What is Tooth Decay?

Tooth decay occurs when the tooth surface, or enamel, becomes damaged.  Left untreated, tooth decay can cause holes in the teeth (cavities or dental caries), infection, pain, and ultimately tooth loss.

Causes of Tooth Decay

Bacteria are naturally occurring in the mouth.  Some of the bacteria are beneficial while others, such as the ones involved in tooth decay, are harmful.  The harmful bacteria combine with food to form a sticky film known as plaque.  Decay is caused by the acidic byproduct produced by the bacteria metabolizing sugars and starches from food consumed.  Within minutes, these acids begin to eat away minerals on the enamel.  In time, the plaque hardens to form tartar.  In addition to damaging the teeth, tartar and plaque can also cause gum irritation and disease.

Fluoride, a naturally occurring mineral, can be found in water, toothpastes, and other sources.  Along with saliva, fluoride helps replace minerals allowing the enamel to repair itself.  The natural process of losing and replenishing minerals occurs throughout the day.  But if the teeth are not properly cleaned and excessively starchy or sugary things are consumed, the enamel begins losing minerals which leads to decay.

Signs and Symptoms of Tooth Decay

During the initial stage of tooth decay, a white spot may appear on the tooth surface where minerals were lost.  At this point, it may be possible to stop or potentially reverse the damage.  The enamel can repair itself if starchy/sugary foods are avoided and the teeth are properly cared for.

If the decay is not addressed and allow to progress, the loss of additional minerals will further weaken the enamel and a cavity, or hole, in the tooth will appear.  A cavity is permanent damage that the dentist will likely need to repair using a filling.

In the early stages of tooth decay, patients may not show any signs of symptoms.  As the decay worsens, typical symptoms include a toothache/pain, sensitivity to temperature or sweets, white or brown stains on the tooth surface, a cavity, infection, and an abscess.  Once an abscess has formed, facial swelling, a fever, and significant pain are typical.

Diagnosis

Dentists can generally diagnose tooth decay by conducting an examination.  X-rays may be needed to further diagnose the severity of the condition.

Treatment

Treating tooth decay and cavities will vary based on the severity of the problem.  Some typical treatments include:

  • Fluoride Treatments: Fluoride treatments can help replace lost minerals in the enamel during the initial stage of tooth decay.  Fluoride can be topically applied to the teeth, taken orally in pill form, or found in toothpastes and mouth rinses.
  • Fillings: For most cavities, the dentist can remove the decayed tooth tissue before restoring the tooth with a filling.
  • Root Canal: If infection is severe enough that it penetrates the inner tooth pulp, a root canal procedure may be needed.  During the root canal, the dentist removes the decayed pulp before cleaning out the tooth and root.  The tooth is then filled with a temporary filling before the permanent filling or crown is placed in a subsequent visit.
  • Tooth Extraction: In advanced cases where the pulp damage cannot be repaired, the dentist may elect to pull or extract the tooth.  A bridge or implant may be used to replace the missing tooth.

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