Tooth decay, also known as cavities or caries, is one of the most common health problems worldwide. It occurs when acids produced by bacteria in your mouth attack and dissolve the hard outer surface of your teeth, called enamel.
If tooth decay is left untreated, it can lead to pain, infection, and even tooth loss. While very young children and older adults are at higher risk for tooth decay, it can affect people of all ages.
Addressing tooth decay early is essential to prevent further damage and more extensive dental treatment down the road.
What causes tooth decay? How can you recognize the signs of tooth decay? What are the available treatment options? We’d consider these and more in this article.
Signs of Tooth Decay
Before addressing what causes tooth decay, we need you to be able to recognize its symptoms. In its early stages, tooth decay may not cause any symptoms at all. However, as the decay process progresses, you may experience some of the following signs:
- Tooth Discoloration
One of the first visible signs is a chalky white or brown spot on the surface of your tooth. This indicates that acids have started to dissolve the mineral content of the tooth enamel. - Tooth Pain
As the decay penetrates further into the dentin layer underneath the enamel, you may experience pain or discomfort when biting down or when eating or drinking hot, cold, or sweet foods and beverages. - Holes or Pits
More advanced decay appears as holes, pits, or cavities that have broken through the enamel surface. You may notice stains around the area as well. - Bad Breath/Unpleasant Taste
The bacteria that cause tooth decay can leave a lingering, unpleasant taste in your mouth or make your breath smell foul. - Tooth Sensitivity
If decay reaches the inner pulp chamber containing nerves and blood vessels, you may suffer from persistent tooth sensitivity or pain that gets worse with hot, cold, or sweet sensations.
While not always painful, keep an eye out for any visible spots, stains, or abnormalities on your teeth that could indicate the presence of tooth decay. Catching it early makes treatment easier and inexpensive.
See your dentist immediately if you notice any signs, especially if accompanied by pain, swelling around the tooth, fever, difficulty swallowing or breathing. These can be symptoms of a severe abscess or infection that requires prompt treatment.
Causes of Tooth Decay
So, what actually cause tooth decay? While acids from bacteria are the direct cause of tooth decay, several key factors contribute to this process occurring:
- Bacteria in the Mouth
Certain types of bacteria that thrive in the mouth produce acids as they feed on the sugars and starches from foods and beverages you consume. These acids attack and weaken tooth enamel over time. - Frequent Snacking/Sipping
Each time you eat or drink something sugary or starchy, the bacteria produce acids that attack tooth enamel for 20-30 minutes. Snacking or sipping frequently throughout the day causes a continual acid attack. - Poor Oral Hygiene
Not brushing and flossing thoroughly allows plaque (a sticky film of bacteria) to accumulate on teeth. Plaque produces acids that promote tooth decay. - Lack of Saliva
Saliva helps neutralize and wash away acids and food particles. Conditions that cause dry mouth reduce this protective effect, increasing decay risk. - Certain Foods/Drinks
Consuming sugary snacks, sodas, juices, candy, and other sweets exposes teeth to decay-causing acids repeatedly. Starchy snack foods can have a similar effect. - Bedtime Bottles
Allowing a baby or toddler to sleep with a bottle can cause severe decay, as the sugary liquids constantly pool around teeth.
Does Sugar Cause Tooth Decay?
Apart from the query, what causes tooth decay, another issue people are curious about is the idea of sugar being a causative factor.
Well, while sugar itself does not directly cause tooth decay, it does play a major contributing role by feeding the bacteria in your mouth that produce the decay-causing acids.
The bacteria Streptococcus mutans and Lactobacilli use sugars and starches from the foods and beverages you consume as a fuel source. As they metabolize these sugars, they release acids as a byproduct that attack and dissolve tooth enamel.
The more frequently you consume sugary foods and drinks like candy, cookies, sodas, juices, and sports drinks, the more frequently you are exposing your teeth to an acidic environment that promotes demineralization and cavity formation.
However, tooth decay can still occur in the absence of dietary sugars, as these bacteria can also metabolize starches from foods like crackers, bread, chips, and other snacks. This creates a similar acidic condition in the mouth.
To help prevent tooth decay, it’s best to limit the frequency of consuming sugary and starchy snacks and beverages. Try to avoid sipping on sweet drinks throughout the day. Be sure to brush and floss thoroughly after eating.
While completely cutting out sugar is impractical for most people, being mindful of your overall sugary food and beverage intake can go a long way toward keeping decay-causing bacteria under control.
