Tooth decay happens if the bacteria in plaque produce acid and attack the tooth enamel.
90% of those aged 20–64 and 96% of those aged 50–64 deal with tooth decay.
The main reason for tooth decay is a lack of oral hygiene. Sometimes medications or diseases can be provocative causes.
It is beneficial to diagnose tooth decay early, which can become a painful problem that affects daily life. Tooth decay, which is diagnosed in many ways, also has several alternative treatment methods.
In this article, you will see how tooth decay occurs and how dentists treat it.
- The tooth decays when bacteria attack the tooth enamel.
- At least 90% of the population experiences tooth decay.
- Cavity and tooth decay are not the same thing.
- Tooth decay forms in five stages.
- Consuming sugar is the key to forming tooth decay.
- Sjogren’s syndrome can be the cause of tooth decay.
- Early diagnosing is necessary to treat it easily.
How Do Dentists Fix Tooth Decay?
It is possible to treat tooth decay. There are five types of treatment methods for this. These are:
- Dental Filling
- Dental Crown
- Root Canal Treatment
- Tooth Extraction
- Preventative Treatments
Dental Filling
The rotten part of the patient’s tooth is removed. This area is cleaned and filled with filling material. This is generally done to minor decays.
There are tooth-colored (composite) and silver-colored (amalgam) fillings to fill the cleaned area.
Another point about the treatment is that it is not a permanent treatment. It may need to be replaced in the future.
Root Canal Treatment
Root canal treatment can also be applied to a decayed tooth. Tooth decay can reach living pulp tissue, and this can also mean that tooth decay is progressing. If it has descended into living pulp tissue, the inflamed tissue is removed from the root canals. Root canals are cleaned and filled.
Tooth Extraction
If tooth decay progresses too far, the decay can reach the nerves. At this point, it may become impossible to correct and other treatment options cannot be done. In this case, tooth extraction is performed. After this procedure, if there is inflammation in that area, the inflammation is cleared.
Dental Crown
Dental crowns are tooth-shaped prostheses placed over a decayed tooth. It is preferred for large cavities and extremely damaged teeth. However, when filed, there still needs to be 2 mm of teeth should be left for the crown to fit. If it’s more damaged than that, the only solution will be a tooth extraction.
Dental crowns are cosmetic treatments. The main focus is generally aesthetics as well as tooth restoration in this treatment.
Preventative Treatments
This includes good oral hygiene. Fluoride intake is a must at this point. You should prefer toothpaste that contains a good amount of fluoride.
Teeth cleaning by dentists can help to prevent the formation of tooth decay.
Antibiotic treatment is also a good alternative to prevent tooth decay.
It is important not to consume sugary foods and drinks. These are treatment methods that work in the early stages of caries.
How Are Dental Caries in Children Treated?
Tooth decay is not only encountered in adolescence, adulthood, or old age. It can also occur in children. Cavities in children under the age of 6 are called ‘early childhood caries’.
Fluoride is important to treat cavities, which usually occur as a result of consuming excessively sugary drinks and foods. The toothpaste of children under the age of 6 should contain 0.05% fluoride, and the toothpaste of those over 0.1% should contain fluoride.
Tooth extraction is also preferred. It is important to do this before the bruise spreads. Since anesthesia is applied, the child does not feel any pain or suffering.
What Is Tooth Decay?
Tooth decay is defined as the destruction of the tooth surface (tooth enamel) because of acid produced by bacteria.
Dental plaque plays a big role in the tooth decay process. Plaque is a colorless, sticky film on the teeth’ surface. Dental plaque is the habitat of bacteria, food particles, and saliva.
When you consume sugary things, these bacteria produce acid. Over time, these acids dissolve the minerals in the tooth enamel and creates small holes or cavities.
According to clinical research, while 90% of those between the ages of 20 and 64 have cavities. This rate increases to 96% for those between the ages of 50 and 64.
A Fun Experiment: Tooth decay experiment with eggs
It is an experiment conducted to see the difference between brushed teeth and non-brushed teeth, especially for children. It shows the importance of brushing in the process of tooth decay. Also, it shows how the acid affects teeth.
