Tooth decay is the destruction of tooth material, which includes:
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Enamel–the hard outer surface of the tooth
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Dentin–the second layer beneath the enamel
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Pulp–the inside of the tooth
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Root–the nerve of the tooth
Causes
Tooth decay is caused by bacteria interacting with food particles left on the surface of the tooth. Bacteria feed on the sugars in the food and produce acids. These acids and bacteria combine to form a sticky substance called plaque. Plaque clings to your teeth and gives the acids a chance to eat away at the protective enamel of the tooth, eventually causing tooth decay.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:
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Poor dental hygiene
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Diet high in sugars
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Malnutrition, including vitamin and mineral deficiencies
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Medical conditions, such as Sjogren's syndrome, that decrease the flow of saliva in the mouth
Symptoms
Symptoms include:
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Sensitivity of a tooth to hot or cold
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Tooth discomfort after eating
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Darkening of the tooth surface
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Bad breath or a foul taste in mouth
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Throbbing, lingering pain in tooth
Diagnosis
A dentist checks for tooth decay by:
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Asking about pain in the teeth
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Visually inspecting the surface of the teeth
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Probing teeth with dental instruments to check for:
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Taking x-rays of teeth
Treatment
Tooth decay that is stopped before it reaches the dentin (second layer of the tooth) will repair itself.
Treatment for more severe decay includes:
Fillings
When decay reaches the dentin, your dentist will treat it by:
Root Canal
Tooth decay that reaches the pulp and/or root of the tooth is treated with a root canal:
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The tooth is numbed and a hole is drilled through top of the tooth.
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Pus and dead tissue are removed from the tooth.
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The inside of the tooth and the root (nerve) canals are cleaned and filled with a permanent filling.
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The root (nerve) canal is sealed.
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A crown is placed on the tooth to protect it.
Tooth Extraction (Removal)
Removal of the tooth is required if:
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Tooth decay and/or tooth infection is too extensive for filling or root canal.
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A break or crack in tooth that has allowed for decay is too severe to be repaired.
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An extensive infection between the tooth and gum.
If the tooth is removed, it will be replaced with:
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A partial bridge
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A denture
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A tooth implant
Prevention
Measures that help prevent and stop tooth decay include:
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Proper dental hygiene, including:
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Limiting the amount of sugar you eat, including:
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Rinsing your mouth with water after eating sugars.
Prevention is particularly important for children, especially after the permanent teeth come in. Supplemental fluoride in early childhood (with dose adjustment for the amount of natural or added fluoride in local water supplies) can prevent early caries. Fluoride can also be applied to permanent teeth as a long acting “varnish,” though revarnishing is usually necessary at least twice yearly.
Another common and effective preventative is the use of a sealant, a thin coating put on the teeth by a dentist as a barrier to tooth decay. Sealants may be more difficult to apply than fluoride varnishes, but they last longer and probably are more effective.
Avoiding sugar-containing drinks (including fruit juices), especially in nursing bottles, and careful tooth brushing can help prevent childhood tooth decay.
RESOURCES:
Academy of General Dentistry
http://www.agd.org/consumer
American Dental Association
http://www.ada.org
References:
American Dental Association website. Available at: http://www.ada.org.
The Merck Manual of Medical Information—Home Edition. Simon and Schuster, Inc.; 2000.
National Institutes of Health website. Available at: http://www.nih.gov/.
