Overview
The bacteria in your mouth, frequent snacking, sipping sugary drinks, and poor teeth cleaning cause cavities, which are permanently damaged areas on the hard surface of your teeth that develop tiny openings or holes. Cavities are also known as tooth decay or caries.
Cavities and tooth decay affect people of all ages, including children, teenagers, and older adults, making them common health problems globally. Infants are not exempt.
If people do not treat cavities, the cavities will expand and affect deeper layers of the teeth, resulting in severe toothache, infection, and ultimately tooth loss. Maintaining good brushing and flossing habits and visiting a dentist regularly are crucial to safeguard against cavities and tooth decay.
Symptoms
The decay can cause the following signs and symptoms, which vary depending on the extent and location of the cavities, even though initially there may be no symptoms at all.
• Spontaneous pain or pain without any apparent cause in the affected tooth
• Tooth sensitivity
• Pain ranging from mild to sharp when consuming sweet, hot, or cold foods and beverages
• Visible holes or pits in the teeth
• Discoloration in the form of brown, black, or white stains on any tooth surface
• Pain when biting down.
when should I visit the dentist
It is important to have regular dental checkups and cleanings, even if you feel fine, because a cavity may be forming without your knowledge. If you experience a toothache or mouth pain, you should visit your dentist as soon as possible.
Causes
Tooth decay causes cavities over time. The process of tooth decay develops in the following way:
• Eating a lot of sugars and starches and not cleaning your teeth well leads to the formation of dental plaque, which is a clear sticky film that coats your teeth.
• Bacteria feed on the sugars and starches in plaque, causing it to harden into tartar. Tartar creates a shield for bacteria and makes plaque more difficult to remove.
• The acids in plaque attack the hard outer enamel of your teeth, causing tiny openings or holes, which is the first stage of cavities.
• Bacteria and acid continue to wear away the enamel, reaching the softer dentin layer, which is less resistant to acid and has tiny tubes that communicate with the tooth nerve, causing sensitivity.
• The bacteria and acid eventually reach the inner tooth material (pulp) that contains nerves and blood vessels, causing swelling and irritation. The nerve becomes pressed, causing pain. Discomfort can even extend outside of the tooth root to the bone.
Risk elements
The following factors can increase the risk of getting cavities, although everyone with teeth is at risk:
• Tooth location. Your back teeth (molars and premolars), which have lots of grooves, pits, and crannies, and multiple roots that can collect food particles, are more susceptible to decay than your smoother, easy-to-reach front teeth, making them harder to keep clean.
• Certain foods and drinks. Foods that cling to your teeth for a long time, such as milk, ice cream, honey, sugar, soda, dried fruit, cake, cookies, hard candy and mints, dry cereal, and chips, are more likely to cause decay than foods that are easily washed away by saliva.
• Frequent snacking or sipping. Steadily snacking or sipping sugary drinks provides mouth bacteria with more fuel to produce acids that attack your teeth and wear them down. Additionally, sipping soda or other acidic drinks throughout the day creates a continual acid bath over your teeth.
• Bedtime infant feeding. Giving babies bedtime bottles filled with milk, formula, juice, or other sugar-containing liquids feeds decay-causing bacteria, as these beverages remain on their teeth for hours while they sleep. This damage is often referred to as baby bottle tooth decay, and similar damage can occur when toddlers wander around drinking from a sippy cup filled with these beverages.
• Inadequate brushing. Plaque forms quickly if you don’t clean your teeth soon after eating and drinking, and the first stages of decay can begin.
• Many public water supplies add fluoride, a naturally occurring mineral that helps prevent cavities and can even reverse the earliest stages of tooth damage, due to its benefits for teeth. Toothpaste and mouth rinses also commonly contain fluoride, but bottled water usually lacks fluoride, leading to insufficient consumption of the mineral.
• In the United States, cavities are common in very young children and teenagers, and older adults are also at higher risk. Teeth can wear down over time, and gums may recede, making teeth more vulnerable to root decay. Additionally, older adults may use more medications that reduce saliva flow, which increases the risk of tooth decay.
• Dry mouth. A lack of saliva, which helps prevent tooth decay by washing away food and plaque from your teeth and countering the acid produced by bacteria, causes dry mouth. Certain medications, medical conditions, radiation to your head or neck, or certain chemotherapy drugs can increase your risk of cavities by reducing saliva production.
• Worn fillings or dental devices. Dental fillings can weaken, begin to break down or develop rough edges over the years, allowing plaque to build up more easily and making it harder to remove. Dental devices can also stop fitting well, allowing decay to begin underneath them.
• Heartburn. Stomach acid from heartburn or gastroesophageal reflux disease (GERD) can flow into your mouth (reflux), wearing away the enamel of your teeth and causing significant tooth damage. This exposes more of the dentin to attack by bacteria, creating tooth decay. Your dentist may recommend that you consult your doctor to see if gastric reflux is the cause of your enamel loss.
