Tooth Decay
“The use of fluoride-containing dentifrice (toothpaste) is critical for dental caries prevention.”
“Over 50% of 5-9 year olds have at least one cavity. This increases to 78% among 17 year olds.” – U.S. Surgeon General’s Report.
- What is tooth decay?
- What causes tooth decay?
- What are dental plaque, calculus and tartar?
- How does decay progress through the tooth?
- What are the symptoms of tooth decay?
- How does the dentist discover decay?
- Which tooth surfaces are most likely to decay?
- Why are regular brushing and flossing necessary?
- What measures should be taken to prevent tooth decay?
- How can decayed teeth be saved?
- Toothache/pain chart. What is causing my pain?
1. What is tooth decay?
- Tooth decay is a disease that destroys teeth.
- It can result in the loss of teeth if it is not treated.
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2. What causes tooth decay?
- Tooth decay is caused by the bacteria in dental plaque.
- The bacteria feed on dietary sugars and release acids, which dissolve and destroy the teeth.
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3. What are dental plaque, calculus and tartar?
- Dental plaque is a thin coating of bacteria and food particles that sticks to teeth.
- It cannot be rinsed off, but it can be removed by brushing, flossing and dental scaling.
- It causes tooth decay and gum disease.
- The longer that plaque is allowed to remain on teeth, the greater are the risks of gum disease.
- If plaque is not removed, it can harden to form calculus, also called tartar.
- Calculus should be removed by a dentist or hygienist, as it cannot be removed by brushing.
- Diets rich in soft, sticky, carbohydrate foods (refined sugars) assist plaque formation.
See Diet and Decay
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4. How does decay progress through the tooth?
- The first layer of tooth to be affected is the outermost, the enamel.
- It then spreads to underlying dentine.
- The decay can eventually reach the pulp, which is the name for the nerves and blood vessels of the tooth.
Spread of decay |
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5. What are the symptoms of tooth decay?
- The symptoms of decay will vary according to the extent to which it has spread into the tooth.
- Decay is quite painless in the early stages when only the enamel is affected.
- When decay has spread to the dentine, pain can be caused by sweet foods, such as chocolate, sugary snacks and drinks.
- When the decay spreads deeper, sensitivity can be felt with hot and cold drinks.
- Severe ongoing pain that is caused by hot food and drinks indicates that the nerves and blood vessels have become affected by the decay.
This condition is called a pulpitis.
Visit our Pain Chart to learn more about the causes of pain (#11 above)
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6. How does the dentist discover decay?
- The dentist uses a special fine explorer instrument to discover cavities that have developed.
- Regular check ups by the dentist, and periodic x-rays will ensure that decay will be detected soon after it has started.
X-rays can reveal decay that cannot be detected by visual dental examination.
- A dull white patch on the tooth could be a sign of early decay.
Illustration of x-ray showing decay |
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7. Which tooth surfaces are most likely to decay?
- The chewing surfaces of back teeth with their grooves and pits, are usually the first to decay.
This is because dental plaque accumulates in these areas.
- The tooth surfaces where adjoining teeth meet are also common places for decay to start.
- Tooth decay can start around and under old fillings that have cracked, chipped or broken down.
- Decay can also occur at the gum line, which is at the neck of the tooth.
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8. Why are regular brushing and flossing necessary?
- Plaque formation is an ongoing process which starts again soon after brushing.
This is why regular brushing and flossing are necessary to keep plaque off the teeth.
- Brushing cleans mainly the surfaces of the teeth that can be seen.
- Floss removes dental plaque from between the teeth where the toothbrush cannot reach.
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9. What measures should be taken to prevent tooth decay?
- Tooth decay can be prevented by home care and oral hygiene, professional care and diet control.
- Home Care and Oral Hygiene
- Regular brushing and flossing are essential:
- Brush your teeth at least twice a day, after breakfast and before bedtime.
- Regular flossing will remove harmful plaque from the areas between teeth, that the brush cannot reach.
- Special brushes and devices, prescribed by the dentist, can help to clean areas in the mouth that are difficult to reach.
- Your dentist may recommend a mechanical or ultrasonic toothbrush to remove dental plaque.
- The surface application of fluoride is made with the daily use of fluoride toothpastes and mouthwashes.
Fluoride is a chemical that hardens the enamel of a tooth, and increases its resistance to decay. It can also help to stop the early stages of decay.
- Professional care
- Adults and children should see the dentist twice a year.
- Regular visits to the dentist for professional examination and cleaning are essential.
- The early detection and treatment of decay and gum disease will only be possible with regular dental inspection.
- X-rays will help the dentist to find early signs of decay.
- Fissure sealants can be applied to back teeth to protect them from decay.
- Fluoride applied to the teeth by the dentist will also help to prevent decay.
Before sealants |
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After sealants |
- Diet Control
- Reduce the amount of refined carbohydrate in your diet.
- This includes the refined sugar found in table sugar, biscuits, cakes, chocolates, sweets, and fizzy soft drinks.
- The acid in carbonated soft drinks, including diet drinks, is harmful to teeth.
- Fruit, vegetables and juices, which contain natural sugars are preferable.
See Oral Hygiene, Diet and Decay, Fissure Sealants and Fluoride
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10. How can decayed teeth be saved?
- Decayed teeth can in most instances be saved.
- Early decay is easily treated by first removing the decay, and then replacing the lost tooth substance with a filling.
- Larger areas of decay can be restored with inlay restorations or replacement crowns.
- Even when decay has reached the nerves and blood vessels of the tooth, the tooth can still be saved. It is dealt with by having a root canal treatment, followed by restoration of the tooth.
See Tooth Restoration
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11. Toothache / pain chart. What is causing my pain?
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Pain severity + = Small degree ++ = Medium degree +++ = High degree |
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Glossary Acute = Fast developing Apical = End of root Chronic = Slow forming Periodontal = Around the tooth Pulp = Nerves and blood vessels of tooth |
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