Dental Cavity/ Tooth Decay/Dental Caries

dental
by LVCHEN

Dental Cavity/ Tooth Decay/Dental Caries

Tooth Decay in dental terminology is known as Dental Caries is one the common dental complaints among us all.
Dental caries is nothing but erosion of tooth enamel by the combined effects of bacteria, acids, plaque and tartar.

Bacteria + Acids + Plaque + Tartar = Dental caries

According to Center for Disease Control and Prevention (CDC), Tooth decay is number one Chronic disease among children and primary reason for loss of teeth among 25% seniors.

Tooth decay very much depends on our lifestyle, eating habits & maintaining teeth. It is predominantly common in children and young adults, and rates have been fuelled by an increase in sugars in the diet, and poor dental hygiene.

On contrary the incidence is declining in societies where water is fluorinated or where toothpaste containing fluoride is used.

Cause

This is a fact that Tooth decay is a passive destroyer.
Dental cavities are an infection caused by a combination of carbohydrate-containing foods and bacteria that live in our mouths. The bacteria are contained in a film of plaque that continuously forms on and around our teeth. Although there are many different types of bacteria in our mouths, only a few are associated with cavities. Some of the most common include streptococcus mutans, lactobacillus casei and acidophilus, and actinomyces naeslundii.
When these bacteria find carbohydrates, they metabolize them and produce acid. Every exposure to these foods allows an acid attack on the teeth for about 20 minutes! As the cavity progresses, it invades the softer dentin directly beneath the enamel, and encroaches on the nerve and blood supply of the tooth contained within the pulp.
Cavities attack the teeth in two main ways. The first is through the pits and fissures, which are grooves that are visible on the top biting surfaces of the back teeth (molars and premolars). The pits and fissures are thin areas of enamel that contain recesses that can trap food and plaque to form a cavity. The cavity starts from a small point of attack, and spreads widely to invade the underlying dentin. The second route of acid attack is from a smooth surface, which is between or on the front or back of teeth. In a smooth-surface cavity, the acid must travel through the entire thickness of the enamel. The area of attack is generally wide, and comes to point or converges as it enters the deeper layers of the tooth.

The types of cavities include:
Coronal cavities Its a common type occurring in both children and adults. Occurs on the chewing surfaces or between teeth.
Root cavities Due to age the gums recede, leaving the root parts exposed. Roots do not have enamel so are more prone to get decay.
Recurrent decay Decay around existing fillings or crowns. These areas have more tendency of accumulating plaque finally leads to decay.

Left untreated, a cavity can destroy your tooth and kill the delicate nerves at its center, which may result in an abscess, an area of infection at the root tip.
Once an abscess forms, it can only be treated with a root canal, surgery or by extracting the tooth.

Symptoms:

Generally there are no major considerable symptoms.
Common complaints may include toothache or sensitivity to hot or cold food or beverages.

Common Symptoms Serious Symptoms
Localized to the mouth Seek immediate medical care
Holes in the surface of a tooth Severe swelling or pain in the jawbone
Pain when chewing Severe toothache that cannot be controlled by over-the-counter pain relievers
Sensitivity to hot or cold foods and beverages
Toothache

Diagnosis :

Initial stage of cavities can be discovered during routine checkups with dentists.
Dentist will diagnose with the help of instruments the soft tooth surface.
Pain is usually combined with cavities in advanced stages.
Dental X-rays show the hidden cavities.

Expected Duration:

The duration of caries is determined by the stage at which it is diagnosed.
White spots may indicate early caries that has not yet eroded through the enamel.
Early caries may be reversed if acid damage is stopped and the tooth is given a chance to repair the damage naturally.
Caries that has destroyed enamel cannot be reversed. Most caries will continue to get worse and deeper. With time, the tooth may decay down to the root. The amount of time the erosion takes will vary from person to person. Caries can erode to a painful level within months or years.

Treatments :

Dental cavity treatment is simple.
Prompt treatment of cavity will prevent further tooth damage and save tooth structure.

There are a number of different treatments for cavities depending on the extent of tooth decay.

Type of treatment Indication Procedure
Fillings decay is not extensive Decayed tooth material is removed with help of drill & is replaced with a filling material like Silver, gold, porcelain or composite resin.
Composites closely match with natural tooth appearance because of various shades and is preferred filling material for most of patients.
These filling material are supported to be safe by American dental association(ADA).
Crowns Extensive tooth decay / less tooth structure Tooth with limited structure or large filling area increase the risk of tooth fracture. In this case the decayed or weak area is removed & repaired . Then the crown is fit over the tooth.
Crown can be of gold, porcelain or porcelain fused to metal. Aesthetically porcelain crowns are preferred.
Root Canals Injury or infection of tooth nerve Due to extensive decay at times tooth nerve dies or get injured for which only recommendation is Root canal treatment. The center of the tooth, including the nerve and blood vessel tissue (pulp), is removed along with decayed portions of the tooth. The roots are filled with a sealing material. The tooth is filled, and a crown may be placed over the tooth.

Outlook / Prognosis:

Treatment often saves the tooth. Early treatment is less painful and less expensive than treatment of extensive decay.

Potential complications:

Unattended dental caries are not life threatening but give many complications :

Dental abscess
Difficulty chewing
Pain
Tooth abscess
Tooth damage or loss
Tooth sensitivity

A timely or routine dental check up or following the treatment plan can actually minimize the related risk of dental cavities.

When to contact Dental Professional

Visit dentist when there is tooth ache.

Six monthly appointments should be fixed for routine cleaning and examination to avoid complications of dental caries, time & money as well.

Prevention:

Good oral hygiene – reducing the amount of plaque & bacteria
Professional dental cleaning in every six months
Brushing twice daily ( before going to bed is important)
Flossing at least daily
Reducing sugar in the diet which increases the acid in the oral fluids. Chewy & sticky should be best taken with the meals.
Dentist can evaluate the risk of caries and then suggest fluoride treatments accordingly which strengthens the teeth. Fluoride has the tendency of incorporating with enamel which further avoids enamel erosions.
Dental Sealants are used to prevent the caries. Dentist can apply on the deep grooves of molar which prevent them from erosions.

Alternative Names :

Caries; Tooth decay; Cavities – tooth
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