Tooth Decay: Causes, Symptoms, Diagnosis and Treatment

Understanding Tooth Decay

Tooth decay, also known as dental caries or cavities, is a prevalent issue that can have significant implications for our oral health. It occurs when acids produced by bacteria in the mouth erode the hard outer layer of the teeth, the enamel.

Causes of Tooth Decay

Bacteria in our mouths thrive on sugary and starchy foods and drinks. They convert these into acids, which, when combined with food particles and saliva, form dental plaque. This sticky substance adheres to our teeth and, if not removed through proper brushing and flossing, gradually dissolves the enamel, creating cavities. Risk factors such as dry mouth, frequent consumption of sugary snacks, a family history of tooth decay, gum recession, and previous radiation therapy to the head and neck area can increase the likelihood of developing tooth decay. Moreover, while cavities themselves aren't contagious, the bacteria that cause them can be passed from one person to another, potentially leading to tooth problems over time.

Symptoms of Tooth Decay

In the early stages of tooth decay on the outer enamel surface, symptoms may not be noticeable. However, as the decay progresses and reaches beyond the enamel into the dentin and pulp, one may experience various symptoms. These can include bad breath, a bad taste in the mouth, bleeding gums, facial swelling, toothache, or sensitivity to hot or cold foods and drinks. The stages of tooth decay involve demineralization, where small white chalky spots appear on the tooth, followed by enamel breakdown, dentin involvement with increased tooth sensitivity, pulp infection causing pain and gum swelling, and in severe cases, the formation of an abscess with the potential to spread and cause serious complications.

Diagnosis and Tests for Tooth Decay

Regular twice-a-year dental checkups are crucial for early detection of cavities. Dentists use various instruments to examine the teeth and may take dental X-rays to identify hidden decay. A tooth with a cavity will often feel softer when probed.

Management and Treatment of Tooth Decay

The treatment for tooth decay depends on its severity. In the early stages, fluoride treatments can help repair damaged enamel. When a hole forms, dental fillings are used to remove the decayed tissue and fill the cavity. Root canal therapy may be necessary for advanced decay, and in extreme cases, tooth extraction might be the only option. After root canal treatment, a dental crown might be needed to strengthen the affected tooth.

Prevention of Tooth Decay

Preventing tooth decay involves maintaining good oral hygiene. This includes brushing your teeth with a soft-bristled brush and fluoride toothpaste at least twice a day, preferably after each meal, cutting back on sugary and starchy foods and drinks, daily flossing to remove trapped food and plaque, and scheduling dental checkups at least twice a year. Dental sealants can also provide protection to the top chewing surfaces of the teeth.

Outlook and Prognosis of Tooth Decay

If tooth decay goes untreated for an extended period, it can result in significant tooth loss and severe infections. However, with timely detection and appropriate treatment, most people with cavities do not experience long-term problems. Early fluoride treatments can halt the progression of decay in its initial stages. Once the decay reaches the root, there is a risk of tooth loss or the development of a painful abscess.

Living with Tooth Decay

If you experience symptoms such as bleeding gums, difficulty chewing, signs of infection, a swollen face, or toothache, it's essential to schedule an appointment with a dentist promptly. When visiting the dentist, it's helpful to ask questions such as the reason for the cavity, the best treatment option, steps to reduce the risk of future cavities, potential complications to watch out for, and recommended oral health products.

Common Questions about Tooth Decay

Cavities can be difficult to detect in the early stages but may present as small white chalky areas on the enamel that can progress to brown or black spots. They differ from stains in color and distribution. The sensation of a cavity depends on its severity, with early-stage cavities often being asymptomatic and more advanced ones causing pain or sensitivity. Leaving a cavity untreated can lead to its enlargement, infection, and eventual tooth loss. In the very early stages, cavities may be reversible with fluoride and improved oral hygiene, but once the decay reaches the dentin, professional dental intervention is required. A painful cavity indicates advanced decay, but prompt treatment can often save the tooth.