title: Sympathy for the Devil

text: Furthermore, Jagger stated in the "Rolling Stone" interview: "it's a very long historical figure — the figures of evil and figures of good — so it is a tremendously long trail he's made as personified in this piece." By the time "Beggars Banquet" was released, the Rolling Stones had already caused controversy for sexually forward lyrics such as "Let's Spend the Night Together", and their cover of the Willie Dixon's blues "I Just Want to Make Love to You" etc. There were also claims they had dabbled in Satanism (their previous album, while containing no direct Satanic references in its music or lyrics, was titled "Their Satanic Majesties Request"). "Sympathy" brought these concerns to the fore, provoking media rumours and fears among some religious groups that the Stones were devil worshippers and a corrupting influence on youth.


title: Sympathy for the Devil

text: The lyrics focus on atrocities in mankind's history from Satan's point of view, including the trial and death of Jesus Christ ("Made damn sure that Pilate washed his hands to seal his fate"), European wars of religion ("I watched with glee while your kings and queens fought for ten decades for the gods they made"), the violence of the Russian Revolution of 1917 and the 1918 execution of the Romanov family during World War I ("I stuck around St. Petersburg when I saw it was a time for a change/Killed the Tsar and his ministers/Anastasia screamed in vain"), and World War II ("I rode a tank, held a general's rank when the blitzkrieg raged, and the bodies stank"). The song was originally written with the line "I shouted out 'Who killed Kennedy?'" After Robert F. Kennedy's death on 6 June 1968, the line was changed to "Who killed the Kennedys?".


title: Sympathy for the Devil

text: The song may have been spared further controversy when the first single from the same album, "Street Fighting Man", became even more controversial in view of the race riots and student protests occurring in many cities in Europe and in the United States.


title: Sympathy for the Devil

text: The recording of "Sympathy for the Devil" began at London's Olympic Sound Studios on 4 June 1968; overdubs were done on 8, 9 and 10 June. Personnel included on the recording include Nicky Hopkins on piano, Rocky Dijon on congas and Bill Wyman on shekere. Marianne Faithfull, Anita Pallenberg, Brian Jones, Charlie Watts, producer Jimmy Miller, Wyman, and Richards performed backup vocals, singing the "woo woos". Richards plays bass on the original recording, and also electric guitar. Brian Jones plays a mostly mixed out acoustic guitar, although in isolated tracks of the studio cut, it is audible playing along with the piano.


title: Sympathy for the Devil

text: The backing "who who-woo-woo' vocals, which helped to make the song's sound stand out, came about by accident thanks to Jimmy Miller and Anita Pallenberg. Pallenberg was in the engineering booth with Miller while Jagger was belting out an early vocal take of the song. According to Pallenberg, Miller was half talking to himself as Jagger sang, saying stuff like "Come on Mick, give it your all, who are you singing about? – Who, who?" He then repeated "Who who" several times after that as Jagger sang on, and Pallenberg realised how wonderful that all sounded. After the take, she told Jagger what transpired in the booth and suggested that "who who" be used in the song as a backing vocal chant. The Stones then gave it a go and after the first take, "Who who" became "woo-woo", with most of this caught on film by director Jean-Luc Godard for his "One Plus One" (aka "Sympathy for the Devil") movie.


title: Sympathy for the Devil

text: In an interview with "Creem", Jagger said, "[When people started taking us as devil worshippers], I thought it was a really odd thing, because it was only one song, after all. It wasn't like it was a whole album, with lots of occult signs on the back. People seemed to embrace the image so readily, [and] it has carried all the way over into heavy metal bands today. Some people have made a living out of doing this; for example, Jimmy Page."


title: Sympathy for the Devil

text: Of the change in public perception the band experienced after the song's release, Richards said in a 1971 interview with "Rolling Stone", "Before, we were just innocent kids out for a good time, they're saying, 'They're evil, they're evil.' Oh, I'm evil, really? So that makes you start thinking about evil ... What is evil? Half of it, I don't know how many people think of Mick as the devil or as just a good rock performer or what? There are black magicians who think we are acting as unknown agents of Lucifer and others who think we are Lucifer. Everybody's Lucifer."


title: Sympathy for the Devil

text: Hunter S. Thompson and his attorney Oscar Zeta Acosta kept replaying the song hundreds of times during their drug-induced Chevy ride to Las Vegas in 1971 to maintain focus whilst high on class A drugs. In Thompson's novel, "Fear and Loathing in Las Vegas" and the film of the same name, the song is referenced several times.


title: Sympathy for the Devil

text: Contrary to a widespread misconception, it was "Under My Thumb" and not "Sympathy for the Devil" that the Stones were performing when Meredith Hunter was killed at the Altamont Free Concert. "Rolling Stone" magazine's early articles on the incident typically misreported that the killing took place during "Sympathy for the Devil", but the Stones in fact played "Sympathy for the Devil" earlier in the concert; it was interrupted by a fight and restarted, Jagger commenting, "We're always having—something very funny happens when we start that number." Several other songs were performed before Hunter was killed.


title: Sympathy for the Devil

text: "Sympathy for the Devil" is also the title of a producer's edit of a 1968 film by Jean-Luc Godard whose own original version is called "One Plus One". The film, a depiction of the late 1960s American counterculture, also featured the Rolling Stones in the process of recording the song in the studio. On the filming, Jagger said in "Rolling Stone": "[it was] very fortuitous, because Godard wanted to do a film of us in the studio. I mean, it would never happen now, to get someone as interesting as Godard. And stuffy. We just happened to be recording that song. We could have been recording "My Obsession". But it was "Sympathy for the Devil", and it became the track that we used."


title: Sympathy for the Devil

text: During the several days of recording the Stones as they played, a film lamp set up by Godard's crew started a major fire in the studio that caused substantial damage to the studio and laid waste to some of the band's equipment. However, the song's tapes were saved by producer Jimmy Miller before he fled the studio, and Godard kept his cameras rolling capturing the fire on film as it roared on.


title: Sympathy for the Devil

text: Guns N' Roses recorded a cover in 1994 which reached number 55 on the "Billboard" Hot 100; it was featured in the closing credits of Neil Jordan's film adaptation of Anne Rice's "Interview with the Vampire" and was included on their "Greatest Hits" album. This cover is noteworthy for causing an incident involving incoming guitarist Paul "Huge" Tobias, that was partially responsible for guitarist Slash departing from the band in 1996. Slash has described the Guns N' Roses version of the song as "the sound of the band breaking up".


title: Sympathy for the Devil

text: Rhythm guitarist Gilby Clarke, who does not appear on the recording, noted that the recording foreshadowed his departure from the band:


title: Sympathy for the Devil

text: This was the band's final single until 2021's "Absurd" to feature guitarist Slash and bassist Duff McKagan.


title: Jodha Akbar

text: Jodha Akbar is an Indian Historical drama television series that aired from 18 June 2013 to 7 August 2015 on Zee TV and is also digitally available on ZEE5. The show was produced by Ekta Kapoor under Balaji Telefilms. Starring Rajat Tokas and Paridhi Sharma, it was a successful show with praises for its cast performances.


title: Jodha Akbar

text: "Jodha Akbar" is an epic drama that focuses on how the marriage policy brings the love of Jodha Bai and Akbar in a measure that has changed the destiny of India. This drama period also describes the wars of this time and the relations between the Mughals and Rajputs and how Jodha and Akbar face trials and tribulations to be together. The drama also focuses on the operating Queens, courts, courtesans, ministers and their influence on the love story of Akbar and Jodha Bai. Finally, the show also portrays how Mughal Emperor Jalaluddin Muhammad acquires the title 'Akbar' from the people of India.


title: Jodha Akbar

text: Jalaluddin Mohammad, a fearless warrior, son of Emperor Humayun and Hameeda Bano Begum, became the Emperor of the Mughal dynasty at a very young age. He is under the influence of Bairam Khan, his reagent, and Maham Anga, his foster mother. Bairam Khan has taught Jalal to be a ruthless and cruel ruler, and spread his rule by fear, conquer people by the sword. Jalal, following Bairam Khan's ideals becomes a heartless and fearsome ruler, whom the people dislike. He wants to conquer the entire Hindustaan, and presently, he is eyeing the golden Rajputana.


title: Jodha Akbar

text: Jodha Bai, princess of Amer, daughter of Raja Bharmal and Rani Mainavati, is a kind and intelligent young girl, who believes in ruling people's hearts and that rule is spread by love and togetherness, not by force.


title: Jodha Akbar

text: She decides to go to a far away temple to offer prayers on her birthday, along with Moti Bai, her friend and aide. While offering prayers there, a band of mughal soldiers come and start looting the jewellery of the Goddess. When Moti Bai tries to stop them, they try to molest her. Angered at this, Jodha asks who could be so cruel as to rob people of their religions, to which a temple person replied Jalaluddin Mohammad. Jodha pledges to destroy Jalal and present his head in front of the Goddess.


title: Jodha Akbar

text: Meanwhile, Moti Bai, embarrassed by the turn of events, decides to commit suicide, but Jodha prevents her. This makes Jodha even more vengeful.


title: Jodha Akbar

text: Jalal punishes a man for stealing his shoes by cutting off his legs. He decides to meet Sharifuddin, a subedar of, close to Amer, so that he can wait for the right moment to attack the unaware Rajputs.


title: Jodha Akbar

text: Certain Rajput groups claimed Jodhaa was married to Akbar's son, Jahangir, not Akbar, whereas certain reports state that Jodha and Akbar were not married although the primary history proves that Akbar and the princess of Amber were married on which the show is made as a complete show can't be false. They also protested against the show along with "Bharat Ka Veer Putra – Maharana Pratap", another historical series that aired on Sony TV.


title: Jodha Akbar

text: The title of the series was criticised by members of the Kshatriya community as misleading, politically motivated historical revisionism that minimised Rajput history. The community protested against the series in Rajasthan, and alleged that if the name was not changed they would not let any Balaji Telefilms films to be released in the state. Ekta Kapoor stated, "I always believe it's 80% history and 20% folklore. There are enough proofs that say it's true, but then there are some people who say it's not. Akbar had a certain graph and we know that. We cannot negate that there was a change of heart in him from a power-hungry ruler to a non-biased one because of his Rajput queen." The story is loosely true but has a wholesome addition of drama.


title: Jodha Akbar

text: The producer of the show, Ekta Kapoor was influenced by the 2009 big screen movie, "Jodhaa Akbar", directed by Bollywood's Ashutosh Gowariker.


