Understanding tooth decay- Causes, Process, Treatment and Prevention

Tooth decay is increasing rapidly all over the world. Although common in children and young adults, there’s no specific age limit to it. According to a recent survey, approximately 90% of adults between 20 and 64 years old experience tooth decay. Tooth decay is damage to the tooth structure usually caused by bacteria present in the mouth. It can cause discoloration and holes in the tooth.
If not treated in time, it can even result in tooth loss. 

Understanding the Tooth 

Teeth play a major role in the body. They help in crushing, breaking, and chewing down food for digestion. Each tooth consists of two parts: the crown and the root. The crown is the portion above the gums, usually visible to us. The root is the part of the tooth that lies under the gums and anchors to the surrounding bone and soft tissue.Teeth has 4 main layers- enamel, dentin, cementum, and pulp. Enamel is the outermost layer and the hardest substance in the human body. It is mainly composed of calcium and phosphorous. Dentin and cementum are layers below the enamel in the crown and root respectively. The pulp is the tooth’s central portion, which comprises blood vessels and nerves.

Causes

1. Bacteria in the Mouth – Tooth decay cannot occur without the presence of microorganisms. The mouth naturally contains a lot of bacteria in it. Streptococcus mutans is considered to be a major cause in tooth decay, followed by a few other bacteria.
2. Dietary Habits- The diet one takes can not just affect their internal health but also tooth. Sticky food such as chips, jams, toffee, nuts, etc cause tooth decay. These stay on the teeth for a longer duration and cause decay.
3. Poor Oral Hygiene- Oral hygiene is vital for healthy teeth. If oral hygiene is not maintained decay can occur faster and easily. Regular dental check-ups can also help in maintaining oral hygiene.
4. Dry Mouth (Xerostomia)- The saliva present in the mouth acts as a natural cleanser for teeth. It avoids bacterial build up thereby preventing decay. If a person has a dry mouth also called xerostomia, they have increased chances of tooth decay.
5. Other Factors – Several other factors promote tooth decay. Genetics can also play a role in harming your tooth. Having certain medications that cause dry mouth may also harm your teeth.

 The Process of Tooth Decay

Tooth decay begins with the formation of plaque. Plaque is a thin, transparent, sticky fluid that covers the teeth. It cannot be removed with saliva or tongue movement. Plaque can only be removed by brushing. It consists of saliva, bacteria, and food particles. When plaque sits on the teeth for a long duration it becomes acidic. The enamel which is the outermost layer of the teeth starts to lose its minerals under such acidic conditions, resulting in tooth decay. If it is not controlled at this stage it further destroys the complete enamel layer and reaches the layer below called dentin. Dentin which is less hard than enamel decays faster than enamel. The decay, if not treated at this stage can reach the center of the tooth to the pulp and may even cause pus formation.

 Symptoms

Sometimes, the tooth decay does not show any symptoms until it has formed a hole in the tooth. A few early symptoms include sensitivity, black or brown spots on the tooth, and pain when chewing. If neglected, the situation can worsen and may cause extreme pain, difficulty chewing from that side, or even swelling and pus.

 Tips for prevention

1. Good Oral Hygiene Practice – Brushing twice daily , using a floss and tongue cleaner helps keep your mouth clean and prevents decay.
2. Healthy Diet Choices- Sugar is the major root cause of tooth decay. Frequent snacking and eating sticky sugary items increase the chance of harming your teeth. It would help if you also avoided acidic drinks to reduce the chances of decay.
3. Regular Dental Checkups – Dental checkups should be done at least twice a year. It can help in early detection and treatment of tooth decay and also help prevent unnecessary tooth loss.
4. Fluoride Usage – Fluoride-based toothpaste should be used to help prevent decay. Other ways to intake fluoride are fluoridated water, mouthwashes, topical gels, and dietary intake.
5. Additional Measures – Dental sealants, which are basically thin liquids painted over the teeth and then hardened by a curing light, also help protect the tooth structure and prevent decay.
6. Prevent dry mouth – Certain individuals experience dry mouth in which there is less salivary flow which may help promote tooth decay. Chewing sugar free gums or sucking on lemon candies can help with salivary flow thereby preventing decay caused by dry mouth.

Treating Tooth Decay

There are multiple treatment options for tooth decay depending on the extent . Dentists usually examine the problem using an x-ray of the tooth and its surrounding structures. Applying fluoride can reverse early the decay in the early stages. If the decay is confined to enamel or dentin, dentists can treat it with a filling. When the decay extends to the pulp, dentists may treat it with a root canal procedure. In severe cases, they may need to extract the tooth, depending on its condition.

 Conclusion

Tooth decay is a major dental problem. It occurs in individuals of all age groups. It may start with no symptoms but can be diagnosed by a dentist and treated. If not treated initially it may even result in tooth loss. Maintaining oral hygiene and taking a suitable diet help prevent tooth decay Regular dental visits can help in maintaining good oral health by early detection and suitable advice.

 References/Further Reading

Teeth: Anatomy, Types, Function & Care

Maintaining and Improving the Oral Health of Young Children | Pediatrics | American Academy of Pediatrics