General Dental Informtion

Tooth Decay

tooth decay

Tooth decay, gingivitis, and food getting stuck in teeth are among the factors that cause severe toothache. Gingival recession and the root’s exposure to cold and hot food can also lead to symptoms such as hypersensitivity and pain and discomfort.
The teeth become hypersensitive to cold and heat after decay. These symptoms exacerbate the inflammation inside the mouth and tooth nerve damage, in which case the tooth requires a root canal.

Individuals experience symptoms such as sensitivity to sweets and cold and heat before suffering from severe toothache, and should visit a dentist after observing such symptoms.

Many patients suffering from toothache take sedatives and don’t follow up on toothache afterwards. Reduced toothache is not due to recovery, but the infection of tissue, blood vessels, and tooth nerves.

There is no scientific reason for increasing toothache during the night, and the person waking up in the night due to toothache could need root canal treatment.

Teeth are known to be among the most important organs in the digestive system, and improper food mastication could lead to problems with digestion.

There are many foods that contribute to tooth decay, such as sweets, snacks like cheese puffs, ice cream, cigarettes, tea, coffee, and others.

Microbes should have access to sugar to produce the structure destructive minerals or acids for tooth decay. Tooth decay is the destruction of the tooth’s hard tissue. A disease caused by microbial activities is an infectious disease, and if it can be transferred from one place to another, it is transmissible disease. The definition of tooth decay indicates that decay can be contagious from one tooth to others.

tooth decay

Common Places for Tooth Decay

Not all teeth decay equally. Due to their particular conditions, some teeth are more susceptible to decay. These surfaces include:
The occlusal surface grooves: The occlusal surfaces of molar teeth are narrow and deep and provide a suitable living environment for microbes to grow and cause tooth decay.

This is especially more common in molar teeth, and causes early decay.
Interdental surfaces: This area cannot be cleaned since toothbrushes cannot penetrate it, so it is susceptible to decay and periodontal disease.
The dental cervical line or the connection between the gum and the tooth: Microbial accumulation in this area also causes gum disease.

tooth decay place

Tooth decay symptoms

Tooth decay could be accompanied with one of the following symptoms:
The tooth enamel color changes to brown or black at the decaying spot.
Tooth perforation at the decaying spot. The damage is often low and can only be identified with accurate examination. Sometimes a large portion of the tooth is destroyed, leading the person to believe that the tooth is chipped.

Dental sensitivity or pain while consuming cold, hot, sour and sweet foods, or toothache when the teeth are pressed against each other.
Bad mouth odor can have many reasons, one of which is tooth decay.
Food getting stuck and the tearing of floss between the teeth can also get food stuck.

How and Why do Teeth Decay?

In order to prevent any disease, its causes should be known. Regarding tooth decay and its prevention, it is first necessary to know the factors that cause it. Many people who visit dentists mention heritage and teeth quality when asked why their teeth are damaged. Teeth quality obviously affects their durability, but other factors are also involved.
There are various causes for tooth decay, but four main factors contribute to tooth decay in general, namely microbes, sugar, the resistance of the tooth and the person, and time.
These four factors always cause tooth decay, and if one of them is non-existent, the tooth won’t decay. Tooth decay doesn’t occur without microbes. The decay will not have the same severity if there are microbes but no sugar. The existence of microbes and sugars in people who have a natural resistance against diseases cannot create tooth decay. Finally, microbes, sugars, and the person’s and tooth’s lack of resistance do not cause spontaneous tooth decay. It takes a lot of time for these factors to destroy the tooth’s enamel.

The Destructive Effects of Oral Microbial Plaque

Plaque forming on the teeth change their natural and clear color.
Plaque causes tooth decay.
Plaque causes gingival and other diseases for mouth protecting tissues.
Plaque turns into a hard germ around the tooth.


The Microbes that Cause Tooth Decay

There are various types of natural microbes in every person’s mouth, but not all oral microbes cause tooth decay. If the mouth isn’t cleaned, microbes form a layer over the teeth called microbial plaque. The microbial plaque is a soft and thick layer that consists of a lot of different bacteria and cells, adheres to the tooth, and cannot be easily cleaned with water. As times passes, various types of microbes enter the microbial plaque and make it more pathogenic.
It’s worth mentioning that the microbial plaque is different from the white sediment that sits visibly on the tooth. These white sediments can be easily cleaned with water, whereas the microbial plaque is invisible and colorless. Microbial plaque is visible when it’s colored with specialized coloring materials. Microbial plaque revealing colored tablets are used to reveal microbial plaque. In order to remove microbial plaque, the teeth should be brushed carefully and patiently.

