as Atraumatic Restorative Treatment (ART) and air abrasion minimize the removal of healthy tooth tissue. These approaches align with the principles of minimally invasive dentistry and have been successfully applied in community-based and resource-limited settings. Adhesive materials like glass ionomer cements, which release fluoride, are often used in modern restorative dentistry to both fill the cavity and offer ongoing protection against future decay. Resin-based composites are also widely used for their aesthetic and functional advantages. The development o