TOOTH DECAY

Tooth decay, also called cavities or caries, are permanently damaged areas in the hard surface of your teeth that develop into tiny openings or holes. Tooth decay is caused by a combination of factors, including bacteria in your mouth, frequent snacking, sipping sugary drinks, and not cleaning your teeth well.

Cavities and tooth decay are among the world’s most common health problems. They’re especially common in children, teenagers and older adults. But anyone who has teeth can get cavities, including infants.

If cavities aren’t treated, they get larger and affect deeper layers of your teeth. They can lead to severe toothache, infection and tooth loss. Regular dental visits and good brushing and flossing habits are your best protection against cavities and tooth decay.

The signs and symptoms of cavities vary, depending on their extent and location. When a cavity is just beginning, you may not have any symptoms at all. As the decay gets larger, it may cause signs and symptoms such as:

  • Toothache
  • Tooth sensitivity
  • Mild to sharp pain when eating or drinking something sweet, hot or cold
  • Visible holes or pits in your teeth
  • Brown, black or white staining on any surface of a tooth
  • Pain when you bite down

When to see a dentist

You may not be aware that a cavity is forming. That’s why it’s important to have regular dental checkups and cleanings, even when your mouth feels fine. However, if you experience toothache or mouth pain, see your dentist as soon as possible.

DIAGNOSIS

Your dentist can usually detect tooth decay easily by:

  • Asking about tooth pain and sensitivity
  • Examining your mouth and teeth
  • Probing your teeth with dental instruments to check for soft areas
  • Looking at dental X-rays, which can show the extent of cavities and decay

Your dentist will also be able to tell you which of the three types of cavities you have — smooth surface, pit and fissure, or root.

 

TREATMENTS

Most dentists recommend regular checkups to identify cavities and other dental conditions before they cause troubling symptoms and lead to more-serious problems. The sooner you seek care, the better your chances of reversing the earliest stages of tooth decay and preventing its progression. If a cavity is treated before it starts causing pain, you probably won’t need extensive treatment.

Treatment of cavities depends on how severe they are and your particular situation. Treatment options include:

  • Fluoride treatments. If your cavity is just getting started, a fluoride treatment may help restore your tooth’s enamel. Professional fluoride treatments contain more fluoride than the amount found in tap water, over-the-counter toothpaste and mouth rinses. Fluoride treatments may be liquid, gel, foam or varnish that’s brushed onto your teeth or placed in a small tray that fits over your teeth. Each treatment takes a few minutes.
  • Fillings. Fillings, sometimes called restorations, are the main treatment option when decay has progressed beyond the earliest enamel-erosion stage. Fillings are made of various materials, such as tooth-colored composite resins, porcelain or combinations of several materials. Silver amalgam fillings contain a variety of materials, including small amounts of mercury.
  • Crowns. If you have extensive decay or weakened teeth, you may need a crown — a custom-fitted covering that replaces your tooth’s entire natural crown. Your dentist will drill away all the decayed area and enough of the rest of your tooth to ensure a good fit. Crowns may be made of gold, porcelain, resin, porcelain fused to metal or other materials.
  • Root canals. When decay reaches the inner material of your tooth (pulp), you may need a root canal. This is a treatment to repair and save a badly damaged or infected tooth instead of removing it. The diseased tooth pulp is removed. Medication is sometimes put into the root canal to clear any infection. Then the pulp is replaced with a filling.
  • Tooth extractions. Some teeth become so severely decayed that they can’t be restored and must be removed. Having a tooth pulled can leave a gap that allows your other teeth to shift. If possible, consider getting a bridge or a dental implant to replace the missing tooth.

How to prevent tooth decay

Good oral and dental hygiene can help you avoid cavities and tooth decay. Below are some tips to help prevent cavities. Ask your dentist which tips are best for you.

  • Brush with fluoride toothpaste after eating or drinking. Brush your teeth at least twice a day and ideally after every meal, using fluoride-containing toothpaste. To clean between your teeth, floss or use an interdental cleaner. If you can’t brush after eating, at least try to rinse your mouth with water. If you have a young child, ask the dentist how much fluoride toothpaste to put on your child’s toothbrush so your child gets the cavity-fighting benefits without getting too much fluoride.
  • Rinse your mouth. If your dentist feels you have a high risk of developing cavities, he or she may recommend that you use a mouth rinse with fluoride.
  • Visit your dentist regularly. Get professional teeth cleanings and regular oral exams, which can help prevent problems or spot them early. Your dentist can recommend a schedule that’s best for you.
  • Consider dental sealants. A sealant is a protective plastic coating that’s applied to the chewing surface of back teeth, sealing off the grooves and crannies that tend to collect food. The sealant protects tooth enamel from plaque and acid. Sealants can help both children and adults.The Centers for Disease Control and Prevention recommends sealants for all school-age children. Sealants last up to 10 years before they need to be replaced, though they need to be checked regularly to ensure they’re still intact.
  • Drink some tap water. Most public water supplies have added fluoride, which has helped decrease tooth decay significantly. If you drink only bottled water that doesn’t contain fluoride, you’ll miss out on fluoride benefits.
  • Avoid frequent snacking and sipping. Whenever you eat or drink beverages other than water, you help your mouth bacteria create acids that can destroy your tooth enamel. If you snack or drink throughout the day, your teeth are under constant attack.
  • Eat tooth-healthy foods. Some foods and beverages are better for your teeth than others. Avoid foods that get stuck in grooves and pits of your teeth for long periods, such as chips, candy or cookies, or brush soon after eating them. However, foods such as fresh fruits and vegetables increase saliva flow, and unsweetened coffee, tea and sugar-free gum help wash away food particles.
  • Consider fluoride treatments. Your dentist may recommend periodic fluoride treatments, especially if you aren’t getting enough fluoride through fluoridated drinking water and other sources.
  • Ask about antibacterial treatments. If you’re especially vulnerable to tooth decay — for example, because of a medical condition — your dentist may recommend special antibacterial mouth rinses or other treatments to help cut down on harmful bacteria in your mouth.

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