Tooth Decay

Tooth decay is the destruction of tooth material, which includes:

  • Causes

    Everyone has bacteria in their mouths. The bacteria eat sugars that are left on the tooth, which then creates acid. The acid and the bacteria form plaque on the teeth. This plaque clings to your teeth. It holds the acid to the tooth. The acid wears away the tooth. Over time, the acid can lead to tooth decay.

  • Definition

    Tooth decay is the destruction of tooth material, which includes:

    • Enamel—the hard outer surface of the tooth
    • Dentin—the second softer layer beneath the enamel
    • Pulp—the inside of the tooth containing the nerve and blood supply
    • Root—the area of the tooth anchoring it in the bone
    Tooth Decay
    Nucleus factsheet image
    Copyright © Nucleus Medical Media, Inc.

  • Diagnosis

    Tooth decay is diagnosed over a period of time. This involves clinical examination as well as x-rays.

    A dentist checks for tooth decay by:

    • Asking about pain in the teeth
    • Visually inspecting the surface of the teeth

    • Probing teeth with dental instruments to check for:

      • Sensitivity
      • Pain
      • Softness
      • Surface defects
    • Taking x-rays of teeth

  • Prevention

    Measures that help prevent and stop tooth decay include:


    • Proper dental hygiene, including:

      • Brushing teeth
        with fluoride toothpaste after meals or at least twice per day
      • Daily flossing
        between teeth and gums—Bacteria living between the teeth can only be removed with floss or interdental cleaners.
      • Getting regular dental check-ups and teeth cleaning

    • Limiting the amount of sugar and carbohydrates you eat and drink, including:

      • Honey
      • Sodas
      • Candy
      • Cakes
      • Cookies
      • Other sweets
    • Rinsing your mouth with water after eating sugars
    • Replacing your toothbrush every 3 to 4 months
    • Avoiding sugar-containing drinks (including fruit juices), especially in baby bottles
    • Chewing gum with xylitol or sorbitol (may reduce your risk of developing cavities)


    Talk to your dentist about the use of a
    sealant
    . This is a protective plastic covering. It is applied to the chewing surfaces of teeth. Sealants usually last anywhere from 5-15 years.

    Prevention is particularly important for children. Supplemental fluoride in early childhood can prevent early decay. The dose can be adjusted for the amount of natural or added fluoride in local water supplies. Fluoride can also be applied to permanent teeth as a long acting varnish. Re-varnishing is usually necessary at least twice yearly.

  • Risk Factors

    Everyone has the chance to develop tooth decay. Factors that may increase your risk of cavities include:

    • Snacking
    • Having poor dental hygiene
    • Having high numbers of bacteria in the mouth
    • Having an insufficient amount of fluoride (some communities in the United States add fluoride to the drinking water)
    • Taking medicine that contains sugar or causes dry mouth

    • Eating a diet high in sugar
    • Enamel erosion from
      gastroesophageal reflux disease
      or
      bulimia nervosa
    • Being malnourished (such as vitamin and mineral deficiencies)

    • Having certain conditions that decrease the flow of saliva in the mouth (such as
      Sjogren syndrome
      or Heartburn)
    • For children: having caregivers or siblings with severe dental caries

    Babies are also at risk for developing cavities. Habits that can increase the risk include giving a bottle between regular feedings or while in bed at night.

  • Symptoms

    Symptoms include:

    • Tooth sensitivity to hot or cold
    • Tooth discomfort after eating
    • Darkening of the tooth surface
    • Bad breath or a foul taste in the mouth
    • Throbbing, lingering pain in tooth

  • Treatment

    Sometimes tooth decay will repair itself. This is most likely if it is caught early.

    Treatment for more severe decay includes: