This section is from the book "Dental Medicine. A Manual Of Dental Materia Medica And Therapeutics", by Ferdinand J. S. Gorgas. Also available from Amazon: Dental Medicine.
Dental Caries is indicated by a process of gradual softening and chemical disintegration of the tooth substance, molecule by molecule, caused directly by micro-organisms which attach themselves and grow in contact with the surface of the tooth, being protected by a gelatinous film, and forming an acid which acts upon the tooth tissue, and thus affords access to the micro-organisms. Artificial coverings for the retention and protection of the microorganisms in contact with the tooth substance, may also result from badly performed technical procedures, such as imperfect fillings, irregularity appliances, gold bands, caps, etc. The micro-organisms have no power of penetrating the enamel until its substance is dissolved by their acid excretions making room for them, the lime salts of the tooth substance being first dissolved away by deleterious agents, the progress being hastened by certain structural defects in the enamel and dentine. Incipient dental caries is indicated by an opaque, whitish or gray appearance of the enamel. A pale brown varying to a nearly black color indicates the existence and progress of dental caries in the tooth tissues; the deeper the color the slower the progress of the caries, and the paler the color the more rapid the progress.
Incipient caries should be removed with great care, and the exposed surface of tooth structure prepared to resist further attacks by giving to it as high a polish as is possible, and the patient warned in regard to its future cleanliness. Deep-seated caries should be removed, and its further progress arrested by thoroughly sterilizing or disinfecting the cavity by antiseptics and disinfectants, and the careful insertion of fillings of a durable material. During pregnancy all operations on the teeth should be painless, and long, wearying sittings be avoided. Caries of the teeth of pregnant women can be arrested by plastic fillings until such time as the patient can the better endure more permanent operations. The preventive measures consist in the thorough and frequent use of the tooth-brush and its adjunct, floss silk, at least three times a day, assisted by a proper dentifrice and antacid antiseptic mouth-wash.