The Time and Pace of Tooth Decay

Tooth decays don’t form spontaneously. It takes time for the enamel to dissolve and for the soft enamel tissue to be destroyed. Research indicates that it takes 2 to 5 minutes after eating food for sugar to be delivered to microbial plaques to produce acid. The acid level reaches its maximum in 10 minutes, remains the same from 20 to 60 minutes, and then gradually returns to its normal state. After each meal, the microbial plaque environment becomes acidic and before this environment returns to the normal state, the oral environment becomes acidic again after another meal, creating tooth decay. If a child consumes sugary drinks 9 times a day, smudges will appear on their teeth after a while, indicating the incidence of decay.
Tooth decay occurs mostly in teenagers, meaning that the teeth immediately become more damaged after eruption. In older people, they have been inside the mouth for some time. This adds to the importance of protecting and caring about teeth at these ages.

Personal and Dental Resistance

A collection of defensive factors inside every person’s mouth resist tooth decay. The condition of mouth saliva and its cells, tooth shape, form, placement, and quality, and so on affect tooth decay to a certain extent. Furthermore, some people are more resilient to teeth-destructive factors. Personal resistance can be hereditary, congenital, or acquisitive. Resistance can also be permanent and temporary. Regardless, according to researchers, microbes and sugars are the two most important factors causing tooth decay. There are, however, ways to strengthen the dental structure. One is to deliver fluoride to the teeth, which increases their resistance against tooth decay.

Since infants use breast or glass milk, infant tooth decay occurs between 2 to 4 years of age. In order to prevent infant tooth decay, the infant’s teeth should be cleaned after feeding milk.

Infant tooth decay is a common phenomenon that occur in most infants and is caused by the continuous use of breast or glass milk. Furthermore, infants also consume milk multiple times during the night when it is not possible to clean their teeth. Saliva is also lower during the night, which results in infant tooth decay.

Tooth decay and cavity types

Cavities are decaying parts of the tooth that have a small openings or orifice. As shown in the following figure, there are three types of cavities or decays. Smooth surface cavities occur in the two plain sides of teeth, while root cavities develop around roots. Pit and fissure cavities occur on your tooth’s occlusal surfaces. Failure to clean your teeth and repeatedly eating snacks and drinking sugary drinks are factors that cause cavities.

Many patients state that they brush and floss their teeth regularly but still suffer from tooth decay, why?

Tooth decay is perhaps caused by the person always brushing but also chewing gum and having sugar inside their mouth permanently, or perhaps consuming carbonated drinks (containing sugar and acid), and constantly eating candy, juice, and all things containing sugar. When drinking carbonated drinks, if the “straw” is placed between the teeth, the tooth decay increases significantly since the carbonated drink is continuously between your teeth. It’d better to put the straw inside the mouth.

When to Visit the Dentist

You may not be aware of cavities forming in your teeth, which is why it’s important to have regular dental examinations and clean your teeth even when you think they are in good health. Nevertheless, visit your doctor as soon as you start to have toothache.

Prevention, the Best Way to Treat Tooth Decay

Dental and oral hygiene can prevent cavities and decay. Several tooth cavity prevention guidelines are presented as follows. Ask your dentist which of the following methods is suitable for you:

  1. Brush your teeth with a fluoride toothpaste after eating and drinking. Brush your teeth at least twice a day and ideally after every meal. Use a floss or an interdental cleaner to clean the area between your teeth. If you cannot brush your teeth, at least rinse your mouth after every meal. If you have an underage child, ask your dentist about the amount of fluoride toothpaste so that your children combat tooth decay without getting superfluous fluoride.

prevent tooth decay

  1. Rinse your mouth. If your dentist thinks that there is risk of an advancing cavity, they may recommend you to use a fluoride mouthwash.
  2. Have regular dental examinations. Regular professional dental cleaning and oral tests can help prevent problems at the outset. Your dentist can recommend a plan with a suitable solution for you.
  3. Use dental sealants. Sealants are protective plastic covers that connect to the occlusal surfaces of posterior teeth and seal the gaps between them. They protect the tooth enamel from plaque and acid and can be used in adults as well as children. They are recommended for control and prevention in all school-age children. They don’t need replacement for up to 10 years and only need checkups to make sure they are in the correct position.
  4. Drinking certain types of water Most public water supplies contain fluoride, which significantly prevent tooth decay. If you only drink bottled water without fluoride, you will not take advantage of fluoride.
  5. Don’t repeatedly consume snacks and drinks. Each time you eat or drink something other than water, you help the bacteria to produce acid and destroy your dental enamel. By having snacks and drinks during the day, you expose your teeth to constant attacks.
  6. Eat healthy food for your teeth. Some foods and drinks are better for your teeth than others. Avoid eating foods that get stuck between your teeth, such as chips, candy, or cookies. Foods such as fresh fruits, vegetables, non-sugary coffee, tea and chewing gum increase saliva and help clean the teeth.
  7. Consider treating tooth decay with fluoride. Your dentist may propose you a period of tooth decay treatment with fluoride, especially if you don’t receive the necessary fluoride through water and other resources.
  8. Ask about anti-bacterial tooth decay treatment If you are prone to tooth decay, for example due to special medical conditions, your dentist may wash your mouth with a specific anti-bacterial substance or use other treatments to reduce the harmful bacteria in your mouth.

