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Tooth decay is one of the most common health problems worldwide and can affect anyone at any age. However, cavities are more common in children, teenagers, and older adults.
Tooth decay results in cavities in teeth. Initially, a cavity might only be a small lesion affecting the tooth enamel, but eventually, it will become deeper, reaching the dentin underneath. Dentin is much softer than tooth enamel, so once a cavity reaches the dentin, it can quickly become deeper. Without treatment, it will penetrate the central part of the tooth, called the pulp, which contains the tooth nerve, connective tissues, and blood vessels. This can lead to severe toothache and infection, and potentially tooth loss.
Tooth decay, also called dental caries, is caused by bacteria in dental plaque. Plaque continually builds up over tooth surfaces and is a sticky biofilm. The bacteria in plaque feed on leftover food particles, producing acid as a by-product. The acid weakens and erodes tooth enamel and causes tiny holes in the enamel. Once these holes are present, the bacteria can penetrate the next layer of your tooth, called dentin, which is far softer and more easily damaged by the bacteria and acids. Dentin consists of tiny tubules tightly packed together, transmitting sensations to the tooth nerve, resulting in sensitivity.
Eventually, toothache develops because the acids and bacteria reach the dental pulp containing the tooth nerve, blood vessels, and connective tissues, causing the pulp to become irritated and inflamed. The inflammation causes the pulp to expand, pressing against the nerve and causing discomfort.
The more often teeth are exposed to these acids and the acids found naturally in food, the higher the risk of tooth decay. People with lax oral care are more prone to developing cavities as plaque can build up, allowing the bacteria within it to multiply to unmanageable numbers.
Whenever you eat or drink anything sweet, starchy, or acidic, your mouth remains acidic for about half an hour afterward. Someone who snacks frequently on sugary or starchy foods or acidic foods and beverages is more likely to develop cavities as their mouth will be acidic for longer.
Cavities can even develop in infants’ teeth, especially when babies are given a bedtime bottle containing formula, milk, juice, or other sugary liquids. These liquids can then coat their teeth for hours during sleep, feeding the harmful bacteria that create acids. Children are also more prone to developing cavities because their milk teeth are covered in a thinner layer of tooth enamel that is more easily eroded.
Inadequate fluoride can also result in cavities. Fluoride is a naturally occurring mineral that helps harden tooth enamel, increasing its resistance to tooth decay. Fluoride is found in many public water supplies and toothpaste, and mouthwash. The fluoride in public water supplies is tightly regulated, so you cannot receive too much. If you only drink bottled water, you may not receive enough fluoride, as bottled water typically doesn’t contain this mineral.
Worn dental restorations like fillings or crowns can gradually begin to leak as they age. As the edges break down, they can more easily trap plaque, allowing tooth decay to develop underneath them.
Dry mouth or xerostomia is where inadequate saliva is present to help wash away plaque and food particles. Saliva also contains substances that help neutralize the acids produced by bacteria. Without enough saliva, the risk of tooth decay increases substantially. Certain medications or medical treatments, like chemotherapy, can cause dry mouth.
Some teeth are more prone to tooth decay than others. Tooth decay occurs most frequently in back teeth as the chewing surfaces have grooves and fissures that easily trap food particles and plaque. These intricate surfaces are harder to keep clean than the smooth, easy-to-clean surfaces of front teeth.
Various symptoms can indicate the beginnings of a cavity, but initially, you may have zero symptoms. As decay worsens, it can cause signs that include:
The early signs of cavities are often symptom-free, so regular dental checkups and cleanings are very important, even if you think your dental health is good. If you notice symptoms like tooth sensitivity or pain, please see us at Century Dental as soon as possible.
There are several stages of tooth decay.
Tooth decay treatment depends on the extent of the decay. If you only have a small lesion or soft spot in your tooth enamel, we may treat it with a professional application of fluoride. The fluoride is applied topically to the tooth and helps to re-harden the tooth enamel, so a cavity cannot form. Sometimes it is possible to use dental sealants to stop a small lesion in a tooth from worsening. The sealant consists of a thin layer of plastic material and is very durable and hard-wearing, and seals the lesion completely, preventing the bacteria from causing further damage and decay. These treatments are very quick and affordable and can probably be provided immediately.
Small to medium-sized cavities can be filled using tooth-colored composite resin or another suitable filling material. A dental filling is another affordable treatment completed during a single visit.
If you have a larger cavity that has destroyed much of your natural tooth, you may need a dental crown that covers it entirely. The crown will seal the tooth completely so bacteria cannot get inside the tooth and cause further decay.
When the bacteria have reached the dental pulp, we must carry out a root canal treatment. The treatment removes the damaged and infected pulp and tissues extending into the root canals in your tooth roots and removes the bacteria causing the infection and decay. Afterward, we seal your tooth, restoring it with a dental crown.
If a tooth is severely decayed and infected and has developed into a dental abscess, we may need to remove the tooth. Removing the tooth allows the abscess to drain, preventing the infection and decay from continuing.
If you have recently had a few problems with tooth decay, we can discuss how to manage this problem. We may suggest you have your teeth cleaned professionally more frequently as this helps get rid of plaque and tartar buildup, reducing the risk of decay. We can review your oral care routine, ensuring you use good quality fluoride toothpaste, and we may recommend using a mouth rinse containing fluoride.
We can review your dietary habits if you already have a good oral care routine. Sometimes making small changes like reducing snacking between meals or snacking on healthier foods can reduce the risk of cavities.
When seeing children, we often recommend they have dental sealants to protect their teeth. These are applied to the chewing surfaces of back teeth, sealing these surfaces and preventing tooth decay. They are best applied soon after children get their adult teeth, but sometimes we also use them to protect milk or primary teeth when the risk of tooth decay is higher. Another possible treatment is silver diamine fluoride, which is painted onto teeth to help treat tooth decay. Although it cannot cure tooth decay, it stops it from progressing.
If you have young children or a baby in the family, it’s very important to ensure you have good dental health, as the bacteria that cause tooth decay are spread by kissing, sharing utensils, or licking a pacifier before handing it back to a child.
The cost depends on the degree of decay. A small lesion or tiny pit in a tooth is quick and cheap to mend, whereas root canal therapy does cost more because it is a far more intricate and technique-sensitive procedure. If you have dental insurance, it will almost certainly cover the cost of treating tooth decay, including dental sealants for children and cosmetic restorative treatments like fillings, root canal therapy, and crowns.
Century Medical and Dental Center is an accredited healthcare facility in NY that operates in accordance with Article 28, a public health law. This law regulates and recognizes accreditation for public healthcare facilities, ensuring they are licensed and operated correctly. By undergoing the Article 28 process and achieving accreditation, Century Medical and Dental Center demonstrates its commitment to meeting the highest standards of care.
As a multidisciplinary medical center, we have highly qualified doctors, nurses, and support staff who are working hard to provide the best medical care to patients in Midtown Manhattan, NY, Downtown Brooklyn, NY, including Brooklyn Heights, Dumbo, Prospect Heights, Park Slope, Clinton Hill, Boerum Hill, Red Hook, and Bedford-Stuyvesant.