Tooth Decay (Dental Caries)

Tooth decay or ‘dental caries’ is a very common condition, especially in children. It is caused by the build up of plaque which attacks the outer layer of your teeth and results in small holes or ‘cavities’ in the enamel. If left untreated it can work its way down into the pulp where it will expose the nerves. This results in extreme pain known as toothache.

What causes tooth decay? It is can be caused by a variety of factors, the most common being a poor diet and failing to look after your teeth properly. Treatment for tooth decay includes fillings, crowns or teeth extraction.

Other factors include:

  • Smoking: smoking reduces the amount of saliva in your mouth. But, saliva is very important as it helps to wash away food particles which help to keep your teeth nice and clean.

    And passive smoking is a risk factor as well.

  • Dry mouth: or ‘xerostomia’ is caused by a number of factors which include certain drugs, medical conditions such as diabetes and the ageing process.

    With this condition your ability to produce saliva is reduced which leaves you with a burning sensation in your mouth and heightened sensitivity to certain foods.

    The problem with this is that saliva helps to remove food debris and plaque as well as preventing bacterial growth in your mouth. It also neutralises acids present in your mouth.

  • Ageing: unfortunately older people suffer more from tooth decay which is due to the fact that their teeth have worn out over time.
  • Gum recession: if your gums recede then this leaves your tooth root exposed which makes it a fertile ground for plaque formation.
  • Bottled water: if you drink bottled water with fluoride added then this helps to protect the teeth against tooth decay. But you can miss out on these protective qualities if you drink the non-fluoride version.
  • Eating disorder: anorexia or bulimia can increase the risk of tooth decay. Anorexia tends to reduce saliva production. Whereas bulimia results in excess acids, often as a result of vomiting which attacks the teeth and gums.
  • Problems with dental fillings: dental fillings can weaken over a period of time and provide ideal conditions for tooth decay.
  • Chemotherapy/radiotherapy: patients who are receiving treatment for mouth or neck cancer are at higher risk of tooth decay. This is because cancer treatment can change saliva composition making it easier for bacteria to grow.
  • Reflux: this is a disease which affects the stomach only. Acid from the stomach is regurgitated into the mouth which corrodes the teeth.

Diet is another important factor. If you consume a diet high in sugary foods then these will erode your teeth over a period of time. This erosion is what causes tooth decay.

If you feel that you cannot do without sugar then try and limit your intake and brush your teeth after every meal.

Brushing and flossing is an important part of your oral hygiene routine. This needs to be followed on a daily basis and combined with twice yearly visits to your dentist. Doing this will maintain your teeth.

Is there more than one type of tooth decay?

There is more than one type of tooth decay:

  • Root cavities
  • Smooth surface cavities
  • Pit and/or fissure cavities

The root type of cavity is more common in older patients. This type of decay happens at the front of the tooth root.

The smooth surface cavity is the easiest one to treat. It’s usually found on the flat surface of the tooth and affects those teeth found at the side of your mouth.

The pit and fissure type of cavity affects the grooves of your back teeth and can spread very quickly.

Tooth decay tends to affect the back teeth (molars and premolars) which you use to chew your food. Food particles get lodged here due to the shape of these teeth which are a fertile ground for bacteria. Plus these teeth are difficult to clean with a toothbrush.

The problem with tooth decay is once it has started it tends to work its way through the enamel and the dentin (soft material which supports the enamel) before reaching the pulp. The pulp is the soft centre of the tooth which contains nerves, blood vessels and soft tissue.

Tooth decay consists of bacteria and plaque which, once they reach the pulp directly inflame the nerves and cause that all too familiar pain!

What are the symptoms of tooth decay?

These include tooth sensitivity, pain in your tooth when you eat anything sweet, hot or cold; bad breath, pain when you bite anything and the formation of pus around your tooth.

Holes in your tooth or brown or black spots on the surface are also warning signs.

A trip to your dentist’s will uncover any signs of tooth decay.

How do you treat tooth decay?

There are several ways of doing so which include using fluoride based products such as toothpastes, gels or a varnish. Fluoride can be added to bottled water or as part of a professional clean, carried out by your dentist.

Dental fillings are a popular form of treatment. These are used to fill in the middle or outer surface of a tooth and are made from a variety of materials. These include composite resins, silver amalgam and the very popular porcelain filling.

A dental crown is another option. This is also known as a ‘cap’ and can fit over the eroded part of a tooth. These are made from porcelain or gold.

If a tooth is badly decayed then the only course of action might be an extraction. This may sound drastic but it can help to prevent the spread of the infection. Your dentist may advise you to replace this with a dental implant.

Another treatment for severe tooth decay is root canal surgery. This sounds rather extreme but dental technology has advanced and can ensure that this is a lot less painful than it used to be.
Another treatment is dental sealants. These can be applied to the grooves or ‘fissures’ within your teeth and help to protect them.

To learn more visit our section on dental fissure sealants.

The important message here is that tooth decay, if left untreated, can cause complications. These include gingivitis and periodontal gum disease, abscesses and teeth extractions.

Is it preventable?

Tooth decay is preventable: even though it is very common there are a range of precautions you can take. These are easy to do and can become part of a daily dental routine. These include:

  • Brushing your teeth twice a day with a fluoride toothpaste. And use dental floss as well as this gets rid of any food debris lodged between your teeth.
  • Rinse away any food particles with a mouthwash. This also helps to prevent the build of bacteria in your mouth which is a major contributor of tooth decay.
  • Avoid sugary or starchy foods. If you find it hard to resist then limit them to a ‘treat’ only and brush your teeth after you have eaten them.
  • Have a professional clean at your dentist’s. Your dentist or a dental hygienist can perform a thorough dental clean (scale and polish) which will remove tartar and plaque.

Many of us do get tooth decay but it can be prevented if we follow a few sensible precautions.

Common Dental Problems Guide Index:

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