Cavities or tooth decay

Overview  

Cavities, also known as tooth decay or caries, are permanent damaged areas that form on the hard surface of your teeth, resulting in tiny openings or holes. They are caused by a combination of factors, including the presence of bacteria in your mouth, frequent snacking, consumption of sugary drinks, and inadequate dental hygiene. 

These dental issues are highly prevalent worldwide and affect people of all ages, with children, teenagers, and older adults being particularly susceptible. Even infants can develop cavities. 

Types of cavities

Any tooth surface can become a site for a cavity. The following list includes typical cavity kinds and locations:  

• Smooth surface: This type of tooth decay, which develops slowly and gradually dissolves tooth enamel, can be prevented and even reversed through appropriate oral hygiene practices. It is commonly observed among individuals in their 20s, specifically occurring between their teeth. 
• Pit and fissure decay: Cavities form on the top part of your tooth’s chewing surface and can also affect the front side of your back teeth. Pit and fissure decay typically initiates during adolescence and progresses rapidly.  
• Root decay:  Adults experiencing receding gums face an increased susceptibility to root decay, as the recession exposes the teeth roots to dental plaque and acid, making prevention and treatment challenging. If one is prone to gum recession, it is advisable to consult their dentist about scheduling an appointment with a periodontist for further evaluation and potential management.If left untreated cavities can expand and affect deeper layers of the teeth, leading to intense toothaches, infections, and ultimately tooth loss. Regular dental check–ups and practicing good oral hygiene, such as regular brushing and flossing, are crucial for protecting against cavities and tooth decay. 

Symptoms 

The signs and symptoms of cavities can differ based on their size and location. In the initial stages of a cavity, there might be no noticeable symptoms. However, as the decay progresses and becomes more extensive, it can lead to various signs and symptoms such as: 

• Sensitive teeth  
• Pain when biting  
• Unpleasant taste in your mouth or bad breath   
• Slight to severe pain while consuming sweet, spicy, or cold foods or beverages.  
• Swelling of the face  
• Bleeding of the gums or other gum defects  
• Holes which can be seen on the tooth  
• Stains on any part of a tooth, whether they are brown, black, or white.  
• A toothache, a pain that comes on suddenly, or a pain for which there is no obvious reason  

Regular dental checkups and cleanings are crucial because cavities can form without noticeable symptoms. It’s essential to prioritize preventive care and visit your dentist regularly, even when your mouth feels fine. However, if you do experience a toothache or mouth pain, it’s crucial to seek dental attention promptly to address the issue and prevent potential complications.

Causes  

Tooth decay, which happens gradually, is what leads to cavities. This is how tooth decay happens:  

• Plaque formation. Dental plaque is a clear sticky film that coats the teeth. Its formation is attributed to the consumption of sugars and starches, combined with inadequate oral hygiene. When sugars and starches are not properly cleaned from the teeth, bacteria rapidly feed on them and create plaque. If this plaque is not removed, it can harden below or above the gum line, forming tartar (calculus). Tartar makes plaque more challenging to eliminate and provides a shield for bacteria. 
• Plaque attacks. Acids in plaque erode the hard enamel of your teeth, creating small openings or holes, which marks the initial stage of cavities. As the enamel wears away, bacteria and acid can penetrate the softer layer beneath it, known as dentin. Dentin contains tiny tubes that lead directly to the tooth’s nerve, resulting in sensitivity. 

• Persistent damage. As tooth decay progresses, bacteria and acid advance towards the inner tooth material (pulp), which houses nerves and blood vessels. This leads to swelling and irritation of the pulp from the bacterial activity. The confined space inside the tooth doesn’t allow for the swelling to expand, resulting in pressure on the nerve and causing pain. The discomfort may even spread beyond the tooth root to the surrounding bone. 

Risk factors

Cavities can affect everyone who has teeth; however the following things can make it occur more likely:  

• Tooth position. Decay primarily affects the back teeth, known as molars and premolars, due to their numerous grooves, pits, crannies, and multiple roots that can accumulate food particles. Consequently, maintaining their cleanliness is more challenging when compared to the smoother and easily accessible front teeth. 
• Foods and drinks. Foods that adhere to teeth for extended periods, like milk, ice cream, honey, sugar, soda, dried fruit, cake, cookies, hard candy and mints, dry cereal, and chips, have a higher potential to promote decay compared to foods that can be easily washed away by saliva. 
• Snacking or drinking. Consistently snacking or sipping sugary drinks provides mouth bacteria with additional fuel to produce acids, which can lead to the erosion of your teeth. Moreover, continuously consuming acidic beverages, such as soda, results in a prolonged acid exposure that constantly bathes your teeth. This can be harmful to your dental health. 
• Feeding the baby in between sleeping time. When babies are given bottles containing milk, formula, juice, or other liquids containing sugar at bedtime, these drinks stay on their teeth for hours while they sleep, feeding bacteria that causes tooth rot. Baby bottle tooth rot is a common name for this injury. When children roam the house sipping from a sippy cup loaded with these drinks, similar harm may result.  
• Not brushing your teeth adequately. Plaque builds quickly on the teeth after eating and drinking, and the early stages of decay might start if you don’t brush them right away.  

• Inadequate fluoride. Fluoride, a mineral that occurs naturally, aids in the prevention of cavities and can even repair minor tooth damage. Fluoride is added to many public water systems due of its benefits for teeth. In addition, it is frequently found in toothpaste and mouthwash. But fluoride is typically absent from bottled water.  
• Age. Cavities are common in young kids, teenagers, and older adults. As teeth age, they can wear down and gums may recede, making them more prone to root decay. Older adults are at higher risk because they often take medications that reduce saliva flow, increasing the chances of tooth decay. 
• Dry mouth. Saliva helps prevent dental decay by washing away food and plaque from your teeth, which is why dry mouth is brought on by a lack of it. Salivary substances also work to neutralize the acid that bacteria create. By lowering saliva production, some prescription treatments, medical conditions, radiation to the head or neck, and chemotherapy therapies can increase your risk of cavities.  
• Dental devices. Dental fillings or dental devices may undergo wear and tear over time. Dental fillings can weaken, deteriorate, or develop uneven surfaces, leading to increased plaque accumulation and making plaque removal more challenging. Similarly, dental devices may lose their proper fit, creating gaps that allow decay to initiate beneath them. 
• Heartburn. Heartburn or gastroesophageal reflux disease (GERD) can lead to the backflow of stomach acid into the mouth, which can erode the enamel of your teeth and result in substantial tooth damage. This can expose more vulnerable dentin to bacterial attacks, leading to tooth decay. Your dentist may suggest consulting your doctor to investigate whether gastric reflux is responsible for the enamel loss.
• Eating problems. Anorexia and bulimia may cause severe tooth erosion and cavities due to the harmful effects on dental health. Repeated vomiting during purging exposes the teeth to stomach acid, which gradually dissolves the enamel. Additionally, eating disorders can disrupt saliva production, further contributing to dental problems.