Treating tooth decay

Cavities are permanently damaged areas that are created on your dental enamel and create a small opening or orifice on your teeth. Cavities are also called a tooth decay or caries and are caused by a combination of various factors. Causes of tooth decay include: The bacteria inside the mouth, repeatedly having snacks and sugary drinks, and not carefully cleaning the teeth

Dental cavity and decay are among the world’s common health problems. They are common in children, teenagers, and especially adults. Whoever suffers from toothache could have dental cavities, including infants.

Cavities grow if left untreated, affecting deeper dental layers, and can lead to severe pain, infection, and tooth loss. Regularly examining teeth and carefully brushing and flossing the teeth are the best ways to confront cavities and tooth decay.

What causes early tooth decay in children?

Contrary to what many parents think, iron drops have no effect on creating such decays and only change the color of decaying teeth. The most important causes for tooth decay are as follows:

  • The failure of parents to clean their children’s mouth since the eruption of the first milk teeth.
  • An unsuitable nutritional plan, including:
    Using glasses containing milk or other sugary drinks as pacifiers to calm children and put them to sleep
    B. Repeatedly drinking milk from glass during the night to the child’s desire
  • Reduced saliva generation during sleep
  • Multiple untreated tooth decay in the mouths of the child’s parents
  • The parents’ failure to visit the dentist to examine the child, obtain correct information, and take preventative actions starting with the eruption of the first milk tooth
  • The child repeatedly consuming tooth decaying snacks during the day
    These factors create a suitable condition in the child’s mouth for microbial activity, which causes tooth decay through producing certain acids.

Frequently asked questions about tooth decay

1-How is tooth decay diagnosed?

Tooth decay is usually distinguished by blackening of the teeth. Final diagnosis is possible with regular dental checkups. Symptoms of more advanced decays may involve sensitivity, pain caused by hot, cold or sweet foods and drinks, toothache without any specific reason, and pain when eating food.

2-Is it possible for a tooth decay to be cured naturally?

Tooth decays can be stopped or eliminated during the early stages. Enamel can repair itself using minerals from saliva and fluoride from toothpaste or other sources. But if the tooth decay continues developing, more minerals will be lost. Over time, the enamel weakens and disappears, which will ultimately lead to formation of a cavity.

3-What causes tooth decay?

In order to prevent tooth decay, brush your teeth with fluoride toothpaste at least twice a day. Preferably brush after every meal, especially before bed. Clean your teeth daily with floss or interdental cleaners such as an interdental toothbrush.

4-How long does it take for a tooth cavity to turn into decay?

The time required to form the cavity varies depending on the age, type of diet, oral hygiene of the patient and so on. On average, it can take six months to four or five years before a cavity needs treatment.

5-What color is tooth decay?

Tooth decay, also known as tooth cavities, is caused by acids which are produced by bacteria. The cavities may be a number of different colors from yellow to black. Symptoms may include pain and difficulty while eating.

6-What happens if I do not treat my decayed teeth?

If left untreated, cavities can cause a variety of problems. These include persistent toothache, and dental abscess, which can have dangerous side effects and the infection enters the bloodstream.

7-Why do my teeth decay so quickly?

Tooth decay also occurs when carbohydrate-rich foods get stuck between the teeth and are not completely removed by brushing and flossing. The chief causes of tooth decay are sugary, sticky foods and drinks. The more sugar consumed, the more acid is produced, which leads to decay.

8-Can cavities spread to other teeth?

Cavities cannot spread to other teeth, but they certainly affect the rest of your mouth. First of all, the condition that creates cavities on one tooth can certainly cause cavities in your other teeth.

9-Which medicine is the best option for tooth decay?

If your cavity has just started, fluoride therapy may help repair your enamel and can sometimes eliminate a cavity in its early stages. With fluoride therapy, more fluoride is transferred to the teeth than the amount in tap water.

10-Is mouthwash useful for tooth decay?

Mouthwash can be used to control bad breath and reduce cavities. It can also help with conditions such as gum infections, dryness in the mouth and causing plaque. Mouthwash is used in addition to brushing and flossing.

Dr Abdolreza Jamilian Orthodontist
About Dr Abdolreza Jamilian Orthodontist

Dr. Jamilian, an orthodontist, has a specialized fellowship in orthodontic surgery and maxillofacial abnormalities and is a professor in the orthodontics department of the Dentistry School of the Islamic Azad University. He is member of Iranian and European Board of Orthodontics (EBO) and is a member of the Iranian, American and European Orthodontists Association.

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