Dental decay happens when the enamel and dentine of a tooth become softened by acid attack, producing a cavity (hole).
Dental decay is caused by plaque acids that gradually dissolve away the enamel and dentine of the tooth to produce a cavity. Dental decay is the same as tooth decay and is also known as ‘dental caries’. Decay damages your teeth and may lead to the tooth needing to be filled or even extracted.
Enamel is the hard protective outer coating of the tooth and is the hardest part of the body. It does not contain any nerves or blood vessels and is not sensitive to pain.
Dentine lies under the enamel, forming most of the tooth and can be very sensitive to pain. Dentine covers the central pulp of the tooth.
The pulp is a soft tissue which contains blood vessels and nerves and is in the middle of the tooth.
Decay happens when sugars in food and drinks react with the bacteria in plaque, forming acids. Every time you eat or drink anything containing sugars, the bacteria reacts with it to form acid. These acids attack the teeth and start to dissolve the enamel. The attacks can last for an hour after eating or drinking, before the natural salts in your saliva cause the enamel to ‘remineralise’ and harden again. It’s not just sugars that are harmful: other types of carbohydrate foods and drinks react with plaque and form acid. (These are the ‘fermentable’ carbohydrates such as the ‘hidden sugars’ that can be added to processed food, natural sugars like those found in fruit, and cooked starches.) Snacking on sugary or acidic foods and drinks can increase the risk of decay, as the teeth come under constant attack and do not have time to recover. It is therefore important not to keep snacking on sugary foods or sipping sugary drinks throughout the day.
In the early stages of dental decay there are no symptoms, but your dentist may be able to spot an early cavity when they examine or x-ray your teeth. This is why you should visit your dentist regularly, as small cavities are much easier to treat than advanced decay
Once the cavity has reached the dentine your tooth may become sensitive, particularly with sweet foods and drinks, and acidic or hot foods. As the decay gets near the dental pulp you may suffer from toothache. If the toothache is brought on by hot or sweet foods this may last for only a few seconds. As the decay gets closer to the dental pulp the pain may last longer and you may need to take painkillers – paracetamol or ibuprofen – to control the pain. You must visit your dentist immediately as the tooth is dying and you may develop a dental abscess if it is not treated.
Toothache is a sign that you should visit a dentist immediately, as it is a warning that something is wrong. If you don’t do anything, this will usually make matters worse, and you may lose a tooth that could otherwise have been saved.
The biting surfaces of the teeth and the surfaces between the teeth are most likely to decay, as food and plaque can become stuck in these areas.
If the decay is not too serious, the dentist will remove all the decay and restore the tooth with a filling. Sometimes the nerve in the middle of the tooth can be damaged. If so the dentist will need to carry out root canal treatment by removing the nerve and then restoring the tooth with a filling or a crown. If the tooth is so badly decayed that it cannot be restored, the only option may be to extract the tooth.
No. In the very early stages of decay, your dentist may apply a fluoride varnish onto the area. This can help stop further decay and help ‘remineralise’ the tooth. However, it is important to continue with a good oral hygiene routine, using fluoride toothpaste to prevent further decay developing
The best way to prevent dental decay is by brushing your teeth thoroughly twice a day with fluoride toothpaste, making sure that you brush the inner, outer and biting surfaces of your teeth. Using dental floss, or interdental brushes also helps remove plaque and food from between your teeth and gumline. These are areas a toothbrush can’t reach.
Visit your dentist regularly, as often as they recommend, and have sugary and acidic food and drinks less often. Avoid snacking between meals as this limits the times your teeth are under attack from acids. Chewing sugar-free gum for ten minutes after a meal can help your mouth produce more saliva, which helps to neutralise any acids which have been formed.
Dr. Kamlesh Kothari is one of India's topmost Oral, Maxillofacial surgeon and Dental Implantologist...
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