Stages of Tooth Decay
Tooth decay is a progressive condition that worsens over time if left untreated. It typically occurs in the following stages:
A. Stage 1: Demineralization
At this early stage, the acids produced by bacteria cause small holes or microscopic areas of tooth erosion to form in the enamel surface. These look like white or brown spots on the tooth. The enamel damage is minor and can potentially be reversed with good oral hygiene and remineralization treatments.
B. Stage 2: Enamel Decay
If the demineralized areas continue to be exposed to acid attack, the enamel can break down further, forming a small cavity or pit on the tooth surface. At this point, the damage is physical and irreversible. Dietary changes, fluoride, and improved oral hygiene can help prevent further decay progression.
C. Stage 3: Dentin Decay
The cavity becomes deeper, penetrating through the enamel into the underlying dentin layer. Dentin is softer than enamel, so the decay can spread more quickly at this stage. You may experience pain or sensitivity at this stage.
D. Stage 4: Pulp Involvement
If decay advances far enough to reach the inner pulp tissue containing the nerves and blood vessels, it can cause severe pain and infection. At this advanced stage, a root canal treatment is usually required to save the tooth.
E. Stage 5: Abscess Formation
An untreated, decayed tooth can eventually become so infected that a pocket of pus (abscess) develops, potentially causing swelling of the face, fever, and other serious symptoms. Root canal treatment or extraction is necessary.
The best way to avoid advancing through these stages is to have tooth decay treated promptly in its earliest phase when a simple filling can restore the tooth.
Tooth Decay vs. Cavity
The terms “tooth decay” and “cavity” are often used interchangeably, but they don’t mean exactly the same thing. It’s important to understand the distinction.
Tooth Decay
Tooth decay refers to the actual disease process that occurs when acids from oral bacteria demineralize and damage the hard outer surface of teeth.
Decay is what happens first, before a cavity forms. The decay damages and weakens areas of enamel through acid erosion over time. Proper dental care can sometimes reverse decay in its earliest stages before a physical cavity develops.
A Cavity
A cavity is the actual hole, pit, or physical damage that develops in the tooth as a result of the tooth decay process. Once decay breaks down enough enamel to leave a detectable gap, pocket or hole on the tooth surface, that is a cavity.
Cavities start out small and become bigger over time as the decay penetrates deeper layers of the tooth. They represent more advanced, permanent damage caused by ongoing decay that requires professional dental treatment.
You can have tooth decay occurring without a visible cavity present initially. But untreated decay will eventually lead to the formation of cavities. Tooth decay is the precursor problem that creates an environment allowing cavities to form over time.
Catching tooth decay early through regular dental exams gives an opportunity to remineralize and prevent decay from creating permanent cavities. But once a cavity is present, restorative treatment like a filling is required to repair it.
Tooth Decay Treatment at Home
Now that you know what causes tooth decay, let’s address how to treat tooth decay at home.
While only a dentist can professionally treat cavities once they’ve formed, there are some home remedies that may help remineralize and reverse very early stages of tooth decay:
- Fluoride Treatment
Fluoride is a mineral that can strengthen areas of demineralized enamel in the earliest stages of decay. Use a fluoridated toothpaste and consider adding a fluoride mouth rinse to your daily routine. - Saltwater Rinses
Rinsing with warm saltwater may help reduce bacteria and promote healing of early decay. Simply mix 1 tsp of salt in a cup of warm water and swish it around your mouth. - Brush with Baking Soda
The mild abrasiveness of baking soda can help remove plaque and surface stains/debris from white spots of demineralized enamel. Use it occasionally as a tooth polish. - Sugar-Free Gum
Chewing sugar-free gum stimulates saliva production, which can help neutralize acids and wash away food particles. - Oil Pulling
Swishing coconut, sesame or sunflower oil around the mouth may help remove bacteria and promote tooth remineralization, though evidence is limited. - Ensure Calcium/Vitamin D
Getting enough calcium and vitamin D is crucial for keeping teeth strong and aiding remineralization of enamel.
While these home methods may help in very early stages of enamel erosion, once decay creates a cavity, you will need professional treatment from a dentist to remove decayed areas and restore the tooth properly
What Do Dentists Do for Tooth Decay?
