Tooth decay is the breakdown of the teeth caused by the acid produced by bacteria. It is a process which damages the tooth and leads to the formation of a cavity or dental caries which can appear in varying colors from yellow to black and often seen as a hole in the tooth.
A cavity is characterized by the destruction of the tooth’s enamel, dentin, and cementum — the teeth’s hard tissues. The enamel, which is considered the hardest and most mineralized part of the body, acts as the most protective outer layer of the tooth. It is also the most visible and the first layer to be attacked by bacteria causing cavities.
When the cavity is not treated immediately, it can also destroy the dentin which is a less mineralized layer compared to the enamel. Along with the enamel, it protects cementum which in turn protects the tooth root.
A bit of history about cavity
Up until the early parts of the 19th century, it was believed that the cause of tooth decay where tooth worms, in reference to the Sumerian text found on a clay tablet from 5,000 B.C. known as the Legend of the Worm. The text, which describes the source of tooth decay as worms that drink blood and eat the teeth bone, is one of the earliest text related to tooth decay and Dentistry.
It was only in 1835 when the chemical theory was on the rise, that tooth decay was suggested to have been brought about by the acid formation due to the fermentation of food particles around the teeth.
By 1843, Erdl has proposed the relation of microorganisms to tooth decay. Underwood and Miles, in 1880, reported the role of acid produced by bacteria in the decalcification of the teeth.
How does a cavity develop?
Inside our mouth, hundreds of different bacteria are present, living in our teeth, gums, tongue, and other parts of our mouth. Although not all these bacteria are harmful, some can be detrimental and contribute to the tooth decay process.
When these bacteria are partnered with our food consumption, they can feed on the foods left in our mouth, producing harmful acids that attack the enamel.
Imagine this. You are repeatedly punched without a chance to stand back. You’ll definitely end up bruised or injured. That is what happens with our teeth. The enamel gets continuously attacked by acids without getting the opportunity to repair itself.
These repeated acid attacks lead to mineral loss and ultimately weakening the enamel. When the process is not interrupted, it persists. Minerals are lost, and the enamel, other hard tissues and even the tooth root and bone are destroyed, leading to the eventual formation of a cavity, permanent damage to the tooth.
What contributes to the tooth decay process?
Several factors can cause the formation of cavities by aiding in the tooth decay process.
- Inadequate oral care. Every day, we feed our mouth with various foods and drinks which can get stuck or left inside the mouth. If left unclean, these particles can form into plaque which can lead to the start of the tooth decay process and the formation of cavities.
- Snacking: Food is vital for survival, but food can also lead to oral-related issues by serving as the bacteria’s food in its production of acid. Continually snacking, especially foods that can get stuck to your teeth gives bacteria more fuel to create a continual acid bath over the teeth which attack and wear down the teeth.
- Eating sugary and starchy food. These types of foods can speed up the buildup of plaque.
- Feeding kids before bedtime. Baby bottles filled with formula milk, juice, or other sugar-containing liquids can rest on baby’s teeth while they sleep, leading to what is known as baby bottle tooth decay.
- Worn out dental works. As time passes by, dental restorations like dental fillings can break down, weaken, and create gaps which can serve as the bacteria’s pathway in attacking the tooth.
- Tooth’s location. Premolars and molars, which are located at the back of the mouth, are more susceptible to tooth decay as they are harder to reach and clean. They also have more pits, grooves, and crannies which can provide space for food particles to stay.
Who are at risk of getting cavities?
The National Health and Nutrition Examination Survey (NHANES) has reported that 42 percent of children below 11 years old have dental caries. The figure shows a more rampant incidence of cavities among children by seven times than hay fever and five times than asthma.
Still, adults are not saved from the risk of developing tooth decay as age was found to be a contributor in cavity formation. As we get old, our teeth can begin to wear down, and our gums can also recede.
People with dry mouth, which results in a lack of saliva, are more vulnerable than people without dry mouth. Because of a dry mouth, saliva, which washes away food and plaque from teeth and prevent cavity formation, is insufficient to protect the teeth against bacteria.
Nonetheless, everyone with a tooth is susceptible to developing cavities thanks to our lifestyle, habits, activities, choices, and more.
How do I know if I have a cavity?
Cavities are easy to spot because of the stains on the surface of a tooth that may be brown, black, or white. Also, visible holes or pits can also be observed.
A person with a cavity can experience a toothache, tooth sensitivity, pain when biting down, or a mild to sharp pain while eating or drinking.
Symptoms may differ, depending on the extent and location of the cavity. It may also not be evident in its beginning stages that is why regular dental check-ups are imperative to detect the cavity in its earlier stage which is often not visible to the naked eye. Moreover, a routine dental check-up also provides professional teeth cleaning that can effectively remove plaque or tartar build up.
What are the treatments for cavities?
Treatment will rest on the condition of your teeth and the degree of damage needed to be repaired.
- Dental Filling: The most common dental treatment for a decayed tooth is a dental filling procedure. This procedure uses a restorative material to fill the space created by the removal of the decayed portion of the tooth. The dental filling can be made of amalgam, gold, porcelain, or composite resin which are safe to be used in the procedure.
- Dental Crowns: When a tooth is severely affected by decay with much of it damaged, a dental crown is a recommended option to save the tooth. The dentist will remove and repair the decayed parts of the tooth and will fit a crown for further protection. Crowns can be created from porcelain fused to metal, porcelain, or gold.
- Root Canal. If the decay has reached the tooth root or pulp and repair can no longer be an option, a root canal therapy will be needed. In this procedure, the dentist will remove the nerves, tissues, and blood vessels as well as the damaged part of the tooth. Space will then be filled with gutta-percha, a rubber-like restorative material.
How do I prevent getting cavities?
Although treatments are available, prevention will always be better than cure. Here are ways to prevent dental caries:
- Practicing proper oral hygiene. Your first line of defense against cavities will still be proper oral hygiene. By brushing, flossing, and rinsing with mouthwash, food particles are washed away, leaving bacteria with no food to feed on.
- Eating the right food. Food is an instrumental part of the process of tooth decay. Make sure to limit, or better yet, remove added sugar on your diet. Instead, eat foods that can stimulate saliva production such as cheese.
- Avail sealants. Dental sealants are helpful in strengthening the teeth and providing another layer of protection.
- Do not share your utensils. Sharing will not always be caring. One of the things you must never share utensils as this can result in the transfer of oral bacteria. Aside from utensils, sharing a toothbrush is also a definite no-no.
- Go to your dental appointment. Save your teeth as soon as possible through a routine dental check. Early signs of a cavity can be checked and treated immediately, saving your teeth from pain, money, and time.
Reviewed by Alan Tom, DDS