A pathological process which is driven by different factors, for example, cariogenic bacteria in the mouth, host immune system, and local conditions in the oral environment are known as dental caries. They are formed due to tooth decay that arises as a result of bacterial infections. Different types of bacteria are responsible for producing acids which erode or affect the tooth enamel and the underlying layers, known as dentin. This acid is originated when the concentration of sugar in food and drinks gets reacted with the bacteria present in the plaque. The acid generated leads to the loss of phosphate and calcium from an enamel. This process is known as demineralization.
How Does A Cavity Originate?
High sugar, starch, and bacteria are one of the major factors which contribute towards tooth decay. Near about 500 different types of bacteria shelter in a person’s mouth. They make a combination with food and saliva to develop a sticky substance called plaque which attaches to teeth. Things that contain starch add to the stickiness of the plaque and begin to get hard if it continues to remain on the teeth after a matter of some days and turns into calculus or tartar. Plaque’s bacteria convert sugar into acid which dissolves the teeth structure, resulting in holes or cavities. Due to these factors, dental caries is also termed as a dietobacterial disease.
A substance that is found naturally in some water resources is fluoride. It is also regarded as one of the most common elements on the earth. The most important thing is that fluorides are helpful in preventing dental arises. The work of fluoride regarding dental care is that it slows down the process of demineralization, whereby the enamel loses phosphate and calcium when exposed to acid following ingestion of drinks and foods that contain sugars.
It is also beneficial in healing the surfaces that indicate early signs of phosphate or calcium loss, like opaque appearance. It is good to constantly maintain a low level of fluoride in the mouth whole through the day. Many kinds of toothpaste contain fluoride in it. It is delivered directly or topically to the surfaces of a tooth with the help of toothpaste, rinses, and assists in maintaining the fluoride levels in the mouth. Toothpaste containing fluorides are an important source of additional fluoride and must consume twice a day in order to maintain a constant level of fluoride in the mouth.
Sugar-One Of The Major Cause
According to medical science, frequent consumption of sugars can lead towards dental caries. Dietary advice is given to limit the frequency of sugar intake. Research has stated that consumption of sugar remains a moderate factor of risk for dental caries even when populations have adequate exposure to fluoride. And that exposure is coupled with a reduction of sugar intake has an effect on caries reduction. It is advised that the foods and drinks that contain free sugars, like sugars which have been naturally present in them like fruit juices, honey and syrup should be recognized and the frequency of their intake especially between meals should be reduced.
Dental Caries Causes
Dental caries can be found in two different areas of the teeth, namely occlusal caries and interproximal caries. Occlusal caries, which develop on the topmost part of the teeth where the particles of food repeatedly come in direct contact with the teeth. Interproximal caries is formed between the teeth. These are the two areas where bacteria can fix themselves and pose a risk to a person’s oral hygiene. If the teeth and its surrounding areas are not cared for properly, the bacteria will start digesting sugars that have been left from the food in a person’s mouth.
After that, it will convert into acids as a waste product. Such types of acids are powerful enough to demineralise the enamel on the teeth and produce a tiny hole, which is assumed to be the first stage of dental caries. The tooth loses its ability to reinforce the phosphate and calcium structures of the teeth naturally through saliva properties as the enamel begins to break down, and the acid penetrates into the tooth to destroy or from the inside out.
Dental Caries Symptoms
Dental caries can appear at any stage of our life. We can uplift their standards by not taking care of our teeth and when promote unhealthy eating. Some of the major symptoms of dental caries include toothache, discoloration, pain at the time of chewing food, tooth loss, tooth sensitivity towards cold and hot, loose and bleeding gums, etc.
Risk Factors That Contribute Towards Dental Caries
Saliva prevents the mouth from getting dry and it also assists in preventing plaque to attach with the teeth. It also helps to digest and washes away food particles. A dry mouth or low salivary flow leaves the teeth more prone towards tooth decay. Given below are some of the genetic factors that affect dental caries.
- Size and Shape- Small teeth having different grooves and deep pits will be more vulnerable to the formation of the cavity as compared to the larger teeth with less and shallower grooves. Pits and grooves are responsible for encouraging plaque formation and are difficult to brush thoroughly.
- Enamel’s Thickness- Enamel is the name of the tooth’s main defence against cavities. Longer the presence of enamel, the longer it will take for a cavity to break through to the inside part of the tooth.
- Tooth Position and Bite- Overlapped and crooked teeth deliver more area for plaque to aggregate and are tough to keep clean. Several peculiarities can emerge if the bite is aligned poorly. Poor alignment of the bite can be responsible for causing the enamel on assertive teeth to wear down rapidly, leaving soft dentin exposed. Orthodontics is a deliberate cavity-prevention measure as straight teeth which are in a suitable position tend to stay cleaner as well as more cavity-free throughout a person’s lifetime.
