We all hear about cavities or tooth decay and some of us may have even experienced but what do we really know about it?
Tooth decay is also known as dental cavity and it is the breaking down of teeth due to the production of acids from bacteria which are found on the surface of the tooth. The acid produced by this bacteria dissolves the enamel of the tooth.
The bacteria feed on simple sugars which are found in food and they produce this acid during the breaking down of food debris or simple sugars on the surface of the tooth. That being said, one of the risk factors of tooth decay is a diet which is high in simple sugars.
What Causes Tooth Decay?
The four main requirements for the development of tooth decay are the surface of the tooth, the bacteria which causes cavities, particles of fermented simple sugar and some time. It also requires a conducive environment to promote the growth of plaque. Although there is we all know how a decayed tooth looks, the eventual outcome of cavities varies depending on the individual and their level of personal hygiene, diet and the ability for their saliva to act as a buffer. Cavities generally develop on the surface of the tooth not inside of the tooth.
More often than not we see that tooth decay occurs more in the people who are on the lower end of the socioeconomic scale than it does in those of the higher socioeconomic scale.
The mouth carries thousands of bacteria and those that cause tooth decay are seen to be present in plaque, however, their concentration is usually so low that it does not cause any issues unless there happens to be some distortion in the balance. This usually happens when there is a change in the environment of the mouth; usually from the frequent introduction of sugar or not brushing properly to get rid of all the plaque. We often see that tooth decay is more common in the molars; this is due to the fact that plaque is known to gather on some parts of the mouth more than others and, one of those parts just happen to be the molars where there is a low rate of flow of saliva. The more plaque gathers there, without proper oral hygiene, the minerals on the enamel of the molar begin to wear faster than it is rebuilding and because of this, we see that tooth decay begins to occur.
Generally, the bacteria in the mouth has the ability to convert sugar into acid by fermenting it. When this fermented sugar is not washed off the tooth, they would begin to dissolve the minerals contained on the surface of the tooth. Naturally, this process can be reversed if the acid formed here is washed off the surface of the tooth and neutralised by either saliva or mouthwash. Then the mineral components lost from the tooth’s surface can begin to regenerate. However, if this dissolving of minerals keeps occurring, then over time, the restoration of minerals would not be able to happen fast enough and we will see that the as more mineral contents are lost, the tooth would begin to disintegrate leaving behind a hole.
The more the teeth are exposed to acidic environments the higher the chances of developing cavities. When we have a meal, the bacteria that reside in the mouth go through this process of metabolizing the sugar and this causes the production of acid as a by-product which in turn increases the pH of the mouth. With time, the pH of the mouth would return back to normal as a result of the ability of the saliva to buffer. When the tooth is exposed to an acidic environment, the mineral content at the surface of the tooth would dissolve and remain dissolved for about two hours until they are able to build themselves back up under normal circumstances. Because of how vulnerable the tooth is within these two hours, cavities can occur if the tooth is subjected to frequent exposure to acidic environments.
The teeth itself can be a cause of tooth decay. If a person is suffering from any form of diseases or disorders that affect the teeth, this would leave the person at a higher risk of developing cavities.
The most common cause seen is the hypomineralization of the molar and incisor. Even though the cause is still widely unknown, it has been narrowed down to a mix of genetic factors and environmental factors.
Another cause is Amelogenesis imperfecta. This is a disease which causes the enamel of the tooth not to form fully or to form in amounts that are not sufficient and therefore can fall off the tooth. In this case, this disease leaves the tooth highly vulnerable since there is no enamel to protect it from bacterial attack and this would lead to tooth decay.
Research has shown that most cases of cavities that occur are not as a result of dental disorders or diseases. Although the evidence is weak, it has been seen that the physical anatomy of the teeth can actually affect the chances of cavities occurring. For instance, if a tooth happens to have deep grooves that are hard to reach and clean, then cavities are more likely to develop there.
As discussed earlier, the rate of saliva can also affect the rate of occurrence of cavities and tooth decay. This is because the buffering capacity of the saliva would no longer be available to shift the balance of the acidic environment that is created by some types of foods in the mouth. That said, some medical conditions which can cause the rate of saliva to reduce in the mouth and thereby lead to the dry mouth may also lead to the cause of tooth decay. Some medications as well have been known to inhibit the production and flow of saliva in the mouth. Another cause of possible dry mouth is exposure of the neck and head to radiation. This sort of exposure can lead to damage in the cells of the salivary gland thereby reducing saliva production and increasing the chances of the occurrence of tooth decay.