It is made with 2 eggs, 2 glasses of vinegar water, a toothbrush, and toothpaste. The eggshell represents tooth enamel here.
Each egg is placed in a glass of water. One is brushed, and one is not. The water of the brushed egg is changed every day and brushed.
Neither is done to the other egg. After 1 week, one of the eggs will be clean while the other will be rotten.
Are Cavity and Tooth Decay the Same Thing?
No, they are not exactly the same dental problems. The tooth cavity is the most advanced form of tooth decay. Tooth decay plays a part in the formation of a tooth cavity.
Even though the cause is the same for both tooth decay and tooth cavities, their treatments are different from one another. While fillings are enough to treat tooth decay, the tooth may even need to be extracted to treat the tooth cavity.
Types of Cavities
There are three types of cavities.
| TYPE OF CAVITY | WHAT CAVITY LOOK LIKE | IMAGE |
| Pits and Fissures Cavities | Small, dark fissures or pits appear on the tooth surface, especially on the molars, premolars, and chewing surfaces. |  |
| Smooth Surface Cavities | White spots and lines on the smooth surfaces of the teeth occur, then turn brown and black and become holes. These can cause tooth decay on the gum line. |  |
| Root Cavities | It occurs on the tooth roots of patients with gum recession and gum disease and appears as a brown or dark stain. |
|
Stages of Tooth Decay
There are 5 stages of tooth decay.
- Demineralization
- Enamel Decay
- Dentin Decay
- Pulp Decay
- Abscess Formation
Tooth decay does not occur suddenly. It is a process. If diagnosed early, the possibility of tooth decay is eliminated.
1. Demineralization
This is the stage when plaque begins to accumulate on the tooth. After plaque accumulation, you may experience calcium loss. Because, the sticky plaque collects the calcium in the food and hardens the plaque thoroughly, teeth cannot get enough calcium.
The biggest reason for nourishing and strengthening the plaque that absorbs minerals is sugar consumption.
As a result of sugar consumption, the bacteria in the plaque begin to feed on this sugar and acid. This acid spreads into the enamel and causes white spots.
2. Enamel Decay
This is the early stage of tooth decay. The tooth enamel keeps being damaged by the bacteria in plaque. You can see the white spots turning into brown spots at this stage.
At this point, the tooth decay needs to be treated to prevent further damage. If not, the tooth will keep being demineralized, which will lead to tooth cavities.
3. Dentin Decay
This is the second stage of tooth decay. At this point, the decay spreads to the next layer of the tooth (dentin).
The dentin layer is softer. As the dentin is not as strong as the enamel, the decay spreads much faster. Dentin decay will cause you to experience intense hot and cold sensitivity.
4. Pulp Decay
This is the last stage of tooth decay. At this stage, the decay is already advanced. The bacteria will have advanced into the tooth and created a tooth cavity.
You may experience inflammation along with extreme pain and tenderness.
5. Abscess Formation
If the tooth is not treated at the last stage, the inflammation will spread and cause an abscess formation.
Abcess formation happens when the bacteria reaches the root of the tooth, causing infection at the tip of the tooth root. Increasing infection causes pus to form on the underside of the tooth.
A tooth abscess can be threatening for both oral and general health. If you are concerned about having a tooth abscess, you should call your dentist immediately.
Symptoms of Tooth Decay
You may feel many symptoms of tooth decay. It can manifest itself in many ways. We can list these signs as follows:
- Toothache
- Sensitivity to hot or cold
- White, brown, or black stains on the surface of the tooth
- Pain when biting or chewing
- Redness and swelling
- Bad breath
- Holes or pits
Can Tooth Decay Cause Bad Breath?
Yes, tooth decay can cause bad breath. Tooth decay occurs as a result of the accumulation and strengthening of bacteria. Bacterial accumulation feeds on teeth and gums and this causes a bad tooth decay smell.
Why Does Tooth Decay Hurt?