title: Jodha Akbar

text: Rajat Tokas who had earlier worked with Ekta Kapoor in the soap opera, "Tere Liye" was selected to play the role of the protagonist "Akbar".


title: Jodha Akbar

text: Ekta Kapoor stated she conducted 7000 auditions for the female protagonist Jodha across the nation before selecting Paridhi Sharma.


title: Jodha Akbar

text: Ashwini Kalsekar was selected to play the role of Maham Anga, Akbar's primary caretaker and protector.


title: Jodha Akbar

text: This series is dubbed in Tamil as same name on Zee Tamil, in Telugu language as same name on Zee Telugu, in Bengali Language as same name on Zee Bangla, in Malayalam language as same name on Zee Keralam, and in English language as same name on Zee World Africa


title: 2019 FIFA U-20 World Cup

text: The 2019 FIFA U-20 World Cup was the 22nd edition of the FIFA U-20 World Cup, the biennial international men's youth football championship contested by the under-20 national teams of the member associations of FIFA, since its inception in 1977 as the FIFA World Youth Championship. The tournament was hosted by Poland between 23 May and 15 June 2019. This was the first FIFA tournament hosted by Poland; the country had hosted UEFA international football events in the past including the UEFA Euro 2012 with Ukraine and the 2017 UEFA European Under-21 Championship.


title: 2019 FIFA U-20 World Cup

text: England won the previous tournament in South Korea, but did not qualify for the tournament after finishing sixth at the 2018 UEFA European Under-19 Championship in Finland. In doing so, they became the sixth consecutive incumbent title holders to fail to qualify for the subsequent tournament.


title: 2019 FIFA U-20 World Cup

text: Ukraine won their first FIFA U-20 World Cup title after beating South Korea 3–1 in the final. They did it in their first appearance further than the round of 16, becoming the first team from a former Soviet republic other than Russia to win a FIFA competition title since its dissolution in 1991. The Soviet Union, whose record is now inherited by Russia, previously won the inaugural U-20 World Cup in 1977.


title: 2019 FIFA U-20 World Cup

text: The bidding process to host the 2019 FIFA U-20 World Cup and the 2019 FIFA U-17 World Cup was launched by FIFA in June 2017. A member association may bid for both tournaments, but they would be awarded to different hosts.


title: 2019 FIFA U-20 World Cup

text: FIFA announced Poland as the hosts after the FIFA Council meeting on 16 March 2018 in Bogotá, Colombia. Poland won the bid over India in a 9–5 vote.


title: 2019 FIFA U-20 World Cup

text: A total of 24 teams qualified for the final tournament. In addition to Poland, who qualified automatically as hosts, 23 other teams qualified from six separate continental competitions. The slot allocation was approved by the FIFA Council on 10 June 2018. All 24 teams qualified had played in the tournament prior to this edition, making this the first U-20 World Cup in which none of the teams that earned a spot were making their debut.


title: 2019 FIFA U-20 World Cup

text: Bielsko-Biała, Bydgoszcz, Gdynia, Łódź, Lublin and Tychy were the six cities hosting the competition. Lubin (not to confuse with Lublin) ended up withdrawn from the list due to hotel capacity troubles and was replaced by Bielsko-Biała.


title: 2019 FIFA U-20 World Cup

text: The emblem was unveiled on 14 December 2018. The emblem features a crocus, a flower that blooms every spring in Poland combined with the colors of the Polish flag, symbolising the new faces that will emerge to shape the tournament's trophy.


title: 2019 FIFA U-20 World Cup

text: Grzywek, the official mascot was unveiled on 23 February 2019 one day before the final draw. Grzywek is inspired by a Polish bison distinctive name comes from the Polish word for "mane" – the long and coarse hair that adorns the neck of this striking animal – and also symbolises the country's pride at hosting its first ever FIFA competition.


title: 2019 FIFA U-20 World Cup

text: The final draw was held on 24 February 2019, 17:30 CET (), at the Gdynia Sports Arena in Gdynia. The 24 teams were drawn into six groups of four teams. The hosts Poland were automatically seeded into Pot 1 and assigned to position A1, while the remaining teams were seeded into their respective pots based on their results in the last five FIFA U-20 World Cups (more recent tournaments weighted more heavily), with bonus points awarded to confederation champions. Teams from Pot 1 were drawn first, followed by Pot 2, Pot 3, and finally Pot 4, with each team (apart from Poland) also drawn to one of the positions within their group. No group could contain more than one team from each confederation.


title: 2019 FIFA U-20 World Cup

text: A total of 21 refereeing trios (a referee and two assistant referees), 6 support referees, and 20 video assistant referees were appointed for the tournament.


title: 2019 FIFA U-20 World Cup

text: Players born on or after 1 January 1999 and on or before 31 December 2003 were eligible to compete in the tournament.


title: 2019 FIFA U-20 World Cup

text: Each team had to name a preliminary squad of between 22 and 50 players. From the preliminary squad, the team had to name a final squad of 21 players (three of whom must be goalkeepers) by the FIFA deadline. Players in the final squad could be replaced by a player from the preliminary squad due to serious injury or illness up to 24 hours prior to kickoff of the team's first match.


title: 2019 FIFA U-20 World Cup

text: The four best third-placed teams from the six groups advanced to the knockout stage along with the six group winners and six runners-up.


title: 2019 FIFA U-20 World Cup

text: In the knockout stage, if a match was level at the end of 90 minutes of normal playing time, extra time would be played (two periods of 15 minutes each), where each team was allowed to make a fourth substitution. If still tied after extra time, the match would be decided by a penalty shoot-out to determine the winner.


title: 2019 FIFA U-20 World Cup

text: In the round of 16, the four third-placed teams would be matched with the winners of groups A, B, C, and D. The specific match-ups involving the third-placed teams depended on which four third-placed teams qualified for the round of 16:


title: 2019 FIFA U-20 World Cup

text: The following awards were given at the conclusion of the tournament. They were all sponsored by Adidas, except for the FIFA Fair Play Award.


title: Warren E. Burger

text: Warren Earl Burger (September 17, 1907 – June 25, 1995) was an American attorney and jurist who served as the 15th chief justice of the United States from 1969 to 1986. Born in Saint Paul, Minnesota, Burger graduated from the St. Paul College of Law in 1931. He helped secure the Minnesota delegation's support for Dwight D. Eisenhower at the 1952 Republican National Convention. After Eisenhower won the 1952 presidential election, he appointed Burger to the position of Assistant Attorney General in charge of the Civil Division. In 1956, Eisenhower appointed Burger to the United States Court of Appeals for the District of Columbia Circuit. Burger served on this court until 1969 and became known as a critic of the Warren Court.


title: Warren E. Burger

text: In 1969, President Richard Nixon nominated Burger to succeed the Chief Justice, Earl Warren, and Burger won Senate confirmation with little opposition. He did not emerge as a strong intellectual force on the Court, but sought to improve the administration of the federal judiciary. He also helped establish the National Center for State Courts and the Supreme Court Historical Society. Burger remained on the Court until his retirement in 1986, when he became Chairman of the Commission on the Bicentennial of the United States Constitution. He was succeeded as chief justice by William H. Rehnquist, who had served as an associate justice since 1972.


title: Warren E. Burger

text: In 1974, Burger wrote for a unanimous court in "United States v. Nixon", which rejected Nixon's invocation of executive privilege in the wake of the Watergate scandal. The ruling played a major role in Nixon's resignation. Burger joined the majority in "Roe v. Wade" in holding that the right to privacy prohibited states from banning abortions. Later analyses have suggested that Burger joined the majority in "Roe" solely to prevent Justice William O. Douglas from controlling assignment of the opinion. Although too late, he later abandoned "Roe v. Wade" in "Thornburgh v. American College of Obstetricians and Gynecologists". His majority opinion in "INS v. Chadha" struck down the one-house legislative veto.


title: Warren E. Burger

text: Although Burger was nominated by a conservative president, the Burger Court also delivered some of the most liberal decisions regarding abortion, capital punishment, religious establishment, and school desegregation during his tenure.


title: Warren E. Burger

text: Burger was born in Saint Paul, Minnesota, in 1907, as one of seven children. His parents, Katharine (née Schnittger) and Charles Joseph Burger, a traveling salesman and railroad cargo inspector, were of Austrian German descent. He was raised Presbyterian. His grandfather, Joseph Burger, had emigrated from Tyrol, Austria and joined the Union Army when he was 13. Joseph Burger fought and was wounded in the Civil War, resulting in the loss of his right arm and was awarded the Medal of Honor at the age of 14. At age 16, Joseph Burger became one of the youngest captains in the Union Army.


title: Warren E. Burger

text: Burger grew up on the family farm near the edge of Saint Paul. At age 8, he stayed home from school for a year after contracting polio. He attended John A. Johnson High School, where he was president of the student council. He competed in hockey, football, track, and swimming. While in high school, he wrote articles on high school sports for local newspapers. He graduated in 1925, and received a partial scholarship to attend Princeton University, which he declined because his family's finances were not sufficient to cover the remainder of his expenses.


title: Warren E. Burger

text: That same year, Burger also worked with the crew building the Robert Street Bridge, a crossing of the Mississippi River in Saint Paul that still exists. Concerned about the number of deaths on the project, he asked that a net be installed to catch anyone who fell, but was rebuffed by managers. In later years, Burger made a point of visiting the bridge whenever he came back to town.


title: Warren E. Burger

text: Burger enrolled in extension classes at the University of Minnesota for two years while selling insurance for Mutual Life Insurance. Afterward, he enrolled at St. Paul College of Law (which later became William Mitchell College of Law, now Mitchell Hamline School of Law), receiving his Bachelor of Laws "magna cum laude" in 1931. He took a job at a St. Paul law firm. In 1937, Burger served as the eighth president of the Saint Paul Jaycees. He also taught for twelve years at William Mitchell. A spinal condition prevented Burger from serving in the military during World War II; instead he supported the war effort at home, including service on Minnesota's emergency war labor board from 1942 to 1947. From 1948 to 1953, he served on the governor of Minnesota's interracial commission, which worked on issues related to racial desegregation. He also served as president of St. Paul's Council on Human Relations, which considered ways to improve the relationship between the city's police department and its minority residents.


