Year after year, tooth decay is one of the most common diseases that people face. Indeed, tooth decay, also more commonly known as cavities or caries, plagues mouths across the world. Tooth decay happens when plaque, which is the sticky substance that forms on teeth, combines with sugars from the food we eat. This combination produces acids that can damage and weaken tooth enamel. While there is no cure for tooth decay beyond professional dental treatment, there are actions you can take to prevent cavities.
What causes tooth decay?
Bacteria and food can cause tooth decay. A clear, sticky substance called plaque is always forming on your teeth and gums. Plaque contains bacteria that feed on the sugars in the food you eat. As the bacteria feed, they make acids. The acids attack the teeth for 20 minutes or more after you eat. Over time, these acids destroy tooth enamel, causing tooth decay.
Things that make you more likely to have tooth decay include:
- Not brushing and flossing your teeth regularly and not seeing a dentist for checkups and cleanings.
- Eating foods that are high in sugar and other carbohydrates, which feed the bacteria in your mouth.
- Not getting enough fluoride. Fluoride helps prevent tooth decay by making teeth more resistant to acids produced by plaque. Fluoride is added to many public water supplies.
- Not having enough saliva. Saliva washes away food and harmful sugars, so it helps protect your teeth from decay. A dry mouth may be caused by a condition such as xerostomia or Sjogren’s syndrome, by taking certain medicines, or by breathing through your mouth. Older adults are more likely to have a dry mouth.
- Having diabetes.
- Smoking, using spit (smokeless) tobacco, or breathing secondhand smoke.
How plaque causes tooth decay?
Your mouth is full of bacteria that form a film over the teeth called dental plaque. When you consume food and drink high in carbohydrates – particularly sugary foods and drinks – the bacteria in plaque turn the carbohydrates into energy they need, producing acid at the same time.
If the plaque is allowed to build up, the acid can begin to break down (dissolve) the surface of your tooth, causing holes known as cavities. Once cavities have formed in the enamel, the plaque and bacteria can reach the dentine (the softer, bone-like material underneath the enamel). As the dentine is softer than the enamel, the process of tooth decay speeds up.
Without treatment, bacteria will enter the pulp (the soft center of the tooth that contains nerves and blood vessels). At this stage, your nerves will be exposed to bacteria, usually making your tooth painful. The bacteria can cause a dental abscess in the pulp and the infection could spread into the bone, causing another type of abscess.
What are the symptoms?
Tooth decay usually doesn’t cause symptoms until you have a cavity or an infected tooth. When this happens, you may have:
- A toothache, which is the most common symptom.
- Swelling in your gums near a sore tooth. This can be a sign of severe tooth decay or an abscessed tooth.
- Bad breath or a bad taste in your mouth.
- White, gray, brown, or black spots on your teeth.
Seeing a dentist
If you have a toothache, see a dentist. Sometimes the pain will go away for a while, but the tooth decay will keep growing. If you don’t get treatment, your cavities could get worse and your tooth could die.
Visit your dentist regularly so early tooth decay can be treated as soon as possible and the prevention of further decay can begin. Tooth decay is much easier and cheaper to treat in its early stages.
How is tooth decay diagnosed?
To diagnose tooth decay, your dentist will:
- Ask questions about your past dental and medical problems and care.
- Check your teeth, using a pointed tool and a small mirror.
- Take X-rays of your teeth and mouth to find tooth decay that can’t be seen with the eyes alone.
Treatments for tooth decay in adults
Early-stage tooth decay
Early-stage tooth decay, which is before a hole (or cavity) has formed in the tooth, can be reversed by:
- reducing how much and how frequently you have sugary foods and drinks
- brushing your teeth at least twice a day with fluoride toothpaste
Your dentist may apply a fluoride gel or fluoride paste to the affected tooth. Fluoride helps to protect teeth by strengthening the enamel, making teeth more resistant to the acids from plaque that can cause tooth decay
Treatments for holes in teeth
When there’s a hole in the tooth, treatment may include:
- a filling or crown – this involves removing the dental decay and filling the hole or covering the tooth (read about what NHS fillings and crowns are made of)
- root canal treatment – this may be needed to remove tooth decay that’s spread to the center of the tooth where the blood and nerves are (the pulp)
- removing all or part of the tooth – this is usually advised when the tooth is badly damaged and cannot be restored; your dentist may be able to replace the tooth with a partial denture, bridge or implant
Preventing tooth decay in adults
Although tooth decay is a common problem, it’s often entirely preventable. The best way to avoid tooth decay and keep your gums as healthy as possible is to:
- visit your dentist regularly – your dentist will decide how often they need to see you based on the condition of your mouth, teeth and gums
- cut down on sugary and starchy food and drinks, particularly between meals or within an hour of going to bed – some medicines can also contain sugar, so it’s best to look for sugar-free alternatives where possible
- look after your teeth and gums – brush your teeth properly with a fluoride toothpaste twice a day, and use floss and an interdental brush at least once a day
- see your dentist or a dentist if you have a persistently dry mouth – this may be caused by certain medicines, treatments or medical conditions.