Yet another cause of tooth decay is the use of tobacco and tobacco products. This is due to the fact that some tobacco products have a high level of sugar content. Also, the use of tobacco can lead to the development of gum diseases which if left to fester can, in turn, lead to tooth decay
Symptoms of Tooth Decay
The first sign of tooth decay is usually chalky white appearance on the tooth’s surface which is an indicator of an area where the enamel of the tooth is demineralizing. This is called white spot lesion. If this demineralization continues, the lesion would eventually go from white to brown and then develop into a cavity. If this is detected before the formation of the cavity, the process can be reversed however, once a cavity is formed, the tooth cannot be recovered. If a lesion looks dark brown in colour and appears to be shiny, this means that the process of mineral dissolving was stopped and a stain was left in its stead; this is because when a decaying process is active, the colour is usually lighter and it is usually dull in appearance.
As the demineralization process continues, the enamel of the tooth would be destroyed and this is when you may begin to notice the cavity. The tooth would then change in colour and it would be soft to touch. As the decay goes through the enamel of the tooth and reaches the dentinal tubules, the tooth decay pain would then be felt. This is because the dentinal tubules get to the nerves of the tooth and they are exposed when the enamel is worn off.
The tooth decay pain becomes more evident as the tooth comes in contact with heat and cold or, sweet foods. When the tooth decay has, however, reached the pulp tissue of the tooth, the tooth decay pain would become constant. In some cases, infections resulting from tooth decay can spread off the infected tooth to the soft tissues surrounding it causing bigger complications.
How to Identify Tooth Decay
Normally, tooth decay is diagnosed by inspecting all the surfaces of the tooth however, some cavities may be difficult to see and so a dental x-ray would be carried out. A dental x-ray is the most thorough way of detecting cavities even hidden cavities which have found their way into the dentin and, somehow have a demineralized enamel over them.
Preventing and Treating Tooth Decay
Tooth decay is a serious issue and so is tooth decay pain and the possible complications that come with it. Tooth decay can generally be treated by either restoring or replacing the damaged tooth. In minor cases, the tooth can be filled but in severe cases, it would have to be extracted altogether. That being said, the best form of management of tooth decay taking preventive measures against it.
Take Care of Your Oral Hygiene
Brushing your teeth twice daily is recommended and, it is advised that brushing should be done in a gentle back and forth circular massaging motion and it should also be done with a toothbrush that has soft nylon bristles. As part of a preventive measure, it is beneficial to use a toothpaste that contains fluoride. You may also want to use a toothpaste that repairs and takes care of the gum and the enamel of the tooth. It is also important to note that aggressive and vigorous brushing is bad for oral health as this can cause damages to the gums leading gum diseases. Flossing once a day is recommended to help remove the build-up of plaque and tartar that can be caused by remnants of food particles between the teeth. It is advised to be careful when flossing and not aggressive as over flossing can also damage the gums causing them to be inflamed. It is advised to, therefore, slide the floss carefully between the teeth rather than force it down towards the gum. Drinking of water a lot and constant rinsing of the mouth with water and mouthwash goes a long way to remove a lot of debris and food particles that can stay in hidden corners of the mouth and in between the teeth and if left there can cause formation of plaque over time which in turn would lead to gum disease. It is therefore advised to rinse out the mouth properly and regularly especially after having a meal or a snack as this would help to clear out the debris and food particles that are left in the mouth. Also, it is advised to rinse the mouth with antiseptic mouthwash regularly in order to kill the bacteria which cause plaque. Drinking enough water always helps to keep you hydrated which in turn improves the flow of saliva in the mouth which helps for the counterbalancing of acidic environments in the mouth.
Maintain a Healthy Diet
Good nutrition is not an understatement as it plays an important role in having and maintaining good oral health. Having a proper balanced diet can help improve and strengthen the health of the gums. Also, having adequate vitamin c and calcium in your diet can help reduce the chances of developing gum diseases and can help strengthen the enamel of the tooth. Also having a diet that is fortified with minerals would help to support the demineralizing process of mineral dissolved enamel. Also reducing the consumption of simple sugars and stopping unhealthy habits such as using tobacco would help to improve the strength quality of your oral health.
Take Your Dental Visits Seriously
It is essential for your dental health to take your dental visits and check-ups seriously as early detection of tooth decay is key.