title: Warren E. Burger

text: Burger's political career began uneventfully, but he soon rose to national prominence. He supported Minnesota Governor Harold E. Stassen's unsuccessful pursuit of the Republican nomination for president in 1948. At the 1952 Republican National Convention, Burger played a key role in Dwight D. Eisenhower's nomination by leading the Minnesota delegates to change their votes from Stassen to Eisenhower after Stassen failed to obtain 10 percent of the vote, which freed the Minnesota delegation from their pledge to support him.


title: Warren E. Burger

text: President Eisenhower appointed Burger as the Assistant Attorney General in charge of the Civil Division of the Justice Department.


title: Warren E. Burger

text: In this role, he first argued in front of the Supreme Court. The case involved John P. Peters, a Yale University professor who worked as a consultant to the government. He had been discharged from his position on loyalty grounds. Supreme Court cases are usually argued by the Solicitor General, but he disagreed with the government's position and refused to argue the case. Burger lost the case. Shortly after, in "Dalehite v. United States", 346 U.S. 15 (1953), Burger defended the United States against claims from the Texas City ship explosion disaster, successfully arguing that the Federal Tort Claims Act of 1947 did not allow a suit for negligence in policy making.


title: Warren E. Burger

text: Burger was nominated by President Dwight D. Eisenhower on January 12, 1956, to a seat on the United States Court of Appeals for the District of Columbia Circuit vacated by Judge Harold M. Stephens. He was confirmed by the United States Senate on March 28, 1956, and received his commission on March 29, 1956. His service terminated on June 23, 1969, due to his elevation to the United States Supreme Court.


title: Warren E. Burger

text: In June 1968, Chief Justice Earl Warren announced his retirement, effective on the confirmation of his successor. President Lyndon Johnson nominated sitting associate justice Abe Fortas to the position, but a Senate filibuster blocked his confirmation, and Johnson withdrew the nomination. Richard Nixon was elected president in November 1968, and Johnson did not make another nomination before his term as president ended on January 20, 1969.


title: Warren E. Burger

text: Burger was nominated by President Nixon to succeed Earl Warren on May 23, 1969. The United States Senate Committee on the Judiciary hearing on Burger's nomination took place on June 3, 1969. It was characterized as having been friendly, and saw Burger as the sole individual to deliver testimony. The hearing was reported as having taken only an hour and forty minutes. Afterwards, the committee held a five-minute private session in which they voted unanimously to report favorably on his nomination. The Senate confirmed Burger to the court by a 74–3 vote on June 9, 1969, and he took the judicial oath of office on June 23, 1969.


title: Warren E. Burger

text: Remaking the Supreme Court had been a theme in Nixon's presidential campaign, and he had pledged to appoint a strict constructionist as chief justice. Burger had first caught Nixon's eye through a letter of support he sent to Nixon during the 1952 Fund crisis, and then again 15 years later when the magazine "U.S. News & World Report" reprinted a 1967 speech that Burger had given at Ripon College. In it, Burger compared the United States judicial system to those of Norway, Sweden, and Denmark:


title: Warren E. Burger

text: Through speeches like this, Burger became known as a critic of Chief Justice Warren and an advocate of a literal, strict-constructionist reading of the U.S. Constitution. Nixon's agreement with these views, being expressed by a readily confirmable, sitting federal appellate judge, led to the nomination.


title: Warren E. Burger

text: According to President Nixon's memoirs, he had asked Burger in the spring of 1970 to be prepared to run for president in 1972 if the political repercussions of the Cambodia invasion were too negative for him to endure. A few years later, Burger was on Nixon's short list of vice presidential candidates following the resignation of Spiro Agnew in October 1973, before Gerald Ford was appointed to succeed him.


title: Warren E. Burger

text: The Court issued a unanimous ruling, "Swann v. Charlotte-Mecklenburg Board of Education" (1971), supporting busing to reduce "de facto" racial segregation in schools. However, Burger wrote the majority opinion for "Milliken v. Bradley" (1974), which upheld "de facto" school segregation across school district lines if segregationist policy was not explicitly stated by all of the districts involved. In "United States v. U.S. District Court" (1972), the Burger Court issued another unanimous ruling against the Nixon administration's desire to invalidate the need for a search warrant and the requirements of the Fourth Amendment in cases of domestic surveillance. Then, only two weeks later in "Furman v. Georgia" (1972), the Court, in a 5–4 decision, invalidated all death penalty laws then in force although Burger dissented from that decision. In the most controversial ruling of his term, "Roe v. Wade" (1973), Burger voted with the majority to recognize a broad right to privacy that prohibited states from banning abortions. However, Burger later abandoned "Roe" in "Thornburgh v. American College of Obstetricians and Gynecologists" (1986).


title: Warren E. Burger

text: On July 24, 1974, Burger led the Court in a unanimous decision in "United States v. Nixon", arising from Nixon's attempt to keep several memos and tapes relating to the Watergate scandal private. As documented in Woodward and Armstrong's "The Brethren" and elsewhere, Burger's original feelings on the case were that Watergate was merely a political battle, and Burger "didn't see what they did wrong". The actual final opinion was largely Brennan's work, but each justice wrote at least a rough draft of a particular section. Burger was originally to vote in favor of Nixon but tactically changed his vote to assign the opinion to himself and to restrain the opinion's rhetoric. Burger's first draft of the opinion wrote that executive privilege could be invoked when it dealt with a "core function" of the presidency and that in some cases, the executive could be supreme. However, the other justices were able to convince Burger to excise that language from the opinion: the judicial branch alone would have the power to determine whether something can be shielded under an assertion of executive privilege.


title: Warren E. Burger

text: Burger joined the majority decision in "Board of Education of the Hendrick Hudson Central School District v. Rowley", which was the first special education law case decided by the Supreme Court. The Court upheld the constitutionality of Individual Education Plans, but also held that the school district did not have to provide every service necessary in order to maximize a child's potential.


title: Warren E. Burger

text: Burger also emphasized the maintenance of checks and balances among the branches of government. In "Immigration and Naturalization Service v. Chadha" (1983), he held for the majority that Congress could not reserve a legislative veto over executive branch actions.


title: Warren E. Burger

text: On issues involving criminal law and procedure, Burger remained reliably conservative. He dissented in "Solem v. Helm", which held that a life sentence for a phony check was unconstitutional. He once stated personal opposition to the death penalty in his "Furman v. Georgia" dissent, but defended it as constitutional.


title: Warren E. Burger

text: Rather than dominating the Court, Burger sought to improve administration both within the Court and within the nation's legal system. Criticizing some advocates as unprepared, Burger created training venues for state and local government advocates. He also helped found the National Center for State Courts, which is now in Williamsburg, Virginia, as well as the Institute for Court Management, and National Institute of Corrections to provide professional training for judges, clerks, and prison guards. Burger also began a tradition of annually delivering a "State of the Judiciary" speech to the American Bar Association, many of whose members had been alienated by the Warren Court. However, some detractors thought his emphasis on the mechanics of the judicial system trivialized the office of chief justice. Despite his reputation for being imperious, he was well-liked by the law clerks and judicial fellows who worked with him.


title: Warren E. Burger

text: Burger drew internal controversy within the Supreme Court throughout his tenure, as was revealed in Woodward and Armstrong's "The Brethren". Although Sen. Everett Dirksen noted Burger "looked, sounded, and acted like a chief justice," the reporters depicted Burger as an ineffective chief justice who was not seriously respected by his colleagues for his alleged pomposity and lack of legal acumen. Woodward and Armstrong's sources indicated that some of the other justices were annoyed by Burger's practice of switching his vote in conference or simply not announcing his vote so that he could control opinion assignments. "Burger repeatedly irked his colleagues by changing his vote to remain in the majority, and by rewarding his friends with choice assignments and punishing his foes with dreary ones." Burger would also try to influence the course of events in a case by circulating a pre-emptive opinion. Clerks mocked him for his perceived egotism and intense homophobia, and Justice Lewis Powell allegedly referred to him as "the great white doughnut", a attack on both his intellect and physical appearance.


title: Warren E. Burger

text: Consequently, the Burger Court was described as his "in name only". "Time" magazine called him "plodding" and "standoffish" as well as "pompous," "aloof," and unpopular. Burger was a constant irritant on the Court's group dynamic, according to "The New York Times"' Linda Greenhouse. Jeffrey Toobin wrote in his book "" that by the time of his departure in 1986, Burger had alienated all of his colleagues to one degree or another. In particular, Associate Justice Potter Stewart, who had been considered a candidate to succeed Warren as chief justice, was so discontented with Burger that he became the primary source for Woodward and Armstrong when they wrote "The Brethren".


title: Warren E. Burger

text: Greenhouse pointed to "INS v. Chadha" as evidence of Burger's "foundering leadership". Burger would cause the case to be delayed for over twenty months although there had been five votes to affirm the appeals court's finding of unconstitutionality after the case had been first argued: Brennan, Marshall, Blackmun, Powell, and Stevens. Burger did not allow an opinion to be assigned, first by asking for a special conference on the case and then by delaying the case for reargument when that conference fell through even though he never held a formal vote on holding the case over for reargument.


title: Warren E. Burger

text: No women served on the Supreme Court until 1981, and Burger was strongly opposed to giving a seat to a female judge. In 1971, President Nixon considered nominating Mildred Lillie to the Supreme Court. Former White House Counsel John Dean had said that the greatest opposition to Lillie came from Chief Justice Burger. Dean indicated that Burger threatened to resign over the nomination.


title: Warren E. Burger

text: Burger was deeply prejudiced against gays to an extent which bordered on hysteria. Burger sent Byron White, who wrote the majority opinion in "Bowers v. Hardwick" upholding laws banning homosexual relations between consenting adults, a letter telling him to condemn homosexuality in his opinion. White refused. When Lewis Powell voted to strike down the anti-gay laws, Burger aggressively lobbied him to change his mind, and sent him a letter so hostile towards homosexuals that Powell mockingly described it as "nonsense". Burger wrote his own opinion attacking homosexuality, quoting a description of it as "an infamous crime against nature, of deeper malignity than rape, and an act not fit to be named, the very mention of which is an affront to human nature", and noted, with apparent approval, that homosexuals were once executed. Burger's language mobilized gay rights advocates to work to overturn sodomy laws, eventually succeeding in the 2003 case "Lawrence v. Texas".


title: Warren E. Burger

text: Burger left office on September 26, 1986, in part to lead the campaign to mark the bicentennial of the United States Constitution. He was succeeded as chief justice by William Rehnquist. He served longer than any other chief justice appointed in the 20th century.


