Tooth Decay and How To Avoid It
Tooth decay is damage to a tooth caused by dental plaque turning sugars into acid. Cavities are permanently damaged areas in the hard surface (enamel) of your teeth, that develop into tiny openings or holes. Tooth decay is one of the world’s most common health problems, being especially common in children, teenagers, and the elderly.
In the mouth there are both “good” and “bad” bacteria present. The good bacteria help to keep the bad bacteria in check by helping to keep gums and teeth healthy and maintaining good breath.
Tooth decay
Tooth decay is caused by a variety of factors, including harmful bacteria present in the mouth, snacking, sugary drinks, and substandard teeth cleaning.
Each day, millions of bacteria create a thin layer over your teeth called ‘dental plaque’. This plaque is a soft, sticky film that builds up on your teeth. The bacteria in the plaque causes tooth decay and gum disease if they are not removed regularly through brushing and flossing. For example, when you drink a sugary drink, the bacteria in the plaque convert the carbohydrates in the sugar into the energy they need, whilst at the same time producing a harmful acid. This acid then begins to break down the surface of the tooth (the enamel), resulting in holes called cavities. If untreated, these cavities will erode deeper into the dentine layer of the tooth. The dentine is softer than the enamel, so tooth decay will speed up if it reaches here. Without treatment at this stage, tooth decay will continue, and bacteria will enter the pulp (the soft centre of the tooth that contains nerves and blood vessels). The pulp becomes swollen and irritated from the bacteria. Because there is no place for the swelling to expand inside a tooth, the nerve becomes pressed, causing pain.
Cavities
Cavities in themselves are so common that some people may not take them seriously. However, severe complications can develop from untreated cavities:
- Damaged or broken teeth
- Chewing problems
- Pain that interferes with daily living
- Tooth loss (affects appearance and self-confidence)
- In rare cases, a tooth abscess (a pocket of pus caused by the tooth
decay bacteria) may develop.
In most mild cases of tooth decay there may be no recognisable symptoms. However, if you have dental cavities, you may notice the following symptoms:
- Toothache
- Tooth sensitivity (tenderness when eating or drinking something hot or cold)
- Dark spots appearing on your teeth
- Bad breath
If you notice any of these symptoms, you should try and see a dentist as soon as possible. Treating tooth decay in early stages is much cheaper and simpler. When you go to your dentist with suspected tooth decay, they can usually identify the location of the decay with a simple examination or X-ray. If you have regular dental check-ups, any tooth decay can be spotted early and treated so as to avoid further complications. Within the UK, the NHS recommends adults should have a check-up at least once every 2 years, and under 18s should have a check-up once a year.
If caught soon enough, early-stage tooth decay can be reversed without the need for treatment by:
- Cutting down on how much sugary foods and drinks you consume.
- Brushing teeth at least twice daily with fluoride toothpaste. Fluoride helps to protect teeth by strengthening the enamel, making the teeth more resistant to the acids produced by the bacteria in plaque.
However, if tooth decay is more advanced it can cause a hole in the tooth. This needs treatment by a dentist, which may involve one or more of the following:
- A filling or crown. This involves removing the decay from the tooth, and then filling the hole with dental amalgam (most common) which is silver coloured, or composite which is tooth coloured.
- A root canal. This is used when there is tooth decay to the centre of the tooth (pulp) where blood vessels and nerves could be affected.
- Removing all or part of the tooth. This is used when the tooth is too badly damaged to be restored with other treatment. Your dentist may then be able to replace the tooth with a denture, bridge or implant.
Unfortunately, there are certain risk factors which may predispose you to an increased risk of developing tooth decay:
Location of the tooth
Decay is more likely in the back teeth as they have lots of grooves and multiple roots which can collect particles. This makes them harder to clean, making it harder to brush away bacteria.
Certain food and drinks cling to your teeth for long periods of time.
This includes milk, ice cream, honey and sugar. If saliva does not wash away these culprits, bacteria can quickly build up.
Inadequate brushing
If you do not clean your teeth after eating or drinking, plaque forms quickly and the initial stages of decay can occur. Also, not getting enough fluoride through brushing, mouthwash, or drinking water can leave your teeth less able to protect against bacteria.
Dry mouth
This can be due to a lack of saliva, which can be caused by some medications and medical conditions. Saliva helps prevent tooth decay by washing away food from the teeth.
Heartburn
This causes stomach acid to flow into the mouth, wearing down the enamel which protects the tooth, resulting in significant damage to the tooth.
Bedtime infant feeding
The milk in the formula can remain on the baby’s teeth for hours after feeding into the night. This can cause “baby bottle tooth decay”. A similar phenomenon occurs when toddlers are given a bottle to sip from for an extended period of time.
Good oral and dental hygiene is the best way to avoid tooth decay. In order to decrease your risk of tooth decay, you should:
- Brush with fluoride toothpaste after eating and drinking. In addition, floss can be used to clean between the teeth.
- Use a mouthwash. Fluoride mouthwash can help reduce the risk of tooth decay by removing bacteria missed when brushing.
- Visit the dentist regularly. They can assess your teeth thoroughly, and identify any tooth decay before it develops into a serious problem.
- Visit the dental hygienist regularly. They can provide a level of cleaning that you alone with a brush cannot achieve. This will involve cleaning away plaque that is not possible to do at home, or that you may have missed with your regular brushing and flossing.
- Drinking tap water. Public water supplies (in the UK at least) have added fluoride which helps to protect your teeth. Bottled water does not contain fluoride, so bear this in mind if you are solely drinking bottled water.
- Avoid frequent snacking and sipping of drinks (except water). Whenever you drink beverages other than water, or eat any food, the bacteria in your mouth produce acids as a by-product of their own digestion of carbohydrates. Unfortunately, these also break down tooth enamel. If you are snacking throughout the day, the bacteria are constantly producing acid.
- Eat foods that promote good oral hygiene. Fresh fruit and vegetables increase saliva flow. Water and sugar-free chewing gum help to wash away food particles from the teeth.
Instilling a good oral hygiene routine in children is key to preventing tooth decay at a young age. This involves teaching them to brush their teeth twice daily, and limiting sugary snacks and drinks. Regular visits to the dentist are key to spotting any tooth decay early and getting professional dental advice. Younger children should use children’s toothpaste as it is tailored for developing teeth.
