Dental caries, tooth cavity, or tooth decay is a chronic disease that affects hard dental tissues, particularly the enamel and dentin. It is one of the most prevalent oral diseases globally and may affect individuals of all ages, from children to the elderly. Dental caries can lead to pain, infection, tooth loss, and even systemic complications if left untreated.
Causes of Dental Caries
Dental caries is caused by the interaction of four significant factors: bacterial plaque, dietary sugar, susceptible tooth surfaces, and time. The process begins when food particles, especially sugars and starches, remain on the teeth. Bacteria within the mouth, notably Streptococcus mutans and Lactobacillus species, ferment the sugars and produce acids as metabolic byproducts. The acids then begin dissolving the outermost tooth surface, known as enamel.
If oral hygiene is poor and acid attack persists over a longer period, the enamel becomes weakened, developing a cavity. When decay further advances in the dentin and pulp (interior sections of the tooth), it produces agonizing pain and requires intense dental care in the form of a root canal procedure or extraction of the tooth.
Sequelae of Dental Caries
Dental caries progresses through the following phases:
- Demineralization – At first, acid begins leaching minerals from the enamel, forming white spots.
- Enamel Decay – Continued acid exposure dissolves the enamel, forming a cavity.
- Dentin Involvement – The decay moves further deep into the dentin, which is softer and more rapidly decaying than enamel. At this stage, some patients may develop tooth sensitivity.
- Pulp Damage – If untreated, the decay moves to the pulp, which contains nerves and blood vessels causing pain and possible infection.
- Abscess Formation – In the later stage, the pulp becomes dead and necrosed. A dental abscess may form at the root tip, with a risk of spreading infection to surrounding tissues.
Symptoms of Dental Caries
The symptoms and signs of dental caries vary according to the extent of the decay. Initially, there are no symptoms. As the condition progresses, some of the most prevalent signs and symptoms are:
- Brown, black, or white tooth surface discoloration
- Visible holes or pits in teeth
- Sensitivity to hot, cold, or sweet food and drinks
- Toothache or spontaneous pain
- Bad taste or bad breath
Diagnosis and Treatment
Dental caries is usually diagnosed during a routine dental examination. Dentists can employ visual inspection, dental probes, and radiographic (X-ray) imaging to detect cavities, particularly between teeth or under existing restorations.
Treatment depends on the severity of the decay. A small cavity is treated with a filling of composite resin, glass ionomer, or other materials. More advanced decay may require reshaping of the crown structure. When the pulp gets infected, it can be treated by a root canal treatment and a crown prosthesis. In worst cases, where the tooth is extremely damaged or infected, extraction can be the only option.
Prevention of Dental Caries
The prevention of dental caries needs effective oral hygiene and the addition of healthy practices. The prevention steps are:
- Brushing teeth properly twice daily using fluoride toothpaste
- Flossing once daily to remove plaque and food particles between teeth
- Reducing consumption of sugary and acidic foods and beverages
- Having a dental check-up by a dentist regularly
- Using fluoride treatment or dental sealants as recommended by a dentist
- Education and awareness also play a significant role in prevention, especially among children and caregivers.
Conclusion
Dental caries is a manageable and preventable disease that, if left unchecked, can result in severe oral complications. Good oral hygiene, dental care, and a balanced diet are essential to preventing tooth decay. Early detection and intervention can salvage natural teeth and prevent complications.
