Overview

Tooth decay, also known as dental caries or cavities, is a common oral health problem where the tooth’s hard surface becomes damaged, leading to holes or cavities. It occurs when bacteria in the mouth produce acids that erode the enamel, the outermost layer of the tooth. Tooth decay can affect individuals of all ages, from young children to older adults, and if left untreated, it can lead to pain, infection, and even tooth loss. With proper oral hygiene and regular dental care, tooth decay is largely preventable.

Causes

Tooth decay is caused by a combination of factors, primarily the interaction between oral bacteria, dietary sugars, and poor dental hygiene. The main causes include:

• Plaque buildup: Plaque is a sticky film of bacteria that forms on teeth after consuming foods and drinks, especially those high in sugars and starches.
• Acid production: Bacteria in plaque feed on sugars and produce acids that attack and weaken the tooth enamel.
• Poor oral hygiene: Inadequate brushing and flossing allow plaque and bacteria to accumulate on teeth.
• Frequent snacking and sugary drinks: Constant exposure to sugars increases the risk of acid attacks on the teeth.
• Dry mouth: Reduced saliva flow can impair the natural washing away of food particles and neutralization of acids.
• Deep tooth crevices and misaligned teeth: Make cleaning more difficult, leading to plaque buildup.

Symptoms

The symptoms of tooth decay can vary depending on the stage and severity of the condition:

• White spots on teeth: Early signs of demineralization.
• Visible holes or pits in teeth: Clear signs of cavities.
• Tooth sensitivity: Discomfort or sharp pain when consuming hot, cold, sweet, or acidic foods and drinks.
• Toothache: Persistent or spontaneous pain, especially in advanced decay.
• Bad breath (halitosis): Caused by bacterial activity in decayed areas.
• Discoloration: Brown, black, or yellow staining on the tooth surface.
• Swelling or pus: In severe cases, infection can cause gum swelling or abscess formation.

Diagnosis

Tooth decay is diagnosed during routine dental checkups through:

• Visual examination: Dentists inspect teeth for visible signs of decay, discoloration, or structural damage.
• Dental probing: Special instruments are used to detect soft areas on the tooth surface.
• Dental X-rays: Help detect cavities between teeth and under the surface that are not visible to the naked eye.
• Laser cavity detection: Some dentists use laser devices to identify early demineralization.

Treatment

The treatment of tooth decay depends on the severity and extent of the decay:

• Fluoride treatments: In early stages, professional fluoride applications can help remineralize weakened enamel.
• Dental fillings: Decayed material is removed and the cavity is filled with a suitable material like composite resin, amalgam, or porcelain.
• Crowns: Severely decayed teeth may require a crown to restore structure and function.
• Root canal therapy: If decay reaches the tooth pulp, a root canal may be needed to remove infected tissue and save the tooth.
• Tooth extraction: In cases of extensive decay where the tooth cannot be saved, removal may be necessary followed by replacement options like implants or bridges.

Prognosis

With timely treatment, the prognosis for tooth decay is excellent. Early-stage cavities can be halted and repaired, preventing further damage. Advanced cases, while more complex, can be managed successfully with restorative procedures. If left untreated, tooth decay can lead to severe pain, infections, tooth loss, and even systemic health problems. Regular dental visits, good oral hygiene practices, and a healthy diet play essential roles in preventing tooth decay and maintaining lifelong dental health.