Tooth cavity is the destruction of your tooth enamel, the hard, outer layer of your teeth. It can be a problem for children, teens, and adults. Plaque, a sticky film of bacteria, constantly forms on your teeth. When you eat or drink foods containing sugars, the bacteria in plaque produce acids that attack tooth enamel. The stickiness of the plaque keeps these acids in contact with your teeth and over time the enamel can break down. This is when cavities can form
Two main factors contribute to tooth decay — bacteria in the mouth and a diet high in sugar and starch. There are over 500 different types of bacteria that are normally present in the mouth. These bacteria combine with food and saliva to form a sticky substance called plaque that attaches to teeth. Foods rich in starches add to the stickiness of the plaque, which begins to get hard if it remains on the teeth after a couple of days and turns into tartar or calculus. Bacteria in the plaque convert sugar into acid that dissolves the tooth structure, causing holes, or cavities. Because of these two contributing factors, dental caries has been described as a “diet bacterial” disease.
The parts of teeth that are most vulnerable to tooth decay are areas where plaque can accumulate most easily. Plaque tends to settle into the pits and fissures in the tops of teeth, into the areas in between the teeth, and next to the gum line. Where there is plaque, there are bacteria and acid, and eventually destruction of the tooth surface. The cavity starts in the outer layer of the tooth (enamel) and as it gets deeper, it penetrates the softer inner layer of the tooth (dentin). Typically, it isn’t until the decay reaches the dentin that a person will start to notice signs and symptoms of the cavity.
Saliva helps prevent plaque from attaching to teeth and helps wash away and digest food particles. Low salivary flow or dry mouth leaves the teeth more vulnerable to tooth decay. This is particularly common in patients with diseases that feature dryness of the mouth, such as Sjögren’s syndrome and other diseases of the salivary glands. Genetic factors that affect tooth decay are the following:
When a cavity advances deep into the tooth, it may produce increased sensitivity to foods that are cold, hot, or sweet. But not all cavities will cause a toothache. If they are small or progressing slowly, they may only be detected by a dentist before they cause pain. Cavities on front teeth are easiest for a person to see, and they will be visible as a light or dark brown spot. The brown spot is a tooth structure that has become soft due to the acid attack from bacteria. Generally, light brown represents a fast-growing cavity and dark brown represents a slower-growing cavity. If the cavity gets large enough, part of the affected tooth may break off and leave a hole.
A dentist can detect a cavity by using a sharp instrument to feel a tooth structure that has been softened by tooth decay. If a cavity forms in between the teeth, it may only be visible on an X-ray. Other diagnostic tools that are used to detect cavities include ultrasound, fluorescence, or fiberoptic transillumination. Regular dental exams are recommended so cavities can be diagnosed when they are small cavities (incipient caries or microcavities) instead of waiting until they grow large enough to produce pain and require more extensive treatment.
Tell your doctor about uncomfortable symptoms like tooth sensitivity or pain. Your dentist can identify tooth decay after an oral exam. However, some cavities aren’t visible from an oral exam. So your dentist may use a dental X-ray to look for decay.
Treatment options depend on severity. There are several ways to treat a cavity.
A dentist uses a drill and removes decayed material from a tooth. Your dentist then fills your tooth with a substance, such as silver, gold, or composite resin.
For more severe decay, your dentist may place a custom-fit cap over your tooth to replace its natural crown. Your dentist will remove decayed tooth material before starting this procedure.
When tooth decay causes the death of your nerves, your dentist will perform a root canal to save your tooth. They remove the nerve tissue, blood vessel tissues, and any decayed areas of your tooth. Your dentist then checks for infections and applies medication to the roots as needed. Finally, they fill the tooth, and they might even place a crown on it.
If your dentist detects a tooth cavity in its early stage, a fluoride treatment may restore your tooth enamel and prevent further decay.
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