Dental cavities
Caries; Tooth decay; Cavities -
tooth
Dental cavities are holes (or
structural damage) in the teeth.
Causes,
incidence, and risk factors
Tooth Decay is usually occurs in
children and young adults but can affect any person. Tooth decay is a common
cause of tooth loss in younger people.
Bacteria are normally found in your
mouth. These bacteria change foods -- especially sugar and starch -- into
acids. Bacteria, acid, food pieces, and saliva combine in the mouth to form a
sticky substance called plaque. Plaque sticks to the teeth. It is most common
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 turns into a substance called tartar. Plaque and tartar irritate the
gums, resulting in gingivitis
and periodontitis.
Plaque begins to build up on teeth
within 20 minutes after eating. If it is not removed, tooth decay will begin.
The acids in plaque damage the
enamel covering your teeth, and create holes in the tooth (cavities). Cavities
usually do not hurt, unless they grow very large and affect nerves or cause a
tooth fracture. An untreated cavity can lead to a tooth abscess.
Untreated tooth decay also destroys the inside of the tooth (pulp), which leads
to tooth loss.
Carbohydrates
(sugars and starches) increase the risk of tooth decay. Sticky foods are more
harmful than nonsticky foods because they remain on the teeth. Frequent
snacking increases the time that acids are in contact with the surface of the
tooth.
Symptoms
There may be no symptoms. If symptoms
occur, they may include:
- Tooth pain or achy feeling, 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 dental checkups.
A dental exam may show that the
surface of the tooth is soft.
Dental x-rays
may show some cavities before they are visible to the eye.
Treatment
Treatment can help prevent tooth
damage from leading to cavities.
Treatment may involve:
- Fillings
- Crowns
- Root canals
Dentists fill teeth by removing the
decayed tooth material with a drill and replacing it with a 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 to be
stronger, and these materials are often used on back teeth. There is a trend to
use high strength composite resin in the back teeth as well.
Crowns or "caps" are used
if tooth 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. A crown
is fitted over the remainder of the tooth. Crowns are often made of gold,
porcelain, or porcelain attached to metal.
A root canal is recommended if the
nerve in a tooth dies from decay or injury. 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 is usually needed.
Expectations
(prognosis)
Treatment often saves the tooth.
Early treatment is less painful and less expensive than treatment of extensive
decay.
You may need numbing medicine
(lidocaine) and prescription medications to relieve pain during or after dental
work.
Nitrous oxide with novocaine or other
medications may be preferred if you are afraid of dental treatments.
Complications
- Discomfort or pain
- Fractured tooth
- Inability to bite down on tooth
- Tooth abscess
- Tooth sensitivity
Calling
your health care provider
Call your dentist if you have a toothache.
Make an appointment with your
dentist for a routine cleaning and examination if you have not had one in the
last 6 months.
Prevention
Oral hygiene
is necessary to prevent cavities. This consists of regular professional
cleaning (every 6 months), brushing at least twice a day, and flossing at least
daily. 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 some
cavities. Sealants are thin plastic-like coatings 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 fluoride
solutions (applied to a localized area of the teeth) as part of routine visits.
Doctor Me , 2013021519:54:48
