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Dental TreatmentTooth Decay

General Dentistry
extracted tooth with cavities and dental equipment

Dental caries, which are commonly referred to as tooth decay is a disease of bacterial origin where the tooth material is dissolved by the toxins and acid released by the microbes, and it ultimately leads to the formation of a hollow debris-filled cavity in the tooth.
It may range in colour from yellow to black tooth decay in later stages.

Tooth decay in children is also becoming a prevalent problem as in the modern era, and they are adopting unhealthy lifestyles and consuming high sugar content food such as candies and chocolates from a very tender age leading to early tooth decay.

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What Causes Tooth Decay?

A well-known theory mentioning the attributable causes of tooth decay is the “Acidogenic theory of causation of dental caries.”
According to this, 4 major factors are responsible for tooth decay

  1. A tooth surface susceptible to infection
  2. Microorganisms, particularly the bacteria in the dental plaque or biofilm. The most common bacteria involved being Streptococcus mutans.
  3. A suitable carbohydrate substrate such as glucose, sucrose or fructose that releases lactic acid on fermentation
  4. Time

Another major contributor to tooth decay is the reduced flow rate of saliva.

What Are The Signs And Symptoms Of Tooth Decay?

A person who is ignorant of his/her oral hygiene may not be aware of the development of tooth decay unless the symptoms become significant. Also, most of you must not be aware of what a tooth decay looks like?

  • The earliest symptom of tooth decay is the appearance of a gritty chalky white spot on your tooth, which indicates the beginning of demineralisation of enamel.
  • This white spot or “microcavity” ultimately progresses towards the development of a full-blown hollow cavity in your tooth when all your dental structures will get irreversibly dissolved.
  • A brownish or black stain indicates that the demineralisation process has ceased. Ongoing tooth decay is much whiter in appearance.
  • Rotten teeth may also lead to bad breath because of the active necrosis process.
  • Once the decay passes from enamel and dentin to the root canal, the tooth becomes tender and swollen. Tooth decay pain is very excruciating, throbbing type of pain.
  • The affected tooth develops sensitivity to hot or cold exposure.
  • A decay that has extensively spread on the inside of the tooth can lead to fracture under increased pressure while chewing or biting.

These are the most common symptoms and signs of tooth decay. Once you notice any of these tooth decay symptoms, you should visit a dentist at the earliest possible.

How Is Tooth Decay Classified?

After having a brief insight into what is tooth decay, the next thing is to classify the type of tooth decay.
Dental caries are classified on four principal grounds viz location of decay, underlying aetiology, rate of progression of decay, and the hard tissues involved.

  1. Classification based on location: These are basically the tooth decay stagesClass I: Involvement of occlusal surfaces, particularly of the posterior teeth, presence of lingual pits on Posterior teeth, i.e., the molarsClass II: Involvement of proximal surfaces of molarsClass III: Involvement of interproximal surfaces of the anterior teeth but without the involvement of incisal edgeClass IV: Involvement of interproximal surfaces of the anterior teeth along with the involvement of incisal edgeClass V: Involvement of the lingual surface of the toothClass VI:  Wearing away of incisal edge owing to attrition
  2. Classification based on the rate of progression Based on the rate of progression, tooth decay can be acute or chronic.
    Acute signifies the development in a very short duration and occurs in highly susceptible individuals, whereas chronic decay occurs gradually owing to a large number of factors over time.Recurrent caries is the term given to the decay appearing in a place where there was previous history of caries.Incipient caries refers to the decay developing de novo in any area.
  3. Classification based on hard tissues involved
    Enamel Involvement: Early dental caries affects only the superficial layer of the tooth, i.e., The enamelDentin Involvement: When the decay spreads more in-depth and involves dentin, then a particular term ‘Dentinal caries’ is used.Cementum Involvement: It is the hard tissue covering the root of the teeth and lies much deeper.The term ‘cementum caries’ is used when it gets involved.

Can Tooth Decay Be Reversed?

The answer to this question cannot be consistent as it depends on the extent of disease and the structures involved.

If you are wondering how to reverse tooth decay? Then you must know that it can only be done when the extension of disease is minimal, and cavitation has not occurred. It requires strict dietary modifications and regular workup for enabling the remineralisation of teeth.
However, once cavitation has occurred, the answer to this question is a big NO. It cannot be reversed, but proper treatment will lead to sufficient restoration of tooth function.

How To Get Rid Of Tooth Decay?

If you have already developed tooth decay and are looking for how to fix tooth decay, then you should consider the points given below.

The line of management and tooth decay treatment will depend on the extent of the lesion, nature of the lesion, whether it is cavitated or non-cavitated.
If the lesion is not cavitated and early diagnosis is made, rigorous modifications in dietary habits and adequate care can result in spontaneous re-mineralisation of the tooth.

Once the lesion has become cavitated, it is impossible to reverse the damage and lead to re-mineralisation. In this case, an iatrogenic intervention is a must to repair the damage, cure tooth decay, and restore the function of the tooth.

The procedure involves removal of the entire decayed tooth followed by filling the cavity with restorative material such as porcelain, amalgam, gold, or composite resin.
When the decay is pervasive, a crown is required to keep the restorative material in place.

For kids tooth decay treatment, preformed crowns made of metal are available. Child tooth decay should be corrected by taking adequate measures of precaution.

How To Prevent Tooth Decay?

In line with a general rule, prevention is always better than cure. We as dentists encourage and promote healthy oral practices and adoption of healthy lifestyles so that you may never have to face any trouble like that of tooth decay. If you are wondering about how to stop tooth decay from developing in the first place, then here are a few measures you should consider.

Maintenance Of Oral Hygiene:

Brushing and flossing your teeth are two most simple yet effective processes whose importance in preventing dental caries is unsurpassable.

It prevents the buildup of plaque and biofilm, which is a prerequisite for the development of caries.

Modification Of Dietary Habits:

The intake of free sugars is directly proportional to the risk of development of tooth decay. The food which sticks to the teeth for longer duration increases the risk of dental caries.

It would be best if you avoid the consumption of such unhealthy food items such as candies, cookies,chips, etc.

Use Of Dental Sealants:

Dental sealant is a very fine plastic-like layer that is coated over the posterior teeth predominantly the molars to prevent the trapping or sticking of food in the teeth while chewing. They are a promising preventive measure to avoid dental decay and bad teeth.

These are increasingly being used in children as a prophylactic measure to avoid toddler tooth decay.

Regular Oral Assessment:

Along with taking preventive measures, expert advice is also needed. So, regular oral assessment by our dentists will enable early diagnosis and treatment in case of any dental problem.

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