Types of Dental Caries
Dental caries can also stand as tooth decay or cavities. It is one of the most common forms of oral health problems that people face. Even dental caries concludes different varieties starting from enamel carries to dentin carries, reversible carries, pit and fissure, smooth surface, early childhood caries, acute dental caries, primary and secondary caries. Out of which we will try to explain some of them in detail.
- Enamel Caries- Impact of cavities on enamel is because of the acidic environment produced by bacteria. Bacteria get energy by consuming the sugar content of the food and also develop lactic acid. This acid advances through demineralization of crystals in the enamel. The damage will be caused continuously till the bacteria physically penetrate the dentin.
- Acute Caries- It is a rapid process that affects a large number of teeth. Lesions of these caries are grey or light brown in colour as compared to the lesions caused by other types of caries. The unhealthy consistency of these caries makes the digging of the infected teeth difficult. Sensitive teeth and pulp exposure are the common effects seen in patients regarding acute caries.
- Secondary Caries- Edges of restoration and fracture places in the mouth are some of the common locations of secondary caries to occur. Such types of caries can result from an improper adjustment of restoration or incompetent restoration extension. In order to treat secondary caries completely, the complete removal of the original lesion is needed, that may appear as recurrent caries later.
- Early Childhood Caries- This variety of dental caries usually occurs in young children. Early childhood caries takes place at the time when a baby is fed with a milk bottle at bedtime and some small amount of milk drops remain inside the mouth for a long interval of time. It can eventually cause inflammation of the gums, yellowing the teeth and excessive pain in the teeth, the pain can raise difficulties in eating, speaking or sleeping. Mainly the two upper front teeth are affected in this caries. That is why one needs to take special care like avoiding bottle-feeding and night-time breastfeeding once the first baby teeth begin to visible.
- Arrested Caries- It is yet another variety of caries that becomes static without displaying any tendency to progress further. With the stabilization of oral hygiene, even advanced lesions may be arrested. One of its symptoms contains dark pigmentation without any breakdown of tooth tissues.
What Are Microcavities?
Our teeth have been located in such part of a body where a constant acid attack continues which strips the teeth of important minerals and breaks the teeth down. While these types of attack occur constantly, minerals also need to replenish with the help of fluoridated water or toothpaste and mineral-rich saliva. Even phosphate and calcium also favour fluoride in remineralizing the enamel. After the demineralization happens and is confined to the outermost layer of the enamel, it is known as microcavity, also known as an incipient cavity. Such types of cavities rarely grant anything more than very conservative treatment. It really threatens the tooth only when the cavity breaks through the enamel layer into the dentin.
That’s why when such types of symptoms are detected, it is better to try a remineralization protocol to explore if they can be reversed rather than jumping to a filling right away. A dentist will assist you in determining the most effective conservative treatment for such types of early cavities.
Dentists try to achieve a reputed balance between restoration and prevention, which is a balance between being reactive and proactive. He doesn’t want to be that much proactive that he tells those things that don’t need to be performed. On the other hand, he must not behave so much reactive that small problems become big problems in front of his eyes.
It is common thinking among many people that they often wait for the pain to dictate the timing of the treatment. Once the teeth start hurting, it often gets too late for small filling or remineralization. Pain can indicate towards tooth extraction, a crown or even root canal treatment. It is very important to choose the right dentist who can provide you ideal suggestions according to the condition of your problem.
Regardless of the dentist, regular returns to the dentist can be classified as one of the keys of being conservative so that one should examine, monitor and treat and cavity before it grows too much. More tooth structure gets lost as the cavity tends to grow. It may lead towards a greater likelihood of recurrent decay, tooth loss or fractured teeth.
Dental Caries Treatment
Dental caries, in its early stages, can be stopped and reversed as well. Fluorides can be one of the prevention methods that help a tooth in the early stages of tooth decay in order to remineralize. Once a break appears in the enamel and condition of caries get worse, one must need to knock the doors of a dentist’s lab. To provide relief from the cavity, the standard treatment is to fill the tooth. The dentist might numb the area if he occupies a drill. There might be possibilities of using a laser, that usually does not require a numbing shot. After the process, the decayed material in the cavity gets removed and the cavity gets filled.
Dental amalgam and composite resins are two of the things used in the process of filling. Amalgam can be considered as a silver-grey material that is produced from silver, copper, mercury or other metals. On the other hand, composite resins are durable and tooth-coloured, and thus offer a better appearance. If the cavity seems to be large, the remaining tooth may not get able to support sufficient filling material to fix it. In this case, the practitioner may eject out the decay and cover the teeth with an artificial crown or a ceramic inlay-onlay.
It happens sometimes that bacteria may infect the pulp inside the teeth even if the teeth’s part stays relatively intact. At such cases, root canal treatment might be appreciated. The practitioner will remove the pulp and replace it with an inert material. In many cases, the teeth need a crown.