title: Warren E. Burger

text: In 1987, Princeton University's American Whig-Cliosophic Society awarded Burger the James Madison Award for Distinguished Public Service. In 1988, he was awarded the prestigious United States Military Academy's Sylvanus Thayer Award as well as the Presidential Medal of Freedom.


title: Warren E. Burger

text: In a 1991 appearance on the "MacNeil/Lehrer NewsHour", Burger stated that the notion that the Second Amendment guaranteed an unlimited individual right to obtain guns "has been the subject of one of the greatest pieces of fraud, I repeat the word 'fraud,' on the American public by special interest groups".


title: Warren E. Burger

text: Burger died on June 25, 1995, from congestive heart failure at the age of 87, at Sibley Memorial hospital in Washington, D.C. All of his papers were donated to the College of William and Mary, where he had served as Chancellor; however, they will not be open to the public until ten years after the death of Sandra Day O'Connor, the last surviving member of the Burger Court, per the donor agreement.


title: Warren E. Burger

text: Burger's casket lay in repose in the Great Hall of the United States Supreme Court Building. His remains are interred at Arlington National Cemetery.


title: Warren E. Burger

text: As chief justice, Burger was instrumental in founding the Supreme Court Historical Society and was its first president. Burger is often cited as one of the foundational proponents of Alternative Dispute Resolution (ADR), particularly in its ability to ameliorate an overloaded justice system. In a speech given in front of the American Bar Association, Chief Justice Burger lamented the state of the justice system in 1984, saying, "Our system is too costly, too painful, too destructive, too inefficient for a truly civilized people. To rely on the adversary process as the principal means of resolving conflicting claims is a mistake that must be corrected." The Warren E. Burger Federal Courthouse in Saint Paul, Minnesota, and the Warren E. Burger Library at his alma mater, the Mitchell Hamline School of Law (formerly the William Mitchell College of Law, and the St. Paul College of Law at the time of Burger's attendance) are named in his honor.


title: Warren E. Burger

text: He married Elvera Stromberg in 1933. They had two children, Wade Allen Burger (1936–2002) and Margaret Elizabeth Burger (1946–2017). Elvera Burger died at their home in Washington, D.C., on May 30, 1994, at the age of 86.


title: Tooth decay

text: Tooth decay, also known as cavities or caries, is the breakdown of teeth due to acids produced by bacteria. The cavities may be a number of different colors from yellow to black. Symptoms may include pain and difficulty with eating. Complications may include inflammation of the tissue around the tooth, tooth loss and infection or abscess formation.


title: Tooth decay

text: The cause of cavities is acid from bacteria dissolving the hard tissues of the teeth (enamel, dentin and cementum). The acid is produced by the bacteria when they break down food debris or sugar on the tooth surface. Simple sugars in food are these bacteria's primary energy source and thus a diet high in simple sugar is a risk factor. If mineral breakdown is greater than build up from sources such as saliva, caries results. Risk factors include conditions that result in less saliva such as: diabetes mellitus, Sjögren syndrome and some medications. Medications that decrease saliva production include antihistamines and antidepressants. Dental caries are also associated with poverty, poor cleaning of the mouth, and receding gums resulting in exposure of the roots of the teeth.


title: Tooth decay

text: Prevention of dental caries includes regular cleaning of the teeth, a diet low in sugar, and small amounts of fluoride. Brushing one's teeth twice per day and flossing between the teeth once a day is recommended. Fluoride may be acquired from water, salt or toothpaste among other sources. Treating a mother's dental caries may decrease the risk in her children by decreasing the number of certain bacteria she may spread to them. Screening can result in earlier detection. Depending on the extent of destruction, various treatments can be used to restore the tooth to proper function or the tooth may be removed. There is no known method to grow back large amounts of tooth. The availability of treatment is often poor in the developing world. Paracetamol (acetaminophen) or ibuprofen may be taken for pain.


title: Tooth decay

text: Worldwide, approximately 3.6 billion people (48% of the population) have dental caries in their permanent teeth as of 2016. The World Health Organization estimates that nearly all adults have dental caries at some point in time. In baby teeth it affects about 620 million people or 9% of the population. They have become more common in both children and adults in recent years. The disease is most common in the developed world due to greater simple sugar consumption and less common in the developing world. Caries is Latin for "rottenness".


title: Tooth decay

text: A person experiencing caries may not be aware of the disease. The earliest sign of a new carious lesion is the appearance of a chalky white spot on the surface of the tooth, indicating an area of demineralization of enamel. This is referred to as a white spot lesion, an incipient carious lesion or a "micro-cavity". As the lesion continues to demineralize, it can turn brown but will eventually turn into a cavitation ("cavity"). Before the cavity forms, the process is reversible, but once a cavity forms, the lost tooth structure cannot be regenerated.


title: Tooth decay

text: A lesion that appears dark brown and shiny suggests dental caries were once present but the demineralization process has stopped, leaving a stain. Active decay is lighter in color and dull in appearance.


title: Tooth decay

text: As the enamel and dentin are destroyed, the cavity becomes more noticeable. The affected areas of the tooth change color and become soft to the touch. Once the decay passes through the enamel, the dentinal tubules, which have passages to the nerve of the tooth, become exposed, resulting in pain that can be transient, temporarily worsening with exposure to heat, cold, or sweet foods and drinks. A tooth weakened by extensive internal decay can sometimes suddenly fracture under normal chewing forces. When the decay has progressed enough to allow the bacteria to overwhelm the pulp tissue in the center of the tooth, a toothache can result and the pain will become more constant. Death of the pulp tissue and infection are common consequences. The tooth will no longer be sensitive to hot or cold but can be very tender to pressure.


title: Tooth decay

text: Dental caries can also cause bad breath and foul tastes. In highly progressed cases, an infection can spread from the tooth to the surrounding soft tissues. Complications such as cavernous sinus thrombosis and Ludwig angina can be life-threatening.


title: Tooth decay

text: Four things are required for caries to form: a tooth surface (enamel or dentin), caries-causing bacteria, fermentable carbohydrates (such as sucrose), and time. This involves adherence of food to the teeth and acid creation by the bacteria that makes up the dental plaque. However, these four criteria are not always enough to cause the disease and a sheltered environment promoting development of a cariogenic biofilm is required. The caries disease process does not have an inevitable outcome, and different individuals will be susceptible to different degrees depending on the shape of their teeth, oral hygiene habits, and the buffering capacity of their saliva. Dental caries can occur on any surface of a tooth that is exposed to the oral cavity, but not the structures that are retained within the bone.


title: Tooth decay

text: Tooth decay is caused by biofilm (dental plaque) lying on the teeth and maturing to become cariogenic (causing decay). Certain bacteria in the biofilm produce acid in the presence of fermentable carbohydrates such as sucrose, fructose, and glucose.


title: Tooth decay

text: Caries occur more often in people from the lower end of the socio-economic scale than people from the upper end of the socio-economic scale, due to lack of education about dental care, and lack of access to professional dental care which may be expensive.


title: Tooth decay

text: The most common bacteria associated with dental cavities are the mutans streptococci, most prominently "Streptococcus mutans" and "Streptococcus sobrinus", and lactobacilli. However, cariogenic bacteria (the ones that can cause the disease) are present in dental plaque, but they are usually in too low concentrations to cause problems unless there is a shift in the balance. This is driven by local environmental change, such as frequent sugar intake or inadequate biofilm removal (toothbrushing). If left untreated, the disease can lead to pain, tooth loss and infection.


title: Tooth decay

text: The mouth contains a wide variety of oral bacteria, but only a few specific species of bacteria are believed to cause dental caries: "Streptococcus mutans" and "Lactobacillus" species among them. "Streptococcus mutans" are gram-positive bacteria which constitute biofilms on the surface of teeth. These organisms can produce high levels of lactic acid following fermentation of dietary sugars and are resistant to the adverse effects of low pH, properties essential for cariogenic bacteria. As the cementum of root surfaces is more easily demineralized than enamel surfaces, a wider variety of bacteria can cause root caries, including "Lactobacillus acidophilus", "Actinomyces spp.", "Nocardia spp.", and "Streptococcus mutans". Bacteria collect around the teeth and gums in a sticky, creamy-coloured mass called plaque, which serves as a biofilm. Some sites collect plaque more commonly than others, for example, sites with a low rate of salivary flow (molar fissures). Grooves on the occlusal surfaces of molar and premolar teeth provide microscopic retention sites for plaque bacteria, as do the interproximal sites. Plaque may also collect above or below the gingiva, where it is referred to as supra- or sub-gingival plaque, respectively.


title: Tooth decay

text: These bacterial strains, most notably "S. mutans", can be inherited by a child from a caretaker's kiss or through feeding pre-masticated food.


title: Tooth decay

text: Bacteria in a person's mouth convert glucose, fructose, and most commonly sucrose (table sugar) into acids such as lactic acid through a glycolytic process called fermentation. If left in contact with the tooth, these acids may cause demineralization, which is the dissolution of its mineral content. The process is dynamic, however, as remineralization can also occur if the acid is neutralized by saliva or mouthwash. Fluoride toothpaste or dental varnish may aid remineralization. If demineralization continues over time, enough mineral content may be lost so that the soft organic material left behind disintegrates, forming a cavity or hole. The impact such sugars have on the progress of dental caries is called cariogenicity. Sucrose, although a bound glucose and fructose unit, is in fact more cariogenic than a mixture of equal parts of glucose and fructose. This is due to the bacteria utilising the energy in the saccharide bond between the glucose and fructose subunits. "S.mutans" adheres to the biofilm on the tooth by converting sucrose into an extremely adhesive substance called dextran polysaccharide by the enzyme dextran sucranase.


title: Tooth decay

text: The frequency with which teeth are exposed to cariogenic (acidic) environments affects the likelihood of caries development. After meals or snacks, the bacteria in the mouth metabolize sugar, resulting in an acidic by-product that decreases pH. As time progresses, the pH returns to normal due to the buffering capacity of saliva and the dissolved mineral content of tooth surfaces. During every exposure to the acidic environment, portions of the inorganic mineral content at the surface of teeth dissolve and can remain dissolved for two hours. Since teeth are vulnerable during these acidic periods, the development of dental caries relies heavily on the frequency of acid exposure.


