What causes tooth decay?

Dental cavities, also called caries, are damaged areas of the enamel surfaces of the teeth that have turned into small holes. Cavities are a type of tooth decay and are caused by many factors, including naturally occurring oral bacteria, genetics, frequent snacking and the consumption of sugary drinks, and insufficient or inadequate oral hygiene. Cavities are a very common health problem; anyone who has teeth is susceptible to tooth decay and cavities, though they are more common among children and teenagers, and among the elderly. When cavities are left untreated, they grow and may develop deeper into the teeth, which can lead to infection and tooth loss, as well as causing discomfort or pain. Your best insurance against tooth decay, which leads to cavities, is good oral health habits, including brushing with fluoride toothpaste twice daily and flossing daily, along with regular dental examinations and professional dental cleanings.

Symptoms of cavities vary, depending on their severity and location. At its onset, a cavity may not cause any symptoms at all. As they grow, however, cavities may cause toothache, tooth sensitivity, pain when exposed to extreme temperatures, visible pits in the teeth, staining on the tooth’s surface, and pain when biting down. Because new cavities can develop unnoticed, it’s important to have periodic dental cleanings and checkups, even if you don’t suspect that you have any cavities. If you start to have a toothache or pain in your mouth, however, it’s even more important to see a dentist as soon as you can.

Over time, tooth decay leads to cavities. Tooth decay takes time to develop and begins with the formation of plaque. Plaque is a naturally occurring film that coats the teeth and is worsened by consumption of sugars and starches. When plaque isn’t effectively removed from the teeth, through cleaning, it can harden and form tartar. Tartar is even harder to remove and necessitates professional cleaning. Tartar also encourages further bacterial growth. As plaque mixes with food debris from sugary, starchy foods, it forms acids that erode the tooth’s enamel in tiny holes. Once the enamel has worn away, bacteria and acid can wear away at the deeper layers of the teeth, which are softer than enamel and therefore more susceptible to acid damage. This soft inner layer of the tooth also contains nerve endings, which leads to tooth sensitivity that accompanies advancing decay. As tooth decay progresses, bacteria and acid can continue to erode through the teeth, eventually reaching the tooth’s pulp, which contains even more nerves. When the tooth’s pulp is inflamed and irritated from bacteria buildup, this can press on the tooth’s nerve, which causes pain. This pain can sometimes spread to the surrounding bone, depending on the extent of the decay.

Tooth decay most often affects the back teeth, which have bumpy surfaces that are susceptible to the buildup of bacteria and food debris and can be difficult to clean. Certain foods are more likely to cause tooth decay, especially foods and beverages that are thick and cling to the teeth, which are more difficult to wash away with saliva. These include but are not limited to many dairy products and most sugary foods. Frequent snacking also contributes to the accumulation of acid-causing bacteria, as does the regular consumption of sugary drinks. Tooth decay may occur in babies and children because of their consumption of milk, juice, formula, or sugary liquids, especially if these are consumed just before bedtime or frequently throughout the day, without giving the teeth a break. Plaque begins to form shortly after eating or drinking so brushing your teeth after each meal can help fend off acid-producing plaque; be sure to use a fluoride toothpaste and any additional fluoride supplements that may be recommended by your dentist. Tooth decay may result from dry mouth, which may be caused by certain medications, and it may be exacerbated by ill-fitting dental devices that allow bacteria to build up under and around them. Heartburn or gastric reflux may also cause tooth decay, as the overproduction of stomach acids can affect the health of the teeth, and eating disorders also lead to tooth erosion and decay.

Tooth decay is such a common occurrence that it may be easy to forget that it can be a serious problem. Even in children who don’t yet have permanent teeth, cavities and tooth decay may lead to serious complications. The complications include abscess, pain, swelling, discharge, broken or damaged teeth, problems chewing, and loss of teeth. Sometimes, the pain of tooth decay can interfere with your everyday activities. Pain while eating or chewing can lead to nutrition problems and unwanted weight loss, and the loss of teeth can negatively affect your appearance and your self-esteem. Though it is not common, an abscess, which is a pus-filled, infected pocket inside the tooth, can lead to greater health concerns that may even be life-threatening. Optimal oral hygiene is the best way to avoid tooth decay and cavities. In addition to regular brushing and flossing, combined with periodic professional examinations and cleanings, your dentist may recommend other ways to keep tooth decay at bay. Your dentist may recommend sealants or prescribe a fluoride mouth rinse, or you may be asked to consider dietary changes, such as drinking more water and less soda or snacking less frequently or on more beneficial foods. Even small changes, like drinking fluoridated water and chewing sugarless gum that contains xylitol, can make a difference, so see your dentist to learn more about how to prevent the ravages of tooth decay and cavities.

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