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Caries is one of the most frequent dental pathologies, and is considered to be an infectious disease as it involves different types of bacteria, and is the most prevalent disease in the world today. When a tooth is affected by caries, the bacteria demineralise and destroy the hard tissue of the tooth.
As the caries progresses, the damage caused to the tooth may be more or less superficial, meaning it may only affect the external layer of the tooth (the enamel), but may continue until it reaches the internal tissues such as the dentine and finally the dental pulp (the nerve of the tooth).
Caries is caused by a combination of three factors: the amount of sugar we eat in our diet, bacteria, and the predisposition of the person to develop caries.
Depending on the advance of the disease (its size and depth), symptoms may appear ranging from slight pain or discomfort, through to severe, incapacitating pain accompanied by abscesses and even fever. Generally, the closer the caries is to the dental pulp (the nerve), the more painful and damaging it is.
There are other causes that may affect the nerve of the tooth, such as traumas (impacts caused by sporting and traffic accidents, children's accidents, etc) which also cause pain and require immediate treatment.
Finally, and no less important, are destructive non-bacterial processes (wearing of the teeth). These may be physiological (due to the patient’s age) or pathological, caused by bad habits such as overly aggressive brushing, using highly erosive toothpaste, onychophagy (biting your nails), or bruxism (grinding and clenching your teeth). In many cases, the loss of tooth tissue is so severe that it may affect the nerve, causing different clinical symptoms such as sensitivity (felt when eating or drinking cold things, sugary foods, acidic foods, etc.), pain and abscesses.