What is Tooth Decay
Tooth decay is the process where the tooth surface, or enamel, becomes damaged from acid producing bacteria in the mouth. As decay progresses, small pits or holes, called cavities, form. If left untreated, decay can lead to infection, pain, and eventual tooth loss.
Tooth Decay Causes
Bacteria are naturally occurring in the mouth and while some are helpful, others, such as the ones involved in tooth decay, are harmful. Combined with food, the bacteria form a sticky film of plaque that metabolize the starches and sugars in the food to produce acids. If not cleaned away, the acids begin to erode the tooth enamel. As the plaque hardens, it forms tartar which can further irritate the gums and lead to gum disease.
In addition to plaque, tooth decay can also be caused by a lack of essential minerals such as fluoride. Commonly added to public water sources, fluoride can also be found in toothpastes and mouth rinses. Along with saliva, fluoride helps strengthen enamel by replacing minerals. Throughout the day, the teeth undergo a natural process of losing and replacing minerals. However, if the teeth are not properly cared for or excessive sugar and starch are consumed, the enamel will continue to weaken from mineral loss leading to decay.
In the early stage of decay, white spots may appear on the areas where minerals were lost. At this point, decay may be stopped or potentially reversed. If left untreated, the decay will progress, the enamel will continue to be eroded, and a cavity will form. Cavities are permanent damage that will likely require a filling from a dentist.
Tooth Decay Risk Factors
The primary risk factors for tooth decay are having a diet of excessive sugar or starch and not properly cleaning the teeth. Certain people are at elevated risk for developing tooth decay including those who:
- Have inadequate saliva because of genetics, certain diseases, medications, or other treatments
- Do not get adequate fluoride
- Are babies or toddlers who feed from a bottle, especially if before bedtime. The overnight exposure to sugar can damage the tooth.
- Are elderly. Older adults frequently have greater wear on their teeth or are experiencing receding gums. Both factors can increase the risk of developing decay on the exposed tooth root surfaces.
Tooth Decay and Cavity Symptoms
In the initial stage of tooth decay, there are usually no symptoms. However, as the decay progresses, symptoms can include:
- White or brown discoloration or spots on the tooth surface
- Sensitivity to cold, hot, or sweets
- A cavity (hole or pit in the tooth)
- Infection that could lead to the formation of an abscess (pocket of pus) – abscesses cause severe pain, fever, and facial swelling
- Loss of the tooth (extraction)
Diagnosing Tooth Decay
Dentists can typically identify tooth decay and cavities by visually examining the teeth and probing with dental instruments. Any symptoms will also be discussed and an X-ray could be ordered. Based on the extent of decay, treatment options will be recommended and could include fluoride treatments, fillings, root canal, or tooth extraction.
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