Civitali Dental and Prosthetic Center srl

Dental Caries. The process destructing tooth tissues.


Dental caries are a destructive process affecting dental hard tissues, caused by cariogenic bacteria.

Dental caries are a destructive process affecting dental hard tissues. They consist in the progressive demineralization of the enamel and dentine, the hard tissues constituting the tooth. The cariogenic process develops because of the acids produced by the bacterial plaque.

There are four factors at the basis of dental caries:

1)A susceptible patient

2)A sugar-rich diet

3)Cariogenic bacteria


Susceptible guest

Structural feature of teeth have strong influence on caries formation. If teeth display particularly deep fissures, food residuals and bacteria – the main triggering factors of caries – will have a higher probability of stagnation. Dental crowding too can lead to an accumulation of hardly removable plaque, because niches create where the tooth brush cannot get into. Other conditions, as pregnancy or lactation, may predispose to caries.

Sugar-rich diet

Sugars are the fundamental factor leading to caries formation. Cariogenic bacteria use them for their metabolism and transform them into weak acids (lactic acid and others).

Such acids lower the oral cavity pH and trigger, close to the tooth, the enamel demineralization process which will lead to the caries development. Only elemental sugars, like mono- or disaccharides (glucose, fructose, sucrose, ecc..) are used by bacteria.

Cariogenic bacteria

Main bacteria accountable for caries lesions are Streptococcus mutans and bacteria belonging to the Lactobacillus genus. The first ones can adhere to the enamel surface and build a network of polysaccharides where several other microorganisms stick, creating the bacterial plaque.

Lactobacillus in the bacterial plaque plays also an important role in caries formation: even if it is not capable of adhesion to the enamel, it is the main producer of the acids responsible for caries development.


Time is another fundamental factor. A certain amount of time is needed for bacteria to adhere to the dental surfaces, to organize in thick layers (creating the plaque), to produce acids and start the demineralization process.

It has been calculated that, starting from a perfectly clean and bacteria-free dental surface, 12 hours are necessary to these events to occur and to observe the creation of a cariogenic film. This implies that removing effectively the plaque at least twice a day is of paramount importance.