TOOTH DECAY/DENTAL CARIES
Tooth decay (Dental Caries Or Cavity) is a dental condition that usually occur when decay-causing bacteria in the mouth act and break down food remnants (usually sugar) to release acidic products into the mouth and the teeth surface thereby causing the enamel surface of the teeth to decay. This can lead to a small hole(s) in a tooth/teeth, called a Cavity. This decay can progress from the enamel of the tooth into the dentin of the tooth and even into the pulp of the tooth if the cavity is not treated, and this can cause pain (mild to severe), infection (usually when it progresses deep into the tooth), and even tooth loss.
Dental Caries/Cavities affects all ages inasmuch as there is tooth in the mouth of the individual.
Children have been observed be at risk of “Early Childhood Caries” also referred to as “Baby Bottle Tooth Decay”, and can be severe.
CAUSES OF DENTAL CARIES
Dental caries have been observed to occur when the following conditions are present
1. Susceptible host (tooth/teeth): the posterior teeth (premolars and molars) are more susceptible to caries than the anterior teeth (incisors and canines) and this is due to their structures having grooves and pits. Dental caries can be spotted on different areas of the teeth:
– Occlusal caries, which form on the occlusal or top part or biting surface of the tooth where food particles repeatedly come in direct contact with the teeth
– Interproximal caries, which are dental caries that form between the teeth.
– Body of tooth caries, which are dental caries seen on the body of the tooth (buccal and lingual surfaces)
– Root caries, which are seen on the exposed cementum of the tooth in cases of receding gum.
2. Sugar: this is usually seen in various food we eat. Most of the snacks contain sugar and after eating, remnant of this sugar are seen in the mouth and on surface of teeth which the bacteria act on.
3.Decay-causing bacteria: these are bacteria seen in the mouth that act on the remnant of sugar from food. These bacteria tend to break down sugar to continuously release acids on the tooth surfaces that eventually would cause cavity formation on the teeth.
4. Time: this is the period taken for the acids release by the bacteria to remain on the tooth/teeth surface. As the acid is continuously released over time, so is the tooth gradually demineralised thereby causing tiny cavity/hole on the tooth. As the enamel is breaking down, the tooth will be losing the ability to reinforce the calcium and phosphate structures of the teeth naturally through saliva content and, in time, the acid will penetrate the tooth, destroying it to a level that may cause tooth loss.
However, all these will continue to occur if there is no intervention by the dentist.
In early stage of tooth decay, there are usually no symptoms as the enamel is mostly minerals. As tooth decay advances, it can cause tooth sensitivity to sweets, hot, or cold things and later result in toothache (tooth pain). If the decay continues the tooth becomes infected, an abscess or pocket of pus may form, causing severe pain, facial swelling, and fever.
During a regular dental check-up the dentist can see decay on tooth. Early tooth decay may look like a white spot on the tooth. If the decay is more advanced, it may appear as a darker spot or a hole in the tooth. The dentist can also check the teeth for soft or sticky areas or take an x-ray, which can show decay.
Dentists commonly treat cavities in the following ways;
1. Filling – A dentist will remove the decayed tooth tissue and then restore the tooth by filling it with filling material(s) depending on the extent of the cavity.
2. Root Canal Treatment – As tooth decay progresses through the enamel to the dentin and later into the pulp chamber of the tooth damaging the nerves and blood supply in it. A dental professional would remove the damaged or dead nerve and blood vessel tissue (pulp) and fill the area. The procedure usually ends with the dentist placing a crown over the affected tooth.
3. Extraction (Tooth Removal) – this is preferred in a case whereby the tooth decay has advanced and may be damaged beyond repair. Then extraction has to be done to prevent infection spreading to the jaw bone. After tooth removal, it is highly recommended that artificial replacement of the tooth is done using a partial denture, bridge, or implant be inserted in the edentulous area as the case may be.
Tooth decay can be highly devastating if unattended to but also largely preventable if good oral hygiene is practise. Some of the things one can do to prevent tooth caries/decay:
1. Regular Dental Check-up: with this, the dentist will be able to spot the signs of poor oral hygiene like buildup of plaque and calculus and be able to profer treatment like scaling and polishing which will prevent or stop gum infection and dental caries.
2. Use of Fluoride: fluoride is a mineral that can prevent tooth from decaying and even from progressing, and also reverse, or stop, early tooth decay. Fluoride can be seen in the following
– Toothpaste: the use of toothpaste that contain fluoride to brush morning and last thing at night will help to prevent dental caries. Though not all toothpaste contain fluoride, but we should always go for the ones that do.
– Fluoride treated water
3. Regularly clean between teeth with floss or another interdental (between-the-teeth) cleaner.
4. Make smart food choices that limit foods high in sugars. Eat nutritious and balanced meals and limit snacking.
5. Do not use tobacco products, including smokeless tobacco. If you currently use tobacco, consider quitting.
Written by: Dr Rahman Muhammed Idris