If tooth decay has progressed to form a cavity or area of more significant enamel damage, professional treatment from a dentist is required to restore the tooth and prevent further decay. Depending on the extent of decay, a dentist may recommend one of the following procedures:
- Fluoride Treatment
For areas of early enamel demineralization or decay, a dentist may apply a concentrated fluoride gel, varnish, or high fluoride-containing filling material to help harden the enamel. - Fillings
Once a cavity has formed, the decay must be removed by drilling, and the area filled to restore the missing tooth structure. Fillings can be made from tooth-colored composite resin. - Crowns
If decay is very extensive, removing enough tooth to place a filling may weaken the tooth too much. In this case, a crown or cap that covers the entire tooth may be needed to restore its shape and strength. - Root Canal Treatment
When decay reaches the inner pulp containing nerves and blood vessels, root canal treatment is performed to remove the infected pulp, disinfect the root canals, and seal them to prevent abscess formation. - Tooth Extraction
If a tooth is too severely decayed or infected to be restored, the dentist may need to extract or remove the entire tooth to prevent the spread of infection.
Extraction of Decayed Teeth
In some cases of severe, advanced tooth decay, the tooth may be too badly damaged to be repaired with a filling or crown. When decay penetrates deep into the inner layers and roots of the tooth, extraction (removal) may be necessary to prevent further infection and complications.
Here are some signs a tooth may need extraction:
- A large cavity or decay extending into the tooth pulp
- Abscess or pus-filled pocket around the tooth root
- Significant pain or swelling
- Crack or fracture in the tooth extending below the gum line
- Loosening or excessive mobility of the tooth
The Extraction Procedure
Having a decayed tooth extracted typically involves:
- Administering local anesthesia to numb the area
- Using dental instruments to loosen and remove the tooth
- Controlling bleeding by having the patient bite on a gauze
- Providing aftercare instructions for managing discomfort and healing
After a tooth has been extracted, replacement options like dental implants, bridges or partial dentures can be considered to restore function and appearance.
While permanent tooth loss is never ideal, sometimes extraction is the best choice to relieve severe pain, halt infection spread, and promote overall oral health when a tooth cannot be viably restored.
What to Do When You Have Tooth Decay
Knowing what causes tooth decay is ideal, but what should you do if you think you may have a decayed tooth?
If you suspect you may have a cavity or area of tooth decay, it’s important to have it evaluated and treated promptly by a dentist.
Allowing decay to progress can lead to more extensive damage, pain, infection, and potential tooth loss.
- See a Dentist
As soon as you notice any signs of tooth decay like brown or white spots, holes, pits, or sensitivity, make an appointment to see your dentist. They will examine the area closely, take x-rays if needed, and recommend the most appropriate treatment based on the extent of decay. - Don’t Delay Treatment
While very minor, early-stage decay may potentially be remineralized, once a cavity forms, it requires professional cleaning and restoration with a filling or other treatment. Putting off treatment allows more time for decay to spread deeper into the tooth. - Undergo Recommended Procedures
Depending on how advanced the decay is, your dentist may recommend procedures like fillings, crowns, root canals, or tooth extraction. Follow through with the complete treatment plan to remove all decayed areas and restore the tooth properly. - Adjust Your Oral Hygiene
After treatment, be diligent about brushing twice daily with fluoride toothpaste, flossing once a day, using an antiseptic mouthwash, and limiting sugary/acidic foods and drinks that feed decay-causing oral bacteria. - Have Regular Checkups
To catch any new decay early, be sure to continue getting six-month professional cleanings and exams. Your dentist can identify problem areas and remineralize or treat them before a cavity forms.
Taking quick action at the first signs of potential decay, combined with thorough daily oral care, professional cleanings, and a tooth-friendly diet can help halt the decay process and minimize future damage. Don’t ignore tooth decay – the sooner it’s treated, the better!
Final Words
Tooth decay is one of the most common health issues impacting children and adults alike. While largely preventable through good oral hygiene habits and a balanced diet, decay can progressively worsen and lead to pain, infection, and tooth loss if left untreated.
By understanding the causes of decay, being able to recognize the signs, and knowing what professional treatment options are available, you can take control of your oral health.
At C.W. Williams Community Health Center Inc., our experienced dental team prioritizes preventative care and education to help keep your smile healthy for life.
Whether you need a routine cleaning, fillings, pediatric dentistry services, or any other dental treatment, we provide affordable, high-quality care using the latest techniques and technology. Contact us today to schedule an appointment at one of our convenient locations. Don’t let tooth decay keep you from achieving a confident, healthy smile!