• Eating disorders. Anorexia and bulimia can lead to significant tooth erosion and cavities. Repeated vomiting (purging) washes stomach acid over the teeth and begins dissolving the enamel, while eating disorders can also interfere with saliva production.
Complications
You may not take cavities and tooth decay seriously, as they are so common. It may also seem unimportant if children get cavities in their baby teeth. However, cavities and tooth decay can cause serious and lasting complications, even for children who haven’t yet got their permanent teeth.
Complications of cavities can include:
• Pain
• Tooth abscess
• Swelling or pus around a tooth
• Damaged or broken teeth
• Chewing problems
• Positioning shifts of teeth after tooth loss
When decay and cavities are extensive, they can lead to:
• Pain that interferes with daily living
• Weight loss or nutrition problems from painful or difficult eating or chewing
• Tooth loss, which can affect your appearance, as well as your confidence and self-esteem
• In rare cases, bacterial infection can cause a tooth abscess, which can lead to more serious or even life-threatening infections.
Prevention
• Here are some tips to prevent cavities and tooth decay:
• Brush your teeth at least twice a day and ideally after every meal, using fluoride-containing toothpaste. Clean between your teeth using floss or an interdental cleaner.
• Use a mouth rinse with fluoride if your dentist thinks you have a high risk of developing cavities.
• Get regular teeth cleanings and oral exams from your dentist to prevent problems or detect them early.
• Consider getting dental sealants to protect your teeth from plaque and acid. The Centers for Disease Control and Prevention (CDC) recommends sealants for all school-age children.
• Drink tap water as it contains fluoride that can significantly reduce tooth decay.
• Avoid frequent snacking and sipping on beverages other than water, as it can create acids that destroy tooth enamel.
• Eat tooth-healthy foods such as fresh fruits and vegetables that increase saliva flow and avoid foods that get stuck in your teeth for long periods.
• Consider periodic fluoride treatments and custom trays for application of prescription fluoride to prevent tooth decay.
• Ask your dentist about special antibacterial mouth rinses or other treatments to reduce harmful bacteria in your mouth.
• Chew xylitol-based gum along with prescription fluoride and an antibacterial rinse to reduce the risk of cavities. Remember to ask your dentist which tips are best for you.
Teeth deterioration in stages
Bacteria, food particles, and saliva combine to form a colorless and sticky film called dental plaque, which covers the surfaces of your teeth. If you do not clean your teeth regularly, plaque buildup can occur and harden over time, resulting in the formation of tartar. Tartar, in turn, is formed and provides additional protection to the bacteria, making it harder to remove.
Tooth decay generally progresses through five stages, which we will examine in more detail below.
Stage 1: Initial demineralization
Plaque bacteria produce acids that cause the enamel, which is the hardest tissue in your body and mostly composed of minerals, to lose its minerals. As a result of this mineral loss, a white spot may appear on one of your teeth, which is an initial sign of tooth decay.
Stage 2: Enamel decay
If you allow the process of tooth decay to continue, it will further break down the enamel, and you may observe that a white spot on your tooth changes to a brownish color. The weakened enamel will cause your teeth to develop small holes known as cavities or dental caries, which your dentist will need to fill.
Stage 3: Dentin decay
The dentin lies under the enamel and is softer than enamel, making it more sensitive to damage from acid, which causes tooth decay to proceed at a faster rate when it reaches the dentin. The dentin also contains tubes that lead to the nerves of the tooth, causing sensitivity when affected by tooth decay. This sensitivity is particularly noticeable when consuming hot or cold foods or drinks.
Stage 4: Pulp damage
The innermost layer of your tooth is called the pulp, which contains the nerves and blood vessels that help keep the tooth healthy and provide sensation to it. When the pulp is damaged, it may become irritated and start swelling, causing pressure to be placed on the nerves as the surrounding tissues cannot expand to accommodate the swelling. This pressure can result in pain
Stage 5: Abscess
Bacteria can invade and cause an infection as tooth decay advances into the pulp. An abscess, a pocket of pus, can form at the bottom of your tooth due to increased inflammation in the tooth. Severe pain that may radiate into the jaw, swelling of the gums, face or jaw, fever, and swollen lymph nodes in your neck are some symptoms that may be present.
Prompt treatment is necessary for a tooth abscess because the infection can spread into the bones of your jaw and other areas of your head and neck. In some cases, removing the affected tooth may be necessary
Children with decayed teeth
The Centers for Disease Control and Prevention (CDC) state that tooth decay can affect children as well and they consider it one of the most prevalent chronic childhood conditions in the United States. Children may be more vulnerable to tooth decay compared to adults due to the thinner and more sensitive enamel on their baby teeth. Bacteria break down sugars into acids, which can damage tooth tissues and cause tooth decay in both children and adults. Thus, it is vital to make sure that children do not consume excessive amounts of sugary foods or drinks, and that they brush their teeth regularly.
Keeping baby teeth healthy is essential, even though they will eventually fall out. Baby teeth are necessary for children to chew and speak properly, and they also serve as placeholders for adult teeth. If decay causes the loss of baby teeth prematurely, adult teeth may not grow in correctly