Tooth decay or dental caries is the most common disease throughout the world. It is a progressive disease of the hard dental tissue caused by bacteria. Bacterial infection progresses and damages the hard tooth structure (enamel, dentin, cementum) until they break down producing cavities known as dental caries. There are different factors that cause tooth decay and they should be present on the same time to create the tooth cavity.
These factors include:
- Individual predisposition
- Carbohydrates (sugar )
The most important bacteria that are present on a tooth cavity are Streptococcus mutans and Lactobacillus. They feed on carbohydrates stuck on the tooth occlusive surface producing acids like lactic acid that reduces oral pH causing demineralization of the hard dental tissue which leads to tooth cavity (caries).
Individual predisposition means that a person can have particular tooth anatomy like deep pits and fissures of the tooth that cause accumulation of dental plaque therefore bacteria or a tooth disorder like Amelogenesis imperfecta where enamel isn’t normally form and makes the tooth more vulnerable to decay. Also a person with a systemic disorder that can cause lower quantity of saliva can have a bigger predisposition of tooth decay.
Carbohydrate types are a very important factor of decay, not all of them can be fermented by oral bacteria. However the remineralization can occur if acid is neutralized by saliva or mouthwash. The preferred carbohydrates by oral bacteria are glucose, fructose and the most commonly sucrose (table sugar). A diet with low quantity of sucrose can prevent cavity forming.
The time that teeth are exposed to acid environment affects caries development. The caries process begins within days but a cavity can’t form over night. It needs time for the bacteria to colonize and to knock down organism defenses.
The caries process form a cavity that exposes dentinal tubules or pulp tissue of the tooth causing toothache that can have different range of values from 1 to 10 depending on cavity depth.
If the cavity is found only on enamel there is an exposure of dentinal tubules that causes hypersensibility so the toothache is felt when the person uses cold drinks or foods and after their uses the ache stops immediately.
If the cavity is found on half of the dentine tissue, toothache persists for a moment even after the usage of cold foods or drinks but it is a bearable pain.
At last if the cavity penetrates all the way throw the dentine then the pulp tissue of the tooth is exposed on the oral environment and bacteria and the pain can be severe causing dental emergences. If left untreated happens the necrosis of the pulp which leads to the formation of a granuloma or tooth abscess.
Big cavities can also lead to irrecoverable fractures of the tooth loosing it.
The treatment of the caries process depends on the gravity of the situation. If it is in the first steps the usage of fluoride toothpaste can remineralize dental tissue or if the cavity is formed professional help by a dentist is needed. About this topic we will talk on other articles.
Preventive measures for tooth decay are: good oral hygiene and dietary modification. Brushing your teeth after each meal is indispensable also not eating foods that contain carbohydrate all day long can prevent caries formation. You need to avoid sticky food (candy), frequent snacks. Chewing gums also increase salivary formation which reduces acid pH preventing demineralization and causing remineralization of the hard tooth tissue.