Tooth decay is damaged areas on the hard surface of the teeth. Over time, these areas develop into cavities (holes), which can lead to severe toothache, infection, and even tooth loss.
There are several causes of tooth decay, including bacteria in the mouth, frequent consumption of sweets, poor oral hygiene, and more.
Tooth decay is one of the most common health problems worldwide. It is especially common in children, teenagers and the elderly, but no one is immune to it—not even infants.
If left untreated, tooth decay can affect deeper layers of the teeth. Regular dentist visits and proper toothbrushing are the best ways to protect your teeth from tooth decay.
Symptoms of Tooth Decay
Tooth decay can manifest in two forms.
Occlusal decay forms in the area directly above the tooth and is easily noticeable.
Interproximal caries forms between the teeth and may go unnoticed in the early stages, showing no symptoms. This is why it’s important to have regular dental checkups and cleanings, even if your mouth seems to be fine.
As the damage progresses, it may cause:
- severe toothache;
- tooth sensitivity;
- sharp pain when eating sweets, hot or cold food;
- visible holes or pits in the tooth;
- brown, black, or white spots on any surface of the tooth.
Even with just one of these symptoms, you should immediately contact your dentist.
Causes and Stages of Tooth Decay
Tooth decay begins with the formation of dental plaque—a clear, sticky film that covers the teeth. Plaque usually forms due to the consumption of large amounts of sugar and starch, combined with poor oral hygiene. If you don’t clean your teeth of sugars and starches, bacteria feed on them and form plaque.
Plaque that remains on your teeth can harden below or above the gum line and turn into tartar. Tartar makes it more difficult to remove plaque and creates a protective shield for bacteria. The acids produced by bacteria strip minerals from the hard outer enamel of the tooth, causing tiny holes or cavities. This marks the initial stage of tooth decay.
In the second stage, as areas of enamel wear away, bacteria and acids can reach the next layer of the tooth, called dentin. This layer is softer than enamel and less resistant to acids, making the tooth more sensitive.
Next, the bacteria and acids move toward the inner part of the tooth (pulp), which contains nerves and blood vessels. The pulp becomes swollen and irritated due to bacterial invasion. Since there is no room for swelling inside the tooth, the nerve is compressed, causing pain.
In some cases, the pain and damage may spread beyond the tooth root to the bone, leading to bone loss around the tooth and potentially affecting nearby teeth.
Risk Factors
Anyone who has teeth can experience tooth decay, but certain factors increase this risk.
Tooth Location
Cavities most often form on the back teeth—molars and premolars. These teeth have many grooves, pits, and fissures, as well as multiple roots, which can trap food particles. This makes them harder to clean compared to smoother and more accessible front teeth.
Certain Foods and Drinks
Food that clings to your teeth for long periods is more likely to cause cavities than food that gets easily washed away with saliva. This includes foods like milk products, such as ice cream, as well as honey, sugar, soda, dried fruit, cakes, cookies, candy, dry cereal, and chips.
Frequent Snacking
When you snack often, you give your mouth bacteria more fuel to produce acids that attack and wear down your teeth.
Irregular or Poor Tooth Brushing
If you don’t brush your teeth regularly, plaque builds up, leading to cavities.
Younger or Older Age
Tooth decay is common in very young children and teenagers. Older people are also at greater risk. Over time, teeth can wear down, which increases the likelihood of tooth decay. Additionally, older people may take medications that reduce saliva production, which raises the risk of cavities.
Dry Mouth
Dry mouth occurs due to a lack of saliva. Saliva helps prevent tooth decay by washing away food and plaque from teeth. The substances in saliva also help neutralize acids produced by bacteria.
Worn Fillings or Dental Devices
Over time, dental fillings can weaken and start to break down. This makes it easier for plaque to form and harder to remove it. Dental devices may also stop fitting properly, allowing infections to develop underneath.
Heartburn
Heartburn can cause stomach acid entering the mouth. This condition, known as gastroesophageal reflux, can erode tooth enamel and cause damage.
Eating Disorders
Anorexia and bulimia can lead to significant tooth erosion and cavities. Stomach acid from frequent vomiting, known as purging, washes over the teeth and begins to erode the enamel. Eating disorders can also reduce saliva production.
Complications of Caries
Complications of caries may include:
- Abscess — a bacterial infection that causes pus formation in the tooth.
- Swelling or pus around the tooth.
- Вamage or loss of a tooth.
- Chewing difficulties.
- Shifting of teeth after tooth loss.
If left untreated, cavities can lead to severe pain , making daily life difficult. This may also result in weight loss or nutritional problems because eating or chewing becomes painful and hard.
Tooth loss can affect your appearance, which in turn can impact your confidence and self-esteem. In rare cases, a tooth abscess can develop, leading to more serious or even life-threatening infections.
How Cavities Affect Baby Teeth
Cavities in young children’s baby teeth are also known as early childhood cavities. Parents are often surprised to learn that a child’s cavity can develop as early as 6 months, when teeth first erupt. Cavities in baby teeth can cause pain, and the infection can spread. If left untreated, it can destroy baby teeth, which “hold” space in the jaw for adult teeth. If a baby tooth is lost too early, neighboring teeth may shift into the empty space. As a result, when the adult tooth grows in, there might not be enough room, potentially leading to crowding and misalignment in adulthood.
If a child has healthy baby teeth, it’s more likely they will have healthy adult teeth. Children who develop cavities in their baby teeth are more prone to face the same issue as adults.
Additionally, issues with baby teeth affect a child’s overall health. Due to the pain and discomfort, a child may stop eating and not receive enough vitamins and minerals to grow healthily.
Tooth decay is not only harmful to health, but it also significantly affects one’s smile. If your child has tooth decay, they may feel uncomfortable in kindergarten or school.
Children learn healthy habits from their parents. You can instill good habits by teaching your child to brush their teeth, feeding them healthy foods, and taking them to the dentist regularly.
Caries Treatment
Depending on the stage of the caries, four of the most common treatment methods are used.
Fillings — the most common way to treat caries, when the dentist removes the affected part of the tooth and fills the empty space with a filling.At the Yarema Dental clinic, caries is prepared under a microscope. With visual control, the dentist is able to remove only necrotic tissue and minimize the removal of living and healthy tooth tissue.
Crowns– if a large part of the tooth is damaged, the dentist will choose a crown to cover the remaining part of the tooth and protect it from further damage.
Root Canal — if the decay reaches the nerves, a root canal procedure is performed to remove the damaged or dead nerves to prevent further damage and infection.
Extraction — in severe cases, the affected tooth is completely removed along with the root.
Caries Prevention
Good oral hygiene and regular visits to the dentist can help prevent cavities.
Here are a few tips to help you avoid cavities:
- Brush your teeth with fluoride toothpaste.
- Rinse your mouth regularly.
- Avoid foods that stick to the gaps and pits of your teeth for long periods.
- Make sure to visit your dentist at least twice a year. With proper oral care and dental check-ups, you will be one step ahead of tooth decay and maintain healthy teeth and gums.