title: Tooth decay

text: The carious process can begin within days of a tooth's erupting into the mouth if the diet is sufficiently rich in suitable carbohydrates. Evidence suggests that the introduction of fluoride treatments has slowed the process. Proximal caries take an average of four years to pass through enamel in permanent teeth. Because the cementum enveloping the root surface is not nearly as durable as the enamel encasing the crown, root caries tend to progress much more rapidly than decay on other surfaces. The progression and loss of mineralization on the root surface is 2.5 times faster than caries in enamel. In very severe cases where oral hygiene is very poor and where the diet is very rich in fermentable carbohydrates, caries may cause cavities within months of tooth eruption. This can occur, for example, when children continuously drink sugary drinks from baby bottles (see later discussion).


title: Tooth decay

text: There are certain diseases and disorders affecting teeth that may leave an individual at a greater risk for cavities.


title: Tooth decay

text: Molar incisor hypo-mineralization, which seems to be increasingly common. While the cause is unknown it is thought to be a combination of genetic and environmental factors. Possible contributing factors that have been investigated include systemic factors such as high levels of dioxins or polychlorinated biphenyl (PCB) in the mother's milk, premature birth and oxygen deprivation at birth, and certain disorders during the child's first 3 years such as mumps, diphtheria, scarlet fever, measles, hypoparathyroidism, malnutrition, malabsorption, hypo-vitaminosis D, chronic respiratory diseases, or undiagnosed and untreated coeliac disease, which usually presents with mild or absent gastrointestinal symptoms.


title: Tooth decay

text: Amelogenesis imperfecta, which occurs in between 1 in 718 and 1 in 14,000 individuals, is a disease in which the enamel does not fully form or forms in insufficient amounts and can fall off a tooth. In both cases, teeth may be left more vulnerable to decay because the enamel is not able to protect the tooth.


title: Tooth decay

text: In most people, disorders or diseases affecting teeth are not the primary cause of dental caries. Approximately 96% of tooth enamel is composed of minerals. These minerals, especially hydroxyapatite, will become soluble when exposed to acidic environments. Enamel begins to demineralize at a pH of 5.5. Dentin and cementum are more susceptible to caries than enamel because they have lower mineral content. Thus, when root surfaces of teeth are exposed from gingival recession or periodontal disease, caries can develop more readily. Even in a healthy oral environment, however, the tooth is susceptible to dental caries.


title: Tooth decay

text: The evidence for linking malocclusion and/or crowding to dental caries is weak; however, the anatomy of teeth may affect the likelihood of caries formation. Where the deep developmental grooves of teeth are more numerous and exaggerated, pit and fissure caries is more likely to develop (see next section). Also, caries is more likely to develop when food is trapped between teeth.


title: Tooth decay

text: Reduced salivary flow rate is associated with increased caries since the buffering capability of saliva is not present to counterbalance the acidic environment created by certain foods. As a result, medical conditions that reduce the amount of saliva produced by salivary glands, in particular the submandibular gland and parotid gland, are likely to lead to dry mouth and thus to widespread tooth decay. Examples include Sjögren syndrome, diabetes mellitus, diabetes insipidus, and sarcoidosis. Medications, such as antihistamines and antidepressants, can also impair salivary flow. Stimulants, most notoriously methylamphetamine, also occlude the flow of saliva to an extreme degree. This is known as meth mouth. Tetrahydrocannabinol (THC), the active chemical substance in cannabis, also causes a nearly complete occlusion of salivation, known in colloquial terms as "cotton mouth". Moreover, 63% of the most commonly prescribed medications in the United States list dry mouth as a known side-effect. Radiation therapy of the head and neck may also damage the cells in salivary glands, somewhat increasing the likelihood of caries formation.


title: Tooth decay

text: Susceptibility to caries can be related to altered metabolism in the tooth, in particular to fluid flow in the dentin. Experiments on rats have shown that a high-sucrose, cariogenic diet "significantly suppresses the rate of fluid motion" in dentin.


title: Tooth decay

text: The use of tobacco may also increase the risk for caries formation. Some brands of smokeless tobacco contain high sugar content, increasing susceptibility to caries. Tobacco use is a significant risk factor for periodontal disease, which can cause the gingiva to recede. As the gingiva loses attachment to the teeth due to gingival recession, the root surface becomes more visible in the mouth. If this occurs, root caries is a concern since the cementum covering the roots of teeth is more easily demineralized by acids than enamel. Currently, there is not enough evidence to support a causal relationship between smoking and coronal caries, but evidence does suggest a relationship between smoking and root-surface caries.


title: Tooth decay

text: Intrauterine and neonatal lead exposure promote tooth decay. Besides lead, all atoms with electrical charge and ionic radius similar to bivalent calcium,


title: Tooth decay

text: Poverty is also a significant social determinant for oral health. Dental caries have been linked with lower socio-economic status and can be considered a disease of poverty.


title: Tooth decay

text: Forms are available for risk assessment for caries when treating dental cases; this system using the evidence-based Caries Management by Risk Assessment (CAMBRA). It is still unknown if the identification of high-risk individuals can lead to more effective long-term patient management that prevents caries initiation and arrests or reverses the progression of lesions.


title: Tooth decay

text: Saliva also contains iodine and EGF. EGF results effective in cellular proliferation, differentiation and survival. Salivary EGF, which seems also regulated by dietary inorganic iodine, plays an important physiological role in the maintenance of oral (and gastro-oesophageal) tissue integrity, and, on the other hand, iodine is effective in prevention of dental caries and oral health.


title: Tooth decay

text: Teeth are bathed in saliva and have a coating of bacteria on them (biofilm) that continually forms. The development of biofilm begins with pellicle formation. Pellicle is an acellular proteinaceous film which covers the teeth. Bacteria colonize on the teeth by adhering to the pellicle-coated surface. Over time, a mature biofilm is formed and this create a cariogenic environment on the tooth surface. The minerals in the hard tissues of the teeth (enamel, dentin and cementum) are constantly undergoing processes of demineralization and remineralization. Dental caries results when the demineralization rate is faster than the remineralization and there is net mineral loss. This happens when there is an ecologic shift within the dental biofilm, from a balanced population of micro-organisms to a population that produce acids and can survive in an acid environment.


title: Tooth decay

text: Tooth enamel is a highly mineralized acellular tissue, and caries act upon it through a chemical process brought on by the acidic environment produced by bacteria. As the bacteria consume the sugar and use it for their own energy, they produce lactic acid. The effects of this process include the demineralization of crystals in the enamel, caused by acids, over time until the bacteria physically penetrate the dentin. Enamel rods, which are the basic unit of the enamel structure, run perpendicularly from the surface of the tooth to the dentin. Since demineralization of enamel by caries, in general, follows the direction of the enamel rods, the different triangular patterns between pit and fissure and smooth-surface caries develop in the enamel because the orientation of enamel rods are different in the two areas of the tooth.


title: Tooth decay

text: As the enamel loses minerals, and dental caries progresses, the enamel develops several distinct zones, visible under a light microscope. From the deepest layer of the enamel to the enamel surface, the identified areas are the: translucent zone, dark zones, body of the lesion, and surface zone. The translucent zone is the first visible sign of caries and coincides with a one to two percent loss of minerals. A slight remineralization of enamel occurs in the dark zone, which serves as an example of how the development of dental caries is an active process with alternating changes. The area of greatest demineralization and destruction is in the body of the lesion itself. The surface zone remains relatively mineralized and is present until the loss of tooth structure results in a cavitation.


title: Tooth decay

text: Unlike enamel, the dentin reacts to the progression of dental caries. After tooth formation, the ameloblasts, which produce enamel, are destroyed once enamel formation is complete and thus cannot later regenerate enamel after its destruction. On the other hand, dentin is produced continuously throughout life by odontoblasts, which reside at the border between the pulp and dentin. Since odontoblasts are present, a stimulus, such as caries, can trigger a biologic response. These defense mechanisms include the formation of sclerotic and tertiary dentin.


title: Tooth decay

text: In dentin from the deepest layer to the enamel, the distinct areas affected by caries are the advancing front, the zone of bacterial penetration, and the zone of destruction. The advancing front represents a zone of demineralized dentin due to acid and has no bacteria present. The zones of bacterial penetration and destruction are the locations of invading bacteria and ultimately the decomposition of dentin. The zone of destruction has a more mixed bacterial population where proteolytic enzymes have destroyed the organic matrix. The innermost dentin caries has been reversibly attacked because the collagen matrix is not severely damaged, giving it potential for repair.


title: Tooth decay

text: The structure of dentin is an arrangement of microscopic channels, called dentinal tubules, which radiate outward from the pulp chamber to the exterior cementum or enamel border. The diameter of the dentinal tubules is largest near the pulp (about 2.5 μm) and smallest (about 900 nm) at the junction of dentin and enamel. The carious process continues through the dentinal tubules, which are responsible for the triangular patterns resulting from the progression of caries deep into the tooth. The tubules also allow caries to progress faster.


title: Tooth decay

text: In response, the fluid inside the tubules brings immunoglobulins from the immune system to fight the bacterial infection. At the same time, there is an increase of mineralization of the surrounding tubules. This results in a constriction of the tubules, which is an attempt to slow the bacterial progression. In addition, as the acid from the bacteria demineralizes the hydroxyapatite crystals, calcium and phosphorus are released, allowing for the precipitation of more crystals which fall deeper into the dentinal tubule. These crystals form a barrier and slow the advancement of caries. After these protective responses, the dentin is considered sclerotic.


title: Tooth decay

text: According to hydrodynamic theory, fluids within dentinal tubules are believed to be the mechanism by which pain receptors are triggered within the pulp of the tooth. Since sclerotic dentin prevents the passage of such fluids, pain that would otherwise serve as a warning of the invading bacteria may not develop at first.


title: Tooth decay

text: In response to dental caries, there may be production of more dentin toward the direction of the pulp. This new dentin is referred to as tertiary dentin. Tertiary dentin is produced to protect the pulp for as long as possible from the advancing bacteria. As more tertiary dentin is produced, the size of the pulp decreases. This type of dentin has been subdivided according to the presence or absence of the original odontoblasts. If the odontoblasts survive long enough to react to the dental caries, then the dentin produced is called "reactionary" dentin. If the odontoblasts are killed, the dentin produced is called "reparative" dentin.


