Dental Caries

Dental caries (also called tooth decay) is the most common oral disease. It can occur at any age, but is more common in children and young adults.

HOW DENTAL CARIES DEVELOPS

The process of decay begins when bacteria and foods (particularly sugars and starches) combine in your mouth to produce plaque. Plaque is a substance that sticks to the hard, outer surface of a tooth (enamel). The bacteria in plaque produce acids that attack enamel. These acids may also attack the root surface of a tooth (cementum) if it is exposed. Repeated attacks dissolve these surfaces and create holes in the tooth (cavities). If left untreated, the acids destroy the other layers of the tooth.

RISK FACTORS

  • Frequent sipping of sugary beverages.  

  • Frequent snacking on sugary and starchy foods, especially those that easily get stuck in the teeth.  

  • Poor oral hygiene.  

  • Dry mouth.  

  • Substance abuse such as methamphetamine abuse.  

  • Broken or poor-fitting dental restorations.  

  • Eating disorders.  

  • Gastroesophageal reflux disease (GERD).  

  • Certain radiation treatments to the head and neck.

SYMPTOMS

In the early stages of dental caries, symptoms are seldom present. Sometimes white, chalky areas may be seen on the enamel or other tooth layers. In later stages, symptoms may include:

  • Pits and holes on the enamel.

  • Toothache after sweet, hot, or cold foods or drinks are consumed.

  • Pain around the tooth.

  • Swelling around the tooth.

DIAGNOSIS

Most of the time, dental caries is detected during a regular dental checkup. A diagnosis is made after a thorough medical and dental history is taken and the surfaces of your teeth are checked for signs of dental caries. Sometimes special instruments, such as lasers, are used to check for dental caries. Dental X-ray exams may be taken so that areas not visible to the eye (such as between the contact areas of the teeth) can be checked for cavities.

TREATMENT

If dental caries is in its early stages, it may be reversed with a fluoride treatment or an application of a remineralizing agent at the dental office. Thorough brushing and flossing at home is needed to aid these treatments. If it is in its later stages, treatment depends on the location and extent of tooth destruction:

  • If a small area of the tooth has been destroyed, the destroyed area will be removed and cavities will be filled with a material such as gold, silver amalgam, or composite resin.  

  • If a large area of the tooth has been destroyed, the destroyed area will be removed and a cap (crown) will be fitted over the remaining tooth structure.  

  • If the center part of the tooth (pulp) is affected, a procedure called a root canal will be needed before a filling or crown can be placed.  

  • If most of the tooth has been destroyed, the tooth may need to be pulled (extracted).

HOME CARE INSTRUCTIONS

You can prevent, stop, or reverse dental caries at home by practicing good oral hygiene. Good oral hygiene includes:

  • Thoroughly cleaning your teeth at least twice a day with a toothbrush and dental floss.  

  • Using a fluoride toothpaste. A fluoride mouth rinse may also be used if recommended by your dentist or health care provider.  

  • Restricting the amount of sugary and starchy foods and sugary liquids you consume.  

  • Avoiding frequent snacking on these foods and sipping of these liquids.  

  • Keeping regular visits with a dentist for checkups and cleanings.

PREVENTION

  • Practice good oral hygiene.

  • Consider a dental sealant. A dental sealant is a coating material that is applied by your dentist to the pits and grooves of teeth. The sealant prevents food from being trapped in them. It may protect the teeth for several years.

  • Ask about fluoride supplements if you live in a community without fluorinated water or with water that has a low fluoride content. Use fluoride supplements as directed by your dentist or health care provider.

  • Allow fluoride varnish applications to teeth if directed by your dentist or health care provider.