Dental caries, tooth decay, and cavities are all terms given to the disease in which the teeth’s hard tissues, namely the enamel and the cementum get destroyed by acids produced by oral bacteria.
To have a clear idea of how this happens, normally in your mouth there live some bacteria which part normal oral flora; meaning that they live there without causing harm. They feed on simple sugars or monosaccharides, which are mainly found in the sweet foods like candies, biscuits, chocolates, without forgetting sweet drinks and many others.
After you chew on these sweet foods, your oral bacteria begin to feed on the sugars inside food particles on your teeth surface, releasing acids by the process called fermentation. So, when you don’t properly brush and flush your teeth to reduce the number of these bacteria, and also even remove the remnant of the foods, bacteria can multiply by feeding on the remnant of the sugars. They can form tacky films called plaques on teeth’s surface which houses a lot of bacteria and they keep releasing more acids on the teeth’s surfaces, which eventually leads to the destruction of your teeth tissues. Usually, bacteria like to form plaques in pits or grooves in the back teeth, and near the gumline and between teeth where they can easily hide. This is why tooth decay is most likely to occur in these areas even though they can be found elsewhere on teeth.
Signs and Symptoms
At early stage, it might be symptomless as the enamel is not all eaten up. When the enamel is gone, the pulp (part of the tooth which houses nerves and blood vessels) of the affected tooth become exposed resulting in a tooth which is very sensitive to sweet, hot or very cold foods and drinks, hence toothaches. Other signs include some spots on teeth, holes, and gaps between teeth, blood on your toothbrush, teeth fractures, swelling and bleeding of your gums, fever, etc.
To tell that you have tooth decay and at what extent, dentists can diagnose you by examining your tooth surfaces, but also, they can take some X-ray to see if the cavity has gone deep to erode the dentin or the pulp of the tooth.
Treatment and prevention
When the disease is not very advanced, the dentist may fill the tooth cavity with sealants without removing your teeth. But for advanced cases, management may require tooth extraction, antibiotics and pain relievers. When dental caries is not treated, they can cause a number of much more severe complications including osteomyelitis of the jaw, hematogenous spread which can result into sepsis, and can also result into valvular and coronary heart diseases. As discussed above, poor oral hygiene is the main cause of tooth decay and subsequent associated complications. This is why you should keep your oral hygiene by properly brushing two to three times a day, using toothpaste which contain fluoride which is a chemical that promotes the formation of the hard enamel. And you should regularly visit dentists so that they may track and treat any eminent tooth diseases, because the earlier you start treatment, the better is the prognosis.
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Writer: Evode IRADUFASHA, a medical student at University of Rwanda.