Tooth decay pain intensifies in the third stage. So, this is the stage where the decay approaches the bottom and nerves of the tooth.
Bacteria and acid spread into the tooth and its nerves. At this point, the pulp is affected and it may come with swelling. If this swelling cannot find a place inside the tooth, the nerve is compressed and causes pain.
How to Know If Tooth Decay Has Reached the Pulp
You can check four symptoms to figure out if your tooth decay has reached the pulp.
- Extreme pain and tooth sensitivity
- Redness and swelling in the gums
- Gaps in the teeth
- Brown or black spots
What Causes Tooth Decay?
Bacteria create acids and these acids destroy teeth, causing tooth decay. At this point, things that cause plaque accumulation and bacterial accumulation are the causes of caries.
- Not brushing teeth
- Not using dental floss
- Fluoride deficiency
- Consumption of sugary and acidic food and beverages
- Dry mouth
- Stuck food next to wisdom teeth
Do Wisdom Teeth Decay?
Since there are already 28 teeth in the mouth, these teeth cannot come out and get stuck in the gums. It’s also possible for food to get stuck next to wisdom teeth. If this is the case, it gets hard to clean that area. This will lead to consistent bacteria build-up and eventually decay.
According to research by Dental Press Orthodontics Magazine, wisdom tooth extraction is recommended by dentists for 59% of patients. The National Institutes of Health (NIH) notes that these wisdom teeth appear between the ages of 17 and 21.
How Does Sugar Promote Tooth Decay?
Sugar is a major reason for tooth decay. It has a highly negative effect on the tooth decay process.
The bacteria on our teeth feed on the sugar we consume. It creates acid by feeding on the sugar we consume.
The normal pH of saliva for women is frequently between 5.5 and 6, but for men, it is 7 or 7.4. So, if it goes below 5.5, it is very risky for the mouth due to sugar consumption. These acids first destroy the tooth enamel, then reach the inside of the tooth and cause serious caries.
This problem is common in women because of the pH level differences in their saliva.
Does Diet Affect Teeth Cavities?
Yes, your diet may cause tooth decay. The reason for this is that some foods naturally contain sugar. It occurs naturally in fruits and honey. It is also found in raisins, apples, and apricots.
These foods have an intense acid pH (below 5.5) and cause further acidification in the pH of saliva. The acidification leads to demineralization.
However, proper oral care and the right choice of nutrients can prevent tooth cavities.
Which Autoimmune Diseases Cause Tooth Decay?
Sjogren’s syndrome is known for causing dryness in the mouth and eyes. Lymphocyte (white blood cell) damages the tear and salivary glands, thus causing dryness.
Salivary glands contain bactericidal enzymes. These enzymes fight bacteria that cause tooth decay. This protects the tooth against decay.
Invasion of the salivary glands by lymphocytes reduces the saliva in the mouth and causes dry mouth. Tooth decay also occurs due to dry mouth. Tooth decay accelerates.
| A QUICK REMINDER: Autoimmune diseases are diseases that result from a person’s immune system attacking healthy cells. These diseases seriously threaten oral health. |
Which Medications Cause Tooth Decay?
The use of some medications can cause tooth decay.
- Antihistamines
- Antidepressants
- Acetaminophen
- Decongestants
- Antacids
- Antihypertensive drugs
- Chemotherapy medications
Dry mouth is generally a common side effect of these medications. Dry mouth is a big risk factor for tooth decay.
How Are Dental Caries Diagnosed?
Tooth decay may involve several diagnostic tests. It can be understood in two ways, by seeing and touching.
Dental X-rays are a major diagnostic factor. Tooth decay is detected by focusing on X-rays. This can be done in three ways.
Bitewing X-ray: Specially prepared films are placed in the patient’s mouth and the patient bites the wing.
Periapical X-ray: The patient places the film in the mouth against the teeth and the film is pressed tightly with the finger.
Panoramic X-ray: The jaw is placed on the head of the X-ray device and this device rotates around the head.
