Courtesy of the National
Library of Medicine and the National Institutes of Health
Tooth decay is one of the most common of all
disorders, second only to the common
cold. It usually occurs in children and young adults but can affect any
person. It is the most important cause of tooth loss in younger people.
Bacteria are normally present in the mouth.
The bacteria convert all foods -- especially sugar and starch -- into acids.
Bacteria, acid, food debris, and saliva combine in the mouth to form a sticky
substance called plaque that adheres to the teeth. It is most prominent on the
back molars, just above the gum line on all teeth, and at the edges of fillings.
Plaque that is not removed from the teeth mineralizes into tartar. Plaque and
tartar irritate the gums, resulting in gingivitis
and ultimately periodontitis.
Plaque begins to accumulate on teeth within 20
minutes after eating (the time when most bacterial activity occurs). If this
plaque is not removed thoroughly and routinely, tooth decay will not only begin,
but flourish.
The acids in plaque dissolve the enamel
surface of the tooth and create holes in the tooth (cavities). Cavities are
usually painless until they grow very large inside the tooth and destroy the
nerve and blood vessels in the tooth. If left untreated, a tooth
abscess can develop. Untreated tooth decay also destroys the internal
structures of the tooth (pulp) and ultimately causes the loss of the tooth.
Sugars
and Starches
increase the risk of tooth decay. Sticky foods are more harmful than nonsticky
foods because they remain on the surface of the teeth. Frequent snacking
increases the time that acids are in contact with the surface of the tooth.
Symptoms
- Toothache -- particularly after sweet, hot, or cold foods and drinks
- Visible pits or holes in the teeth
Signs and tests
Most cavities are discovered in the early
stages during routine checkups. The surface of the tooth may be soft when probed
with a sharp instrument. Pain may not be present until the advanced stages of
tooth decay. Dental
x-rays may show some cavities before they are visible to the eye.
Treatment
Destroyed tooth structure does not regenerate.
However, the progression of cavities can be stopped by treatment. The goal is to
preserve the tooth and prevent complications.
In filling teeth, the decayed material is
removed (by drilling) and replaced with a restorative material such as silver
alloy, gold, porcelain, or composite resin. Porcelain and composite resin more
closely match the natural tooth appearance, and may be preferred for front
teeth. Many dentists consider silver amalgam (alloy) and gold as stronger and
are often used on back teeth, although there is a trend to use high strength
composite resin in the back teeth as well.
Crowns are used if decay is extensive and
there is limited tooth structure which may cause weakened teeth. Large fillings
and weak teeth increase the risk of the tooth breaking. The decayed or weakened
area is removed and repaired and a covering jacket or "cap" (crown) is
fitted over the remainder of the tooth. Crowns are often made of gold, porcelain
or porcelain fused to metal.
A root canal is recommended if the nerve in a
tooth dies from decay or from a traumatic blow. The center of the tooth,
including the nerve and blood vessel tissue (pulp), is removed along with
decayed portions of the tooth. The roots are filled with a sealing material. The
tooth is filled and a crown may be placed over the tooth if needed.
Expectations (prognosis)
Treatment often preserves the tooth. Early
treatment is less painful and less expensive than treatment of extensive decay.
Anesthetics -- local, nitrous oxide (laughing gas), or other prescription
medications -- may be required in some cases to relieve pain during or following
drilling or other treatment of decayed teeth. For those who fear dental
treatment, nitrous oxide in combination with anesthesia may be preferred.
Complications
- tooth
abscess
- fractured tooth
- discomfort or pain
- tooth sensitivity
- inability to bite down on tooth
Calling your health care provider
- Call your dentist if you have a toothache.
- Call your dentist for a routine cleaning and examination if you have not
had one in the last 6 months to 1 year.
Prevention
Oral
hygiene is necessary to prevent cavities. This consists of brushing at least
twice a day and flossing at least daily, and regular professional cleaning
(every 6 months). X-rays may be taken yearly to detect possible cavity
development in high risk areas of the mouth.
Chewy, sticky foods (such as dried fruit or
candy) are best if eaten as part of a meal rather than as a snack. If possible,
brush the teeth or rinse the mouth with water after eating these foods. Minimize
snacking, which creates a constant supply of acid in the mouth. Avoid constant
sipping of sugary drinks or frequent sucking on candy and mints.
Dental sealants can prevent cavities. Sealants
are thin plastic-like coating applied to the chewing surfaces of the molars.
This coating prevents the accumulation of plaque in the deep grooves on these
vulnerable surfaces. Sealants are usually applied on the teeth of children,
shortly after the molars erupt. Older people may also benefit from the use of
tooth sealants.
Fluoride is often recommended to protect
against dental caries. It has been demonstrated that people who ingest fluoride
in their drinking water or by fluoride supplements have fewer dental caries.
Fluoride ingested when the teeth are developing is incorporated into the
structure of the enamel and protects it against the action of acids.
Topical fluoride is also recommended to
protect the surface of the teeth. This may include a fluoride toothpaste or
mouthwash. Many dentists include application of topical (applied to a localized
area of the skin) fluoride solutions as part of routine visits.
Save
up to 80% OFF your Dental, Vision, Rx and Chiropractic
expenses. Our $11.95/mo Dental Plan gives you immediate access to the
Dentist. All on-going conditions are accepted too! We are now offer
Medical Benefits for you and your family AmeriPlan�,
CLICK HERE
AmeriPlan
USA� Broker - Work
at Home Based Business Opportunity
AmeriPlan�
- AmeriPlan
USA�
©
©