title: Tooth decay

text: In the case of reparative dentin, other cells are needed to assume the role of the destroyed odontoblasts. Growth factors, especially TGF-β, are thought to initiate the production of reparative dentin by fibroblasts and mesenchymal cells of the pulp. Reparative dentin is produced at an average of 1.5 μm/day, but can be increased to 3.5 μm/day. The resulting dentin contains irregularly shaped dentinal tubules that may not line up with existing dentinal tubules. This diminishes the ability for dental caries to progress within the dentinal tubules.


title: Tooth decay

text: The incidence of cemental caries increases in older adults as gingival recession occurs from either trauma or periodontal disease. It is a chronic condition that forms a large, shallow lesion and slowly invades first the root's cementum and then dentin to cause a chronic infection of the pulp (see further discussion under classification by affected hard tissue). Because dental pain is a late finding, many lesions are not detected early, resulting in restorative challenges and increased tooth loss.


title: Tooth decay

text: The presentation of caries is highly variable. However, the risk factors and stages of development are similar. Initially, it may appear as a small chalky area (smooth surface caries), which may eventually develop into a large cavitation. Sometimes caries may be directly visible. However other methods of detection such as X-rays are used for less visible areas of teeth and to judge the extent of destruction. Lasers for detecting caries allow detection without ionizing radiation and are now used for detection of interproximal decay (between the teeth).


title: Tooth decay

text: Primary diagnosis involves inspection of all visible tooth surfaces using a good light source, dental mirror and explorer. Dental radiographs (X-rays) may show dental caries before it is otherwise visible, in particular caries between the teeth. Large areas of dental caries are often apparent to the naked eye, but smaller lesions can be difficult to identify. Visual and tactile inspection along with radiographs are employed frequently among dentists, in particular to diagnose pit and fissure caries. Early, uncavitated caries is often diagnosed by blowing air across the suspect surface, which removes moisture and changes the optical properties of the unmineralized enamel.


title: Tooth decay

text: Some dental researchers have cautioned against the use of dental explorers to find caries, in particular sharp ended explorers. In cases where a small area of tooth has begun demineralizing but has not yet cavitated, the pressure from the dental explorer could cause a cavity. Since the carious process is reversible before a cavity is present, it may be possible to arrest caries with fluoride and remineralize the tooth surface. When a cavity is present, a restoration will be needed to replace the lost tooth structure.


title: Tooth decay

text: At times, pit and fissure caries may be difficult to detect. Bacteria can penetrate the enamel to reach dentin, but then the outer surface may remineralize, especially if fluoride is present. These caries, sometimes referred to as "hidden caries", will still be visible on X-ray radiographs, but visual examination of the tooth would show the enamel intact or minimally perforated.


title: Tooth decay

text: The differential diagnosis for dental caries includes dental fluorosis and developmental defects of the tooth including hypomineralization of the tooth and hypoplasia of the tooth.


title: Tooth decay

text: The early carious lesion is characterized by demineralization of the tooth surface, altering the tooth's optical properties. Technology utilizing laser speckle image (LSI) techniques may provide a diagnostic aid to detect early carious lesions.


title: Tooth decay

text: Caries can be classified by location, etiology, rate of progression, and affected hard tissues. These forms of classification can be used to characterize a particular case of tooth decay in order to more accurately represent the condition to others and also indicate the severity of tooth destruction. In some instances, caries is described in other ways that might indicate the cause. The G. V. Black classification is as follows:


title: Tooth decay

text: Early childhood caries (ECC), also known as "baby bottle caries," "baby bottle tooth decay" or "bottle rot," is a pattern of decay found in young children with their deciduous (baby) teeth. This must include the presence of at least one carious lesion on a primary tooth in a child under the age of 6 years. The teeth most likely affected are the maxillary anterior teeth, but all teeth can be affected. The name for this type of caries comes from the fact that the decay usually is a result of allowing children to fall asleep with sweetened liquids in their bottles or feeding children sweetened liquids multiple times during the day.


title: Tooth decay

text: Another pattern of decay is "rampant caries", which signifies advanced or severe decay on multiple surfaces of many teeth. Rampant caries may be seen in individuals with xerostomia, poor oral hygiene, stimulant use (due to drug-induced dry mouth), and/or large sugar intake. If rampant caries is a result of previous radiation to the head and neck, it may be described as radiation-induced caries. Problems can also be caused by the self-destruction of roots and whole tooth resorption when new teeth erupt or later from unknown causes.


title: Tooth decay

text: Children at 6–12 months are at increased risk of developing dental caries. For other children aged 12–18 months, dental caries develop on primary teeth and approximately twice yearly for permanent teeth.


title: Tooth decay

text: A range of studies have reported that there is a correlation between caries in primary teeth and caries in permanent teeth.


title: Tooth decay

text: Temporal descriptions can be applied to caries to indicate the progression rate and previous history. "Acute" signifies a quickly developing condition, whereas "chronic" describes a condition that has taken an extended time to develop, in which thousands of meals and snacks, many causing some acid demineralization that is not remineralized, eventually result in cavities.


title: Tooth decay

text: Recurrent caries, also described as secondary, are caries that appear at a location with a previous history of caries. This is frequently found on the margins of fillings and other dental restorations. On the other hand, incipient caries describes decay at a location that has not experienced previous decay. Arrested caries describes a lesion on a tooth that was previously demineralized but was remineralized before causing a cavitation. Fluoride treatment can help recalcification of tooth enamel as well as the use of amorphous calcium phosphate.


title: Tooth decay

text: Micro-invasive interventions (such as dental sealant or resin infiltration) have been shown to slow down the progression of proximal decay.


title: Tooth decay

text: Depending on which hard tissues are affected, it is possible to describe caries as involving enamel, dentin, or cementum. Early in its development, caries may affect only enamel. Once the extent of decay reaches the deeper layer of dentin, the term "dentinal caries" is used. Since cementum is the hard tissue that covers the roots of teeth, it is not often affected by decay unless the roots of teeth are exposed to the mouth. Although the term "cementum caries" may be used to describe the decay on roots of teeth, very rarely does caries affect the cementum alone.


title: Tooth decay

text: The primary approach to dental hygiene care consists of tooth-brushing and flossing. The purpose of oral hygiene is to remove and prevent the formation of plaque or dental biofilm, although studies have shown this effect on caries is limited. While there is no evidence that flossing prevents tooth decay, the practice is still generally recommended.


title: Tooth decay

text: A toothbrush can be used to remove plaque on accessible surfaces, but not between teeth or inside pits and fissures on chewing surfaces. When used correctly, dental floss removes plaque from areas that could otherwise develop proximal caries but only if the depth of sulcus has not been compromised. Additional aids include interdental brushes, water picks, and mouthwashes. The use of rotational electric toothbrushes might reduce the risk of plaque and gingivitis, though it is unclear whether they are of clinical importance.


title: Tooth decay

text: However, oral hygiene is effective at preventing gum disease (gingivitis / periodontal disease). Food is forced inside pits and fissures under chewing pressure, leading to carbohydrate-fuelled acid demineralisation where the brush, fluoride toothpaste, and saliva have no access to remove trapped food, neutralise acid, or remineralise tooth enamel. (Occlusal caries accounts for between 80 and 90% of caries in children (Weintraub, 2001).) Unlike brushing, fluoride leads to proven reduction in caries incidence by approximately 25%; higher concentrations of fluoride (>1,000 ppm) in toothpaste also helps prevents tooth decay, with the effect increasing with concentration up to a plateau. A randomized clinical trial demonstrated that toothpastes that contain arginine have greater protection against tooth cavitation than the regular fluoride toothpastes containing 1450 ppm alone. A Cochrane review has confirmed that the use of fluoride gels, normally applied by a dental professional from once to several times a year, assists in the prevention of tooth decay in children and adolescents, reiterating the importance of fluoride as the principal means of caries prevention. Another review concluded that the supervised regular use of a fluoride mouthwash greatly reduced the onset of decay in the permanent teeth of children.


title: Tooth decay

text: Professional hygiene care consists of regular dental examinations and professional prophylaxis (cleaning). Sometimes, complete plaque removal is difficult, and a dentist or dental hygienist may be needed. Along with oral hygiene, radiographs may be taken at dental visits to detect possible dental caries development in high-risk areas of the mouth (e.g. "bitewing" X-rays which visualize the crowns of the back teeth).


title: Tooth decay

text: Alternative methods of oral hygiene also exist around the world, such as the use of teeth cleaning twigs such as miswaks in some Middle Eastern and African cultures. There is some limited evidence demonstrating the efficacy of these alternative methods of oral hygiene.


title: Tooth decay

text: People who eat more free sugars get more cavities, with cavities increasing exponentially with increasing sugar intake. Populations with less sugar intake have fewer cavities. In one population, in Nigeria, where sugar consumption was about 2g/day, only two percent of the population, of any age, had had a cavity.


title: Tooth decay

text: Chewy and sticky foods (such as candy, cookies, potato chips, and crackers) tend to adhere to teeth longer. However, dried fruits such as raisins and fresh fruit such as apples and bananas disappear from the mouth quickly, and do not appear to be a risk factor. Consumers are not good at guessing which foods stick around in the mouth.


title: Tooth decay

text: For children, the American Dental Association and the European Academy of Paediatric Dentistry recommend limiting the frequency of consumption of drinks with sugar, and not giving baby bottles to infants during sleep (see earlier discussion). Parents are also recommended to avoid sharing utensils and cups with their infants to prevent transferring bacteria from the parent's mouth.


title: Tooth decay

text: Xylitol is a naturally occurring sugar alcohol that is used in different products as an alternative to sucrose (table sugar). As of 2015 the evidence concerning the use of xylitol in chewing gum was insufficient to determine if it is effective at preventing caries.


title: Tooth decay

text: The use of dental sealants is a means of prevention. A sealant is a thin plastic-like coating applied to the chewing surfaces of the molars to prevent food from being trapped inside pits and fissures. This deprives resident plaque bacteria of carbohydrate, preventing the formation of pit and fissure caries. Sealants are usually applied on the teeth of children, as soon as the teeth erupt but adults are receiving them if not previously performed. Sealants can wear out and fail to prevent access of food and plaque bacteria inside pits and fissures and need to be replaced so they must be checked regularly by dental professionals. Dental sealants have been shown to be more effective at preventing occlusal decay when compared to fluoride varnish applications.


