What is tooth decay?

Tooth decay is the deterioration of the teeth due to acids that form when bacteria metabolizes with debris from sugary or starchy food. Tooth decay in its various stages is also known as cavities or dental caries. Cavities range in color from yellow to black and also have a wide range of symptoms that may include pain and difficulty eating. If left untreated, tooth decay may lead to infection of the tooth and the tissue surrounding the tooth, the formation of an abscess, and the eventual loss of the affected tooth. When naturally occurring bacteria in the mouth interact with food debris or sugars on the surfaces of the teeth, this produces acid. This acid bathes the teeth and gradually dissolves the teeth’s solid tissues, which include enamel and dentin. Because these acid-forming bacteria feed on sugars, a diet high in sugar is one of the most significant risk factors for tooth decay. Saliva and beneficial bacteria work in tandem with fluoride, which is added in the form of toothpaste, dental rinses, and most municipal tap water, to help the minerals that make up the teeth regrow and regenerate, but when these natural repair systems are overwhelmed, acid wins the battle and dental cavities result. Sometimes, the body doesn’t produce sufficient saliva, which can lead to cavities; if you have a condition or take a medication that leads to dry mouth, talk to your dentist and primary care provider about solutions and treatments that can counteract this issue. Cavities may also be related to poor oral hygiene.

The most effective treatment for dental cavities is prevention. Maintaining a diet low in sugar and regularly cleaning the teeth with fluoride toothpaste and dental floss can help prevent the earlier stages of tooth decay, stopping cavities before they start. Genetics also play a role in a person’s predisposition to cavities; treating a mother’s cavities is shown to help reduce cavity risk in her children by limiting the amounts of detrimental bacteria she may spread to her children. Because there is no way to regrow the tooth, if a sufficient amount of a tooth is exposed to decay, it may be necessary to remove the tooth, though it is likely that treatments can restore the appearance and function of the affected tooth if decay is diagnosed early enough. It is estimated that as much as 48% of the population of the world has cavities in their permanent teeth. Cavities affect more people in the developed world than in the developing world because of the prevalence of consumption of simple sugars in the developed world.

It is common to have tooth decay and not know, and, in its early stages, tooth decay may be reversed by supporting the remineralization of the teeth through hygiene habits and dietary changes. As the tooth decay continues to progress, it is less reversible; if a cavity forms, this lost dental tissue cannot be regenerated and must instead be repaired. Once a cavity forms, decay has moved into the enamel and into the dentin, the tooth layer below the enamel. This dentin layer is susceptible to pain, which is often the first noticeable symptom of a cavity. If decay and infection pass into the deeper layer beneath the dentin, which is the tooth’s pulp, this pain can become sharper and more constant. If the pulp becomes significantly infected, it can die, which will eliminate the pain but make the tooth tender to pressure, and susceptible to fracture and further infection. This progression of infection can lead to serious complications that may even be life-threatening. Dental cavities also cause bad breath and a foul taste in the mouth.

Cavities affect every person differently, with issues that differ based on tooth shape, hygiene habits, and the makeup of a person’s saliva. Generally speaking, however, the presence of bacteria and food debris can lead to cavities in anyone’s mouth. Certain bacteria in dental plaque, a sticky film that collects on the teeth and gums, combine with simple carbohydrates and form acid, which gradually causes tooth decay. If left untreated, tooth decay can lead to cavities. When the acids that bathe the teeth are allowed to proceed unchecked, they often lead to cavities. This takes time, however, and the process of demineralization of the teeth can be reversed if intervention and treatment happen early enough. Additionally, the frequency of exposure to these harmful acids can affect the likelihood of cavities developing. This means that cavities may be prevented through dietary changes, habitual changes, and the observation of adequate oral hygiene habits. The less time teeth are exposed to this acid bath, the less likely they are to develop cavities; reducing sugar and starch intake, increasing water consumption, and improving oral hygiene can all help reduce the time and severity of acid exposure. The introduction of fluoride treatments can also help reverse the negative effects of acid exposure on the teeth. Your dentist may use a fluoride gel treatment, or you may receive a prescription for a fluoride mouth rinse. Increased calcium in the diet may also help strengthen the teeth and make them less susceptible to demineralization caused by overexposure to acids.

In some cases, cavities may form on young infants whose teeth have only recently erupted; this is a particular risk when infants drink sugary drinks. There are also disorders and diseases that may predispose people to cavities. Certain childhood illnesses, like mumps or diphtheria, may lead to greater mineral loss in the teeth, as can premature birth, oxygen deprivation at birth, or untreated Celiac’s disease. Some disorders, like one called amelogenesis imperfecta, directly affect the production of enamel in the teeth. Other disorders affect the teeth less directly. For example, because the teeth are made up of minerals, diet can affect the health of the teeth. This is a contributing reason to the higher incidence of dental cavities among people from lower socio-economic backgrounds, who may also be undernourished. The positioning of the teeth in the mouth may also affect the development of decay and cavities, as in cases of dental crowding where flossing may be more of a challenge, and the shapes of the teeth themselves may also make them more or less susceptible to decay and cavities, as in the case of teeth that have deep or pronounced pits and ridges where food may be more easily trapped and where bacteria may more easily develop. Because saliva helps keep the teeth free from bacteria and debris and can balance out an acidic environment, reduced salivary rates may also increase the likelihood of cavities. Reduced salivary production rates cause dry mouth and may result from certain illnesses and medications, the use of tobacco and other drugs, and radiation therapy of the head and neck. Though there are many possible contributing factors that increase the risk of tooth decay and cavities, when diagnosed and treated early, this problem can be easily treated, so make sure to schedule regular dental examinations and professional cleanings to help keep tooth decay at bay and prevent cavities from forming, and talk to your primary care provider about any underlying issues you may have that interfere with your oral health.

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