The Sunday News
Kimberly Nyathi
TOOTH decay, which is also called dental cavities or dental caries, is the destruction of the outer surface (enamel) of a tooth.
Decay results from the action of bacteria that live in dental plaque, which is a sticky, whitish film formed by a protein in saliva (mucin) and sugary substances in the mouth. The plaque bacteria sticking to tooth enamel use the sugar and starch from food particles in the mouth to produce acid which then destroys the enamel.
Risk factors
Everyone who has teeth is at risk of getting cavities, but the following factors can increase risk:
-Tooth location. Decay most often occurs in your back teeth (molars and premolars). These teeth have lots of grooves and pits that can collect food particles. As a result, they’re harder to keep clean than your smoother, easy-to-reach front teeth.
Plaque can build and bacteria can thrive between your back teeth, producing the acid that destroys tooth enamel.
-Certain foods and drinks. Foods that cling to your teeth for a long time — such as milk, ice cream, honey, sugar, soda, dried fruit, cake, cookies, hard candy, breath mints, dry cereal, and chips — are more likely to cause decay than foods that are easily washed away by saliva.
-Frequent snacking or sipping. When you steadily snack or sip sodas, you give mouth bacteria more fuel to produce acids that attack your teeth and wear them down. And sipping soda or other acidic drinks throughout the day helps create a continual acid bath over your teeth.
-Bedtime infant feeding. Parents are encouraged not to give babies bedtime bottles filled with milk, formula, juice or other sugar-containing liquids. These beverages will remain on teeth for hours while your baby sleeps, providing food for decay-causing bacteria. This damage is often called baby bottle tooth decay. Letting a toddler who’s transitioning from a bottle wander around drinking from a sippy cup can cause similar damage.
-Inadequate brushing. If you don’t clean your teeth soon after eating and drinking, plaque forms quickly and the first stages of decay can begin.
-Not getting enough fluoride. Fluoride, a naturally occurring mineral, helps prevent cavities and can even reverse the earliest stages of tooth damage. Because of its benefits for teeth, fluoride is added to many public water supplies. It’s also a common ingredient in toothpaste and mouth rinses.
-Younger or older age. Older adults also are at higher risk, as more of us keep our teeth as we age. Over time, teeth can wear down and gums may recede, making teeth more vulnerable to root decay. Older adults also may use more medications that reduce saliva flow, increasing the risk of tooth decay.
-Dry mouth. Dry mouth is caused by a lack of saliva, which helps prevent tooth decay by washing away food and plaque from your teeth. Substances found in saliva also help counter the acid produced by bacteria and can even help repair early tooth decay. Certain medications, some medical conditions, radiation to your head or neck, or certain chemotherapy drugs can increase your risk of cavities by reducing saliva production.
-Worn fillings or dental devices. Over the years, dental fillings can weaken, begin to break down or develop rough edges. This allows plaque to build up more easily and makes it harder to remove. Dental devices can also stop fitting well, allowing decay to begin underneath them.
-Eating disorders. Anorexia and bulimia can lead to significant tooth erosion and cavities. Stomach acid from repeated vomiting (purging) washes over the teeth and begins dissolving the enamel. Eating disorders can also interfere with saliva production.
-Heartburn. Heartburn or gastroesophageal reflux disease (GERD) can cause stomach acid to flow into your mouth (reflux), wearing away the enamel of your teeth and causing significant tooth damage. It is recommend that you consult your doctor to see if gastric reflux is the cause of your enamel loss.
Signs and symptoms
The signs and symptoms of cavities vary, depending on their extent and location. When a cavity is just beginning, you may not have any symptoms at all. As the decay gets larger, it may cause signs and symptoms such as:
-Toothache
-Tooth sensitivity
-Mild to sharp pain when eating or drinking something sweet, hot or cold
-Visible holes or pits in your teeth
-Brown, black or white staining on any surface of a tooth
-Pain when you bite down
Treatments for tooth decay
Treatment of tooth decay depends on how advanced it is.
-For early stage tooth decay — your dentist will talk to you about the amount of sugar in your diet and the times you eat. They may apply a fluoride gel, varnish or paste to the area. Fluoride helps to protect teeth by strengthening the enamel, making teeth more resistant to the acids from plaque that can cause tooth decay.
-Your dentist may discuss a filling or crown with you — this involves removing the dental decay, offering local anaesthetic to numb the tooth and filling the hole.
-If tooth decay has spread to the pulp (in the centre of the tooth, containing blood and nerves) — this may be removed in a process known as root canal treatment.
-If the tooth is so badly damaged that it can’t be restored — it may need to be removed. Your dentist may be able to replace the tooth with a partial denture, bridge or implant.
Kimberley Eve Nyathi is a final year BDS student at Lviv National Medical University in Ukraine.