title: Tooth decay

text: Calcium, as found in food such as milk and green vegetables, is often recommended to protect against dental caries. Fluoride helps prevent decay of a tooth by binding to the hydroxyapatite crystals in enamel. Streptococcus mutans is the leading cause of tooth decay. Low concentration fluoride ions act as bacteriostatic therapeutic agent and high concentration fluoride ions are bactericidal. The incorporated fluorine makes enamel more resistant to demineralization and, thus, resistant to decay. Fluoride can be found in either topical or systemic form. Topical fluoride is more highly recommended than systemic intake to protect the surface of the teeth. Topical fluoride is used in toothpaste, mouthwash and fluoride varnish. Standard fluoride toothpaste (1,000–1,500 ppm) is more effective than low fluoride toothpaste (< 600ppm) to prevent dental caries. It is recommended that all adult patients to use fluoridated toothpaste with at least 1350ppm fluoride content, brushing at least 2 times per day and brush right before bed. For children and young adults, use fluoridated toothpaste with 1350ppm to 1500ppm fluoride content, brushing 2 times per day and also brush right before bed. American Dental Association Council suggest that for children <3 years old, caregivers should begin brushing their teeth by using fluoridated toothpaste with an amount no more than a smear. Supervised toothbrushing must also be done to children below 8 years of age to prevent swallowing of toothpaste. After brushing with fluoride toothpaste, rinsing should be avoided and the excess spat out. Many dental professionals include application of topical fluoride solutions as part of routine visits and recommend the use of xylitol and amorphous calcium phosphate products. Silver diamine fluoride may work better than fluoride varnish to prevent cavities. Systemic fluoride is found as lozenges, tablets, drops and water fluoridation. These are ingested orally to provide fluoride systemically. Water fluoridation has been shown to be beneficial to prevent tooth decay, especially in low social economical areas, where other forms of fluoride is not available. However, a Cochrane systematic review found no evidence to suggest that taking fluoride systemically daily in pregnant women was effective in preventing dental decay in their offspring. While some products containing chlorhexidine have been shown to limit the progression of existing tooth decay; there is currently no evidence suggesting that chlorhexidine gels and varnishes can prevent dental caries or reduce the population of Streptococcus mutans in the mouth.


title: Tooth decay

text: An oral health assessment carried out before a child reaches the age of one may help with management of caries. The oral health assessment should include checking the child's history, a clinical examination, checking the risk of caries in the child including the state of their occlusion and assessing how well equipped the child's parent or carer is to help the child prevent caries. In order to further increase a child's cooperation in caries management, good communication by the dentist and the rest of the staff of a dental practice should be used. This communication can be improved by calling the child by their name, using eye contact and including them in any conversation about their treatment.


title: Tooth decay

text: Most importantly, whether the carious lesion is cavitated or non-cavitated dictates the management. Clinical assessment of whether the lesion is active or arrested is also important. Noncavitated lesions can be arrested and remineralization can occur under the right conditions. However, this may require extensive changes to the diet (reduction in frequency of refined sugars), improved oral hygiene (toothbrushing twice per day with fluoride toothpaste and daily flossing), and regular application of topical fluoride. More recently, Immunoglobulin Y specific to Streptococcus mutans has been used to suppress growth of "S mutans". Such management of a carious lesion is termed "non-operative" since no drilling is carried out on the tooth. Non-operative treatment requires excellent understanding and motivation from the individual, otherwise the decay will continue.


title: Tooth decay

text: Once a lesion has cavitated, especially if dentin is involved, remineralization is much more difficult and a dental restoration is usually indicated ("operative treatment"). Before a restoration can be placed, all of the decay must be removed otherwise it will continue to progress underneath the filling. Sometimes a small amount of decay can be left if it is entombed and there is a seal which isolates the bacteria from their substrate. This can be likened to placing a glass container over a candle, which burns itself out once the oxygen is used up. Techniques such as stepwise caries removal are designed to avoid exposure of the dental pulp and overall reduction of the amount of tooth substance which requires removal before the final filling is placed. Often enamel which overlies decayed dentin must also be removed as it is unsupported and susceptible to fracture. The modern decision-making process with regards the activity of the lesion, and whether it is cavitated, is summarized in the table.


title: Tooth decay

text: Destroyed tooth structure does not fully regenerate, although remineralization of very small carious lesions may occur if dental hygiene is kept at optimal level. For the small lesions, topical fluoride is sometimes used to encourage remineralization. For larger lesions, the progression of dental caries can be stopped by treatment. The goal of treatment is to preserve tooth structures and prevent further destruction of the tooth. Aggressive treatment, by filling, of incipient carious lesions, places where there is superficial damage to the enamel, is controversial as they may heal themselves, while once a filling is performed it will eventually have to be redone and the site serves as a vulnerable site for further decay.


title: Tooth decay

text: In general, early treatment is quicker and less expensive than treatment of extensive decay. Local anesthetics, nitrous oxide ("laughing gas"), or other prescription medications may be required in some cases to relieve pain during or following treatment or to relieve anxiety during treatment. A dental handpiece ("drill") is used to remove large portions of decayed material from a tooth. A spoon, a dental instrument used to carefully remove decay, is sometimes employed when the decay in dentin reaches near the pulp. Some dentists remove dental caries using a laser rather than the traditional dental drill. A Cochrane review of this technique looked at Er:YAG (erbium-doped yttrium aluminium garnet), Er,Cr:YSGG (erbium, chromium: yttrium-scandium-gallium-garnet) and Nd:YAG (neodymium-doped yttrium aluminium garnet) lasers and found that although people treated with lasers (compared to a conventional dental "drill") experienced less pain and had a lesser need for dental anaesthesia, that overall there was little difference in caries removal. Another alternative to drilling or lasers for small caries is the use of air abrasion, in which small abrasive particles are blasted at decay using pressurized air (similar to sand blasting). Once the cary is removed, the missing tooth structure requires a dental restoration of some sort to return the tooth to function and aesthetic condition.


title: Tooth decay

text: Restorative materials include dental amalgam, composite resin, glass ionomer cement, porcelain, and gold. Composite resin and porcelain can be made to match the color of a patient's natural teeth and are thus used more frequently when aesthetics are a concern. Composite restorations are not as strong as dental amalgam and gold; some dentists consider the latter as the only advisable restoration for posterior areas where chewing forces are great. When the decay is too extensive, there may not be enough tooth structure remaining to allow a restorative material to be placed within the tooth. Thus, a crown may be needed. This restoration appears similar to a cap and is fitted over the remainder of the natural crown of the tooth. Crowns are often made of gold, porcelain, or porcelain fused to metal.


title: Tooth decay

text: For children, preformed crowns are available to place over the tooth. These are usually made of metal (usually stainless steel but increasingly there are aesthetic materials). Traditionally teeth are shaved down to make room for the crown but, more recently, stainless steel crowns have been used to seal decay into the tooth and stop it progressing. This is known as the Hall Technique and works by depriving the bacteria in the decay of nutrients and making their environment less favorable for them. It is a minimally invasive method of managing decay in children and does not require local anesthetic injections in the mouth.


title: Tooth decay

text: In certain cases, endodontic therapy may be necessary for the restoration of a tooth. Endodontic therapy, also known as a "root canal", is recommended if the pulp in a tooth dies from infection by decay-causing bacteria or from trauma. In root canal therapy, the pulp of the tooth, including the nerve and vascular tissues, is removed along with decayed portions of the tooth. The canals are instrumented with endodontic files to clean and shape them, and they are then usually filled with a rubber-like material called gutta percha. The tooth is filled and a crown can be placed. Upon completion of root canal therapy, the tooth is non-vital, as it is devoid of any living tissue.


title: Tooth decay

text: An extraction can also serve as treatment for dental caries. The removal of the decayed tooth is performed if the tooth is too far destroyed from the decay process to effectively restore the tooth. Extractions are sometimes considered if the tooth lacks an opposing tooth or will probably cause further problems in the future, as may be the case for wisdom teeth. Extractions may also be preferred by people unable or unwilling to undergo the expense or difficulties in restoring the tooth.


title: Tooth decay

text: Worldwide, approximately 3.6 billion people have dental caries in their permanent teeth. In baby teeth it affects about 620 million people or 9% of the population. The disease is most common in Latin American countries, countries in the Middle East, and South Asia, and least prevalent in China. In the United States, dental caries is the most common chronic childhood disease, being at least five times more common than asthma. It is the primary pathological cause of tooth loss in children. Between 29% and 59% of adults over the age of 50 experience caries.


title: Tooth decay

text: Treating dental cavities costs 5–10% of health-care budgets in industrialized countries, and can easily exceed budgets in lower-income countries.


title: Tooth decay

text: The number of cases has decreased in some developed countries, and this decline is usually attributed to increasingly better oral hygiene practices and preventive measures such as fluoride treatment. Nonetheless, countries that have experienced an overall decrease in cases of tooth decay continue to have a disparity in the distribution of the disease. Among children in the United States and Europe, twenty percent of the population endures sixty to eighty percent of cases of dental caries. A similarly skewed distribution of the disease is found throughout the world with some children having none or very few caries and others having a high number. Australia, Nepal, and Sweden (where children receive dental care paid for by the government) have a low incidence of cases of dental caries among children, whereas cases are more numerous in Costa Rica and Slovakia.


title: Tooth decay

text: The classic DMF (decay/missing/filled) index is one of the most common methods for assessing caries prevalence as well as dental treatment needs among populations. This index is based on in-field clinical examination of individuals by using a probe, mirror and cotton rolls. Because the DMF index is done without X-ray imaging, it underestimates real caries prevalence and treatment needs.


title: Tooth decay

text: Bacteria typically associated with dental caries have been isolated from vaginal samples from females who have bacterial vaginosis.


title: Tooth decay

text: There is a long history of dental caries. Over a million years ago, hominins such as "Paranthropus" had cavities. The largest increases in the prevalence of caries have been associated with dietary changes.


title: Tooth decay

text: Archaeological evidence shows that tooth decay is an ancient disease dating far into prehistory. Skulls dating from a million years ago through the Neolithic period show signs of caries, including those from the Paleolithic and Mesolithic ages. The increase of caries during the Neolithic period may be attributed to the increased consumption of plant foods containing carbohydrates. The beginning of rice cultivation in South Asia is also believed to have caused an increase in caries especially for women, although there is also some evidence from sites in Thailand, such as Khok Phanom Di, that shows a decrease in overall percentage of dental caries with the increase in dependence on rice agriculture.