Caries are also detected with a laser fluorescence device (DIAGNOdent). The device detects caries using low-power light.
Can Tooth Decay Be Reversed?
No. Tooth decay cannot be reversed. If tooth decay starts, dental fillings will be useful as a treatment. But, if it’s a cavity, dental fillings will not be enough.
A root canal will be needed with fillings. If the tooth cannot be treated, it needs to be extracted.
❗ Early treatment is always best for your oral health. If you have tooth decay, consult your dentists as soon as possible.
How to Stop Tooth Decay from Spreading
The formation and progression of tooth decay is a process. Some actions can be taken to prevent tooth decay before it occurs or progresses.
- Do good oral hygiene
- Use fluoride
- Do not consume sugar and acidic foods
- Avoid dry mouth
- Rinse with salt water
- Floss your teeth daily
- Eat a diet rich in calcium
- Visit the dentist as soon as possible
Which Mineral Is Effective in Controlling Tooth Decay?
Calcium is the most important mineral in preventing tooth decay. The substance known as crystalline calcium phosphate is formed by the use of calcium. Thus, tooth enamel is surrounded by this calcium and protects the inner parts of the tooth.
Phosphorus, potassium, and magnesium are minerals that protect teeth not by themselves but by supporting calcium.
How to Prevent Tooth Cavities
If a cavity has formed, what you need to do is visit the dentist. This means that tooth decay is already advanced. It is important to decide and implement the appropriate treatment according to the severity of the condition.
Until you see the dentist, you should:
- Brush your teeth regularly
- Stay away from sugary foods
- Rinse with salt water
- Consume foods that prevent cavities
Foods that Prevent Tooth Decay
Foods do not prevent tooth decay all by themselves. However, they can support the mineral intake that your teeth need.
- Foods with fluoride
- Milk
- Cheese
- Yogurt
- Green and black tea
- Whole grain
- Fruits and vegetables rich in fiber
Who Is at More Risk of Having Dental Caries?
The risk of tooth decay can differ according to certain causes.
| CAUSES OF TOOTH DECAY | THE GROUP AT RISK |
| Excess sugar consumption | Children and adolescents can be at greater risk due to this cause. |
| Wisdom Teeth | Late adolescents and adults can be at greater risk because wisdom teeth appear between the ages of 17 and 25. |
| Proper Oral Hygiene | Adults can be at risk because of not having a good oral hygiene habit. |
| Dry Mouth | Elderly people are at greater risk because of the insufficient secretion of saliva. |
What Happens If a Decayed Tooth Is Left Untreated?
If the decayed tooth is left untreated, first you will feel pain in your decayed tooth area. Meanwhile, the bacteria will continue to progress in the tooth. It will reach the pulp and root of the tooth. The infection will spread and will lead to tooth abscess.
If still left untreated, the decayed tooth will need to be extracted.
Also, this doesn’t just stop with teeth. The infection can spread throughout your body. Thus, you may face a situation that threatens your health.
Can You Die from Tooth Decay?
Even though it sounds like a very extreme case, it is possible; however, it is extremely rare.
The only reason that this can happen is that if decay worsens, the infection can spread to the tooth root, nerves, surrounding teeth, face, and surrounding tissues. After oral, jaw, and neck area, the infection can spread to the brain, bloodstream, and other organs. At this point, the situation can be life-threatening.
❗ If you have a decayed tooth, contact your dentist immediately to prevent further damage to your oral and general health.
References:
- Kidd EA, Fejerskov O. What constitutes dental caries? Histopathology of carious enamel and dentin related to the action of cariogenic biofilms. J Dent Res. 2004;83 Spec No C:C35-8.
- Heng C. Tooth Decay Is the Most Prevalent Disease. Fed Pract. 2016 Oct;33(10):31-33. PMID: 30766141; PMCID: PMC6373711.
- Selwitz RH, Ismail AI, Pitts NB. Dental caries. Lancet. 2007 Jan 6;369(9555):51-9. doi: 10.1016/S0140-6736(07)60031-2. PMID: 17208642..
