Tooth Decay

Definition

Tooth decay also known as tooth caries or dental cavities is the permanent damage of the hard surface of the teeth usually taking the form of tiny holes or openings. Not observing proper hygiene of tooth is one of tthe common cause of tooth decay. It is the most common dental problem worldwide and more frequently seenin children, teenagers and older adults. Tooth decay can cause severe toothache which can severely impair the person’s daily activities.

Symptoms

The extent of tooth decay determines the symptoms. Damage limited to the outer enamel does not produce significant symptoms. The more prominent ymptoms are caused when the infection reaches deeper in the tooth, past the dentin to the pulp, which is the part of the tooth that contains the nerves and blood vessels. The following symptoms are seen :

  • Toothache.
  • Sensitivity in the tooth unable to tolerated excessive hot, cold or sweet substances.
  • Visible cavities.
  • Pain on applying pressure on the tooth.

Usually there are no major complications as most patients cannot bear these symptoms and seek treatment. However, if intervention is not forthcoming then tooth decay can progress to abscess formation, cellulitis and even erode the tooth to the point that it breaks.

Causes

Tooth decay is caused by bacterial infections. This arises when the acidic byproducts produced by the bacteria damage the strong outer covering of the tooth (enamel). Untreated at this point, the decay gradually spreads to the deeper pulp producing symptoms. Not brushing properly or not flushing the mouth after meals provides food for the bacteria to thrive.

Initially, the bacteria along with their acid secretions, food particles and saliva form plaques which are seen as a coating on the teeth. These plaques extract minerals from the tooth creating cavities spreading the infections to the deeper to the pulp. The teeth on the back of the mouth, the molars are the premolars have groves and pits where food particles get trapped easily and thus are the common sites of tooth decay.

There following risk factors increases the chances of developing tooth decay :

  • Not brushing the teeth regularly with a suitable fluoridated toothpaste.
  • Eating sticky foods rich in fermentable carbohydrates such as cakes, hard candy or chocolates.
  • Frequent snacking without at least rinsing the mouth after meals.
  • Stomach acid contact with the teeth due to gastroesophageal reflux disease (GERD) or repeated vomiting.
  • Decreased saliva production due to various chronic salivary gland problems or radiation treatment to the head.

Treatment

X-rays can help in detecting the extent of spread of infection. Antibiotics are prescribed to treat the infection. Other dental treatments include:

  • Fluoride treatment which is usually helpful in treating early stages of tooth decay and helps restore mildly damaged tooth enamel. Over-the-counter fluoride pastes are available. Dentists can also prescribe fluoride mouth rinsing solutions, apply fluoride gels on the tooth or place fluoride in small trays that fit on the tooth. Periodic fluoride treatments may be indicated.
  • When the tooth decay spreads deeper, fillings or dental restorations which involves drilling out the decayed part and filling them up with porcelain, composite resins or other materials can be performed.
  • A more extensive decay can be treated by placing crowns on the teeth and restoring tooth shape.
  • When infection has spread to the pulp a root canal procedure is done which involves removal of the tooth pulp completely and filling the space with fillings.
  • Extraction can be performed in non-restorable teeth and replaced with a bridge or dental implant.

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