title: Tooth decay

text: A Sumerian text from 5000 BC describes a "tooth worm" as the cause of caries. Evidence of this belief has also been found in India, Egypt, Japan, and China. Unearthed ancient skulls show evidence of primitive dental work. In Pakistan, teeth dating from around 5500 BC to 7000 BC show nearly perfect holes from primitive dental drills. The Ebers Papyrus, an Egyptian text from 1550 BC, mentions diseases of teeth. During the Sargonid dynasty of Assyria during 668 to 626 BC, writings from the king's physician specify the need to extract a tooth due to spreading inflammation. In the Roman Empire, wider consumption of cooked foods led to a small increase in caries prevalence. The Greco-Roman civilization, in addition to the Egyptian civilization, had treatments for pain resulting from caries.


title: Tooth decay

text: The rate of caries remained low through the Bronze Age and Iron Age, but sharply increased during the Middle Ages. Periodic increases in caries prevalence had been small in comparison to the 1000 AD increase, when sugar cane became more accessible to the Western world. Treatment consisted mainly of herbal remedies and charms, but sometimes also included bloodletting. The barber surgeons of the time provided services that included tooth extractions. Learning their training from apprenticeships, these health providers were quite successful in ending tooth pain and likely prevented systemic spread of infections in many cases. Among Roman Catholics, prayers to Saint Apollonia, the patroness of dentistry, were meant to heal pain derived from tooth infection.


title: Tooth decay

text: There is also evidence of caries increase when Indigenous people in North America changed from a strictly hunter-gatherer diet to a diet with maize. Rates also increased after contact with colonizing Europeans, implying an even greater dependence on maize.


title: Tooth decay

text: During the European Age of Enlightenment, the belief that a "tooth worm" caused caries was also no longer accepted in the European medical community. Pierre Fauchard, known as the father of modern dentistry, was one of the first to reject the idea that worms caused tooth decay and noted that sugar was detrimental to the teeth and gingiva. In 1850, another sharp increase in the prevalence of caries occurred and is believed to be a result of widespread diet changes. Prior to this time, cervical caries was the most frequent type of caries, but increased availability of sugar cane, refined flour, bread, and sweetened tea corresponded with a greater number of pit and fissure caries.


title: Tooth decay

text: In the 1890s, W. D. Miller conducted a series of studies that led him to propose an explanation for dental caries that was influential for current theories. He found that bacteria inhabited the mouth and that they produced acids that dissolved tooth structures when in the presence of fermentable carbohydrates. This explanation is known as the chemoparasitic caries theory. Miller's contribution, along with the research on plaque by G. V. Black and J. L. Williams, served as the foundation for the current explanation of the etiology of caries. Several of the specific strains of lactobacilli were identified in 1921 by Fernando E. Rodríguez Vargas.


title: Tooth decay

text: In 1924 in London, Killian Clarke described a spherical bacterium in chains isolated from carious lesions which he called "Streptococcus" "mutans". Although Clarke proposed that this organism was the cause of caries, the discovery was not followed up. Later, in 1954 in the US, Frank Orland working with hamsters showed that caries was transmissible and caused by acid-producing "Streptococcus" thus ending the debate whether dental caries were resultant from bacteria. It was not until the late 1960s that it became generally accepted that the "Streptococcus" isolated from hamster caries was the same as "S". "mutans".


title: Tooth decay

text: Tooth decay has been present throughout human history, from early hominids millions of years ago, to modern humans. The prevalence of caries increased dramatically in the 19th century, as the Industrial Revolution made certain items, such as refined sugar and flour, readily available. The diet of the "newly industrialized English working class" then became centered on bread, jam, and sweetened tea, greatly increasing both sugar consumption and caries.


title: Tooth decay

text: Naturalized from Latin into English (a loanword), "caries" in its English form originated as a mass noun that means "rottenness", that is, "decay". The word is an uncountable noun.


title: Tooth decay

text: It is estimated that untreated dental caries results in worldwide productivity losses in the size of about US$27 billion yearly.


title: Anastasia (musical)

text: Anastasia is a musical play with music and lyrics by Lynn Ahrens and Stephen Flaherty, and a book by Terrence McNally. Based on the 1997 animated film of the same name, the musical adapts the legend of Grand Duchess Anastasia Nikolaevna of Russia, who could have escaped the execution of her family. Years later, an amnesiac orphan named Anya hopes to find some trace of her family by siding with two con men who wish to take advantage of her likeness to the Grand Duchess.


title: Anastasia (musical)

text: After completing a pre-Broadway run in Hartford, Connecticut, the show premiered on Broadway at the Broadhurst Theatre in April 2017, and since then it has spawned multiple productions worldwide.


title: Anastasia (musical)

text: A reading was held in 2012, featuring Kelli Barret as Anya (Anastasia), Aaron Tveit as Dmitry, Patrick Page as Vladimir, and Angela Lansbury as the Empress Maria. A workshop was held on June 12, 2015, in New York City, and included Elena Shaddow as Anya, Ramin Karimloo as Gleb Vaganov, a new role, and Douglas Sills as Vlad.


title: Anastasia (musical)

text: The original stage production of "Anastasia" premiered at the Hartford Stage in Hartford, Connecticut for previews on May 13, 2016. The show was directed by Darko Tresnjak and choreography by Peggy Hickey, with Christy Altomare and Derek Klena starring as Anya and Dmitry, respectively.


title: Anastasia (musical)

text: Director Tresnjak explained: "We've kept, I think, six songs from the movie, but there are 16 new numbers. We've kept the best parts of the animated movie, but it really is a new musical". The musical also adds characters not in the film. Additionally, Act 1 is set in Russia and Act 2 in Paris, "which was everything modern Soviet Russia was not: free, expressive, creative, no barriers", according to McNally.


title: Anastasia (musical)

text: The musical also omits the supernatural elements from the original film, including the character of Rasputin and his musical number "In the Dark of the Night", and introduces instead a new villain called Gleb, a general for the Bolsheviks who receives orders to kill Anya.


title: Anastasia (musical)

text: The musical opened on Broadway at the Broadhurst Theatre on March 23, 2017, in previews, later officially on April 24, featuring most of the original Hartford principal cast.


title: Anastasia (musical)

text: The production was met with mixed reviews by critics, citing uneven subplots and an overly long running time as primary issues. The show closed on March 31, 2019 after 808 regular and 34 preview performances.


title: Anastasia (musical)

text: The first European staging opened on October 3, 2018 (officially on October 10) at the Coliseum Theatre in Madrid, Spain, starring Jana Gómez as Anya, Íñigo Etayo as Dmitry, Carlos Salgado as Gleb, Javier Navares as Vlad, Silvia Luchetti as Countess Lily, and Angels Jiménez as Dowager Empress.


title: Anastasia (musical)

text: The production played 556 performances, ending on March 7, 2020, when performances were suspended due to the COVID-19 pandemic. The same year on September 28, Stage Entertainment announced that "Anastasia" would not reopen in Madrid following the pandemic.


title: Anastasia (musical)

text: The first North America tour began on October 9, 2018 (officially on October 12) at the Proctor's Theatre in Schenectady, New York, with Lila Coogan as Anya, Stephen Brower as Dmitry, Jason Michael Evans as Gleb, Edward Staudenmayer as Vlad, Tari Kelly as Countess Lily, and Joy Franz as Dowager Empress, and closed on March 12, 2020 at the Walton Arts Center in Fayetteville, when performances were suspended due to the COVID-19 pandemic.


title: Anastasia (musical)

text: A non-equity North America tour kicked off on October 15, 2021 at the Columbia County Performing Arts Center in Evans, Georgia, starring Kyla Stone as Anya, Sam McLellan as Dmitry, Brandon Delgado as Gleb, Bryan Seastrom as Vlad, Madeline Raube as Countess Lily, and Gerri Weagraff as Dowager Empress.


title: Anastasia (musical)

text: A German production ran from November 15, 2018 to October 13, 2019 at the Stage Palladium Theater in Stuttgart, starring Judith Caspari as Anya and Milan van Waardenburg as Dmitry (later replaced by Thomas Hohler).


title: Anastasia (musical)

text: A Dutch production officially opened on September 22, 2019 at the AFAS Circustheater in The Hague, The Netherlands. Tessa Sunniva van Tol plays the role of Anya with Milan van Waardenburg as Dmitry transferring from the German production to the Dutch production, which made him the first actor to play the role of Dmitry in two different countries and languages. Other principal roles are being played by René van Kooten, Gerrie van der Klei, Ellen Evers and Ad Knippels.


title: Anastasia (musical)

text: From March 23, 2020 onwards performances were suspended due to the COVID-19 pandemic. Stage Entertainment announced in April 2021 that "Anastasia" would not reopen in the Hague following the pandemic.


title: Anastasia (musical)

text: A Japanese production was expected to premiere on March 1, 2020 at the Theatre Orb in Tokyo, but the opening was delayed to March 9 due to the COVID-19 pandemic. The cast was led by Wakana Aoi and Haruka Kinoshita as Anya, Naoto Kaiho, Hiroki Aiba and Akiyoshi Utsumi as Dmitry, Koji Yamamoto, Yoshikuni Dochin (from CHEMISTRY) and Yusuke Tohyama as Gleb, Kenya Osumi and Zen Ishikawa as Vlad, Hikaru Asami, Marcia and Keiko Horiuchi as Countess Lily and Rei Asami as Dowager Empress. The production took its final bow on March 27, having played 14 performances. An Osaka engagement was expected to follow at the Umeda Arts Theater from April 6 to 18 in the same year, but was canceled because of the pandemic.


title: Anastasia (musical)

text: Additionally, the all-female Takarazuka Revue staged "Anastasia" in Takarazuka and Tokyo during the summer of 2020. This version included the new song "She Walks In", written by the original creative team for the character of Dmitry and played by Cosmos Troupe top star Suzuho Makaze.


title: Anastasia (musical)

text: A Finnish production, which was notable for not being a replica of the original Broadway staging, premiered on September 2, 2022 at the Tampere Theatre, Finland, with Pia Piltz as Anya, Petrus Kähkönen as Dmitry, Joel Mäkinen as Gleb, Ville Majamaa as Vlad, Kaisa Hela as Countess Lily, and Sinikka Sokka as Dowager Empress.


title: Anastasia (musical)

text: Another non-replica production opened on September 10, 2022 at the Landestheater in Linz, Austria, starring Hanna Kastner as Anya, Lukas Sandmann as Dmitry, Nikolaj Alexander Brucker as Gleb, Karsten Kenzel as Vlad, Judith Jandl as Countess Lily, and Daniela Dett as Dowager Empress.