Tooth Decay


Tooth Decay

Description, Causes and Risk Factors:

Alternative Name: Dental cavities, caries.

ICD-9-CM: 521.03.

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 a common cause of tooth loss in younger people.

Tooth decay describes the condition wherein the tooth, under a variety of harsh conditions, break down leading to the formation of a cavity. It starts with a hole opening in the enamel. If this is not treated, it progressively reaches the deeper sections of the tooth, where the pulp and the nerves are causing the tooth to become sensitive to a variety of stimuli, a variety of gum problems such as inflammation and swelling, pain and ultimately tooth loss.

Tooth decay is a common dental ailment that may occur at any time or age. However, since the onset of tooth decay is strongly related to the unregulated consumption of sweet foods and beverages; it tends to affect the young and adolescents more than any other age. One form is diagnosed in nursing infants and is referred to as nursing caries.

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 build up 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 and affect nerves or cause a tooth fracture.

Risk Factors:

    Poor oral hygiene: Irregular and improper brushing, not flossing between teeth, not rinsing with water or mouthwash after meals speed up the process of tooth decay.

  • Unregulated diet of sweet food and drinks: Periodic snacking on aerated drinks, jam, marmalade, even potato chips can lead to the formation of acidic by - products which damage the surface of the tooth enamel. This is the reason why most young children adolescents suffer from tooth decay.

  • Bad or worn out dental fillings: Tooth decay might develop again from exposed tooth surfaces.

Symptoms:

Symptoms include toothache -- particularly after sweet, hot, or cold foods and drinks, visible pits or holes in the teeth.

Diagnosis:

Tooth decay will often be diagnosed by a dentist during a dental examination, but the most imporant procedure is the dental x-ray. Dental x-ray is the best way to detect tooth decay that has not yet caused symptoms.

Treatment Options:

Treatment can help prevent tooth damage from leading to cavities.

    Fillings.

  1. Crowns.

  2. Root canals.

    When decay is limited to enamel: Treatment at this initial stage is preventive in nature because it will stop the decay process from extending to deeper areas of the tooth. All that is necessary is a simple filling. It is usually painless at this stage. Your dentist will clean out the decayed part of enamel and fill the resulting cavity with either silver amalgam, or preferably, with the newer tooth coloured composite material.

  • When decay has extended to dentin: This may be painful after eating or with cold water. Food is likely to be lodged in the cavity. Treatment at this stage consists of a more extensive filling. It may be necessary to numb the area during treatment. One of the above materials may be used.

  • When decay has reached the nerve: The invading bacteria cause the nerve of the tooth to become inflamed. Root canal treatment will be necessary at this stage if the tooth has to be saved. Subsequently he will put a veneer or a crown on the tooth as the case may be.

  • Infection reaches bone: The bacteria destroy the nerve and spread to the bone of the jaw. The bone is thus inflamed and infected. The infection may erode through the side of the bone into the mouth, face or neck to cause a swelling.

You may need numbing medicine (lidocaine), nitrous oxide (laughing gas), or other prescription medications to relieve pain during or after drilling or dental work. Nitrous oxide with Novocaine may be preferred if you are afraid of dental treatments.

Prevention:

    Brushing: Brush your teeth twice a day with fluoride toothpaste. Hold a soft brush at the gum line at a 45o angle. Brush in a circular motion to massage the gums and an up-down motion to dislodge plaque. Do this gently on the outer as well as inner surfaces of teeth.

  • Floss: Floss daily to remove plaque from between teeth. Take about 18" of floss and wrap most of it around your middle finger and the rest around the middle finger of the other hand, leaving a 2" length between them. Using your thumb and forefinger, gently scrape the side of each tooth away form the gum.

  • Rinse: Rinse your mouth with water thoroughly after each meal. Rinse for a minute everyday with mouthwash.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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