How to Prevent Tooth Decay from Getting Worse
While not curable, you can try to stop it early with a good oral care regimen. This includes buying an electric toothbrush to help remove plaque better and help prevent cavities from forming in the first place. It’s also important to be aware that enamel is able to repair itself by using saliva’s minerals, and this is greatly assisted by the fluoride sources like toothpaste.
Tooth Decay in Children
What is tooth decay in children?
Tooth decay is the breakdown, or destruction, of tooth enamel. Enamel is the hard outer surface of a tooth. Tooth decay can lead to cavities. These are holes in the teeth. Children, whose teeth are still growing, are more likely than adults to have tooth decay. This is because the minerals in new teeth are not very strong and are easier for acids to eat away.
Even babies can be at risk for tooth decay. Babies who are put to bed with a bottle can get “bottle mouth”—tooth decay caused by the sugar in milk, formula, or juice. Babies aren’t born with decay-causing bacteria in their mouths. But they can get bacteria from adults who share spoons, forks, or other utensils with them.
What causes tooth decay in a child?
Tooth decay is caused by bacteria and other things. It can happen when foods containing carbohydrates (sugars and starches) are left on the teeth. Such foods include milk, soda, raisins, candy, cake, fruit juices, cereals, and bread. Bacteria that normally live in the mouth change these foods, making acids. The combination of bacteria, food, acid, and saliva form a substance called plaque that sticks to the teeth. Over time, the acids made by the bacteria eat away at the tooth enamel, causing cavities.
What are the symptoms of tooth decay in a child?
The following is the common way that teeth develop decay and cavities. But decay may be a bit different for each child.
- White spots begin to form on the teeth in areas affected. These spots mean that the enamel is starting to break down. They may lead to early sensitivity in the teeth.
- An early cavity appears on the tooth. It has a light brown color.
- The cavity becomes deeper. It turns a darker shade of brown to black.
The symptoms of tooth decay and cavities vary from child to child. Cavities don’t always cause symptoms. Sometimes children don’t know they have one until their dentist finds it.
How is tooth decay diagnosed in a child?
Your child’s dentist can usually diagnose tooth decay based on:
- A complete history of your child
- An exam of your child’s mouth
- Dental X-rays
How is tooth decay treated in a child?
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. In most cases, treatment requires removing the decayed part of the tooth and replacing it with a filling. Fillings are materials placed in teeth to repair damage caused by tooth decay. They are also called restorations. There are different types of fillings:
- Direct restorations. These need a single visit to place a filling directly into a prepared hole. These fillings may be made out of silver, fine glass powders, acrylic acids, or resin. They are often tooth-colored.
- Indirect restorations. These may require 2 or more visits. They include inlays, onlays, veneers, crowns, and bridges. These are constructed with gold, base metal alloys, ceramics, or composites. Many of these materials can look like natural tooth enamel.
How can I help prevent tooth decay in my child?
You can help prevent tooth decay in your child with these simple steps:
- Start brushing your child’s teeth as soon as the first one appears. Brush the teeth, tongue, and gums twice a day with a fluoride toothpaste. Or watch as your child brushes his or her teeth.
- For children younger than 3 years old, use only a small amount of toothpaste, about the size of a grain of rice. Starting at 3 years old, your child can use a pea-sized amount of toothpaste.
- Floss your child’s teeth daily after age 2.
- Make sure your child eats a well-balanced diet. Limit snacks that are sticky and high in sugars, such as chips, candy, cookies, and cake.
- Prevent the transfer of bacteria from your mouth to your child’s by not sharing eating utensils. Don’t clean your infant’s pacifier with your saliva.
- If your child uses a bottle at bedtime, only put water in it. Juice or formula contain sugars that can lead to tooth decay.
- Talk with your child’s healthcare provider or dentist about using a fluoride supplement if you live in an area without fluoridated water. Also ask about dental sealants and fluoride varnish. Both are put on the teeth.
- Schedule routine dental cleanings and exams for your child every 6 months.