It’s worth mentioning that formation of a caries lesion doesn’t have to begin with the enamel of the crown.

值得一提的是龋齿的缺损，并不一定从牙冠部的牙釉质开始。

Alcohol can lead to an increase in Gram-positive bacteria such as Streptococcus mutans which can lead to dental caries.

饮酒会导致变异链球菌等革兰氏阳菌的数量增多，从而引发龋齿。

All right, as a quick recap, dental caries lesions are the end result of the dental caries disease process.

得！快速回顾一下：龋齿是牙齿龋坏进展的最。

Symptoms of dental caries include tooth pain and sensitivity, especially when chewing or drinking something that’s cold or hot, or sweet.

龋齿的症状包括疼痛和敏，尤其在咀嚼或饮用冰、热、甜的东西时。

If destruction continues into the dentin layer, then the caries lesion enlarges towards the pulp.

牙本质层的损害继续蔓延，缺损会延伸到牙髓。

If the enamel surface is intact, then the caries lesion can be treated without drilling a tooth and instead using chemical remineralization.

如牙釉质表面完整，使用化学再化剂就可以治愈龋齿，而不需要在牙齿上钻孔了。

These changes may increase pathogenic organisms or their activity causing a series of oral infectious diseases such as dental caries or periodontal diseases.

这些改变可能会增加致病微生物的数量或提高其活，从而导致诸如龋齿、牙周疾病等一系列口腔疾病。

Ultimately, these restorative treatments are useful, but they alone don’t resolve the underlying cause of the caries lesion and can’t prevent new caries lesions from forming.

归根底，这些修复方法虽然有效，但不能去除潜在的致病因素，也不能预防龋齿再次形成。

It’s always ideal to prevent a caries lesion from forming in the first place, and it starts with a risk assessment for identifying individuals at high risk of caries.

预防龋齿形成永远是最理想的治疗方法，首先要进行评估筛选出有患龋齿高危因素的人群。

" It is likely to be related to a change in diet. Our industrialized diet leads to chronic disease, which includes caries. And that may be the main explanation."

这可能与饮食的改变有关，我们工业化的饮食导致龋齿等慢病的出现，其主要原因可能就是这个。

An advanced caries lesion can progress to a point where the tooth surface forms a cavitation or a hole, which is the physical evidence of tooth breakdown.

龋洞进一步发展会导致牙齿表面形成洞穴，是牙齿损坏的实证。

So a sugar-rich diet and frequent snacks can lead to dental caries while a diet with increased fibers foods and diary products help maintain a healthy balance in the oral microbiota.

高糖饮食和经常吃零食，会导致龋齿；而富含高膳食纤维和奶制品的饮食，有助于维持口腔微生物群的健康平衡。

So, when it comes to dental caries, there’s a tug-of-war between the pathogenic factors that promote demineralization of the tooth and protective factors that promote remineralization of the tooth.

所以龋齿的形成过程中，加快牙齿软化的致病因素与加快牙齿再化的保护因素，像是在进行一场拔河比赛。

That environment favors bacteria like mutans streptococci and Lactobacillus, which demineralize enamel and the dentin beneath it, and if untreated, it can eventually result in a cavitated caries lesion.

酸环境下的优势菌例如变形链球菌和乳酸杆菌，可以食牙釉质及其下层的牙本质脱，如不加以治疗，最会形成空洞型龋齿。

However, moderate consumption of red wine may enhance oral health, because it contains a mixture of organic acids that are active against oral streptococci responsible for caries development and streptococcus pyogenes responsible for pharyngitis.

不过，适量饮用红葡萄酒可能会增进口腔健康，因为红葡萄酒中含有一种有机酸混合物可以有效抑制导致龋齿的口腔链球菌属以及导致咽炎的化脓链球菌。

This alteration can disrupt the bacterial equilibrium in the oral cavity by increasing harmful bacteria and decreasing the beneficial ones, thus leading to a series of oral infectious diseases such as dental caries, or periodontal diseases.

这种改变会增加有害菌、减少有益菌，从而破坏口腔中的细菌平衡，导致龋齿、牙周疾病等一系列口腔疾病的发生。

That’s the stage when individuals usually experience pain, although pain can also occur when the caries lesion involves the dentin layer since sensory nerve fibers travel through tubules in the dentin.

在这个阶段，患者常会到疼痛，但牙本质层受累产生龋坏时也可能有疼痛产生，因为觉神经也分布在牙本质的管道中。

So, treatment of dental caries disease depends on the level of risk, more specifically, reducing the pathogenic risk factors like antibacterial rinses to get rid of bacteria and increasing protective factors like products that mimic saliva.

所以龋齿的治疗是由风险的高低决定的，包括减少致病因子，例如用抗菌剂冲洗以去除细菌，增加防护因子，例如使用唾液类似物。

One factor that tips the balance towards caries progression is having less bicarbonate-rich saliva, which can result from conditions like Sjogren syndrome, radiation treatment for cancer, gastric reflux, or as a side effect of a medication or recreational drugs.

可以打破致病因素与保护因素的平衡使龋齿进展的一个原因是含有丰富碳酸氢盐的唾液减少，见于Sjogren综合征、癌症放疗、胃反流或毒品带来的副作用。