A pathological process depends on different factors, such as cariogenic bacteria in the mouth, host immune system, and local conditions in the oral environment, known as dental caries. Due to tooth decay, dental caries arise as a result of bacterial infections. Different bacteria produce acids that erode or affect the tooth enamel and the underlying layers, known as dentin. This acid originated when the sugar concentration in food and drinks reacts with the bacteria in the plaque. The acid generated leads to the loss of phosphate and calcium from an enamel called demineralization.
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 combine 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 some days and turns into calculus or tartar. Plaque bacteria convert sugar into acid, which dissolves the teeth’ structure, resulting in holes or cavities. Due to these factors, dental caries is also a diet-bacterial disease.
A substance that is available naturally in some water resources is fluoride. It is also related to 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 demineralisation process, whereby the enamel loses phosphate and calcium when exposed to acid following the ingestion of drinks and foods containing sugars.
It is also beneficial in healing surfaces that indicate early signs of phosphate or calcium loss, like an 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 delivers directly or topically to the surfaces of a tooth with the help of toothpaste and rinses and assists in maintaining the fluoride levels in the mouth. Toothpaste containing fluorides is an important source of additional fluoride and must consume twice a day to maintain a constant level of fluoride in the mouth.
Dental caries can be available in two different areas of the teeth, namely occlusal caries and interproximal caries. Occlusal caries develop on the topmost part of the teeth, where food particles repeatedly come in direct contact with the teeth. Interproximal caries forms 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 surrounding areas are not cared for properly, the bacteria will start digesting sugars left from the food in a person’s mouth.
After that, it will convert into acids as a waste product. Such 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 naturally reinforce the phosphate and calcium structures of the teeth through saliva properties as the enamel begins to break down, and the acid penetrates the tooth to destroy or from the inside out.
According to medical science, frequent sugar consumption can lead to dental caries. Dietary advice is given to limit the frequency of sugar intake. Research has stated that sugar consumption remains a moderate risk factor for dental caries even when populations have adequate exposure to fluoride. And that exposure, coupled with reduced sugar intake, affects 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 can appear at any stage of our life. We can uplift their standards by not caring for our teeth and promoting unhealthy eating. Some major dental caries symptoms include toothache, discolouration, pain when chewing food, tooth loss, tooth sensitivity towards cold and hot, loose and bleeding gums, etc.
Saliva prevents the mouth from drying and plaque from attaching to the teeth. It also helps to digest and washes away food particles. A dry mouth or low salivary flow makes the teeth more prone to tooth decay. Given below are some of the genetic factors that affect dental caries.
Small teeth with different grooves and deep pits will be more vulnerable to cavity formation than larger teeth with fewer and shallower grooves. Pits and grooves are responsible for encouraging plaque formation and are difficult to brush thoroughly.
Enamel is the name of the tooth’s main defence against cavities. The longer the presence of enamel, the longer it will take for a cavity to break through to the inside part of the tooth.
Overlapped and crooked teeth deliver more area for plaque to aggregate and are tough to keep clean. Several peculiarities can emerge if the bite aligns 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 in a suitable position tend to stay cleaner and more cavity-free throughout a person’s lifetime.
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 conclude different varieties, from enamel to dentin carriers, reversible caries, pit and fissures, smooth surfaces, early childhood caries, acute dental caries, and primary and secondary caries. Out of which we will try to explain some of them in detail.
The impact of cavities on enamel is because of the acidic environment produced by bacteria. Bacteria get energy by consuming the food’s sugar content and developing lactic acid. This acid advances through the demineralization of crystals in the enamel. The damage will cause continuously till the bacteria physically penetrate the dentin.
It is a rapid process that affects a large number of teeth. Lesions of these caries are grey or light brown compared to the lesions caused by other caries. The unhealthy consistency of these caries makes digging the infected teeth difficult. Sensitive teeth and pulp exposure are the common effects in patients regarding acute caries.
Edges of restoration and fracture places in the mouth are some common locations of secondary caries. Such types of caries can result from an improper adjustment of restoration or incompetent restoration extension. To treat secondary caries completely, the complete removal of the original lesion needs, which may appear as recurrent caries later.
This variety of dental caries usually occurs in young children. Early childhood caries occurs when a baby is fed with a milk bottle at bedtime, and some small amounts of milk drops remain inside the mouth for a long time. It can eventually cause inflammation of the gums, yellowing of the teeth, and excessive pain in the teeth; the pain can raise difficulties in eating, speaking or sleeping. Mainly the two upper front teeth affect this caries. That is why one needs to take special care once the first baby teeth become visible, like avoiding bottle-feeding and night-time breastfeeding.
Another variety of caries becomes static without displaying any tendency to progress further. With the stabilization of oral hygiene, even advanced lesions may arrest. One of its symptoms contains dark pigmentation without any breakdown of tooth tissues.
Our teeth have been located in such body parts where a constant acid attack continues, which strips the teeth of important minerals and breaks the teeth down. While these types of attacks 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 a microcavity, also known as an incipient cavity. Such types of cavities rarely grant anything more than very conservative treatment. It threatens the tooth only when the cavity breaks through the enamel layer into the dentin.
That’s why when such symptoms are detected, it is better to try a remineralization protocol to explore whether they can be reversed rather than jumping to a filling immediately. A dentist will assist you in determining the most effective conservative treatment for such early cavities.
Dentists try to achieve a reputed balance between restoration and prevention, which is a balance between reactive and proactive. He doesn’t want to be so proactive that he tells those things that don’t need to be performed.
On the other hand, he must not behave so reactively 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, small filling or remineralization often becomes too late. Pain can indicate tooth extraction, a crown or even root canal treatment. It is very important to choose the right dentist who can provide you with ideal suggestions according to the condition of your problem.
Regardless of the dentist, regular returns can be classified as one of the keys to being conservative, so one should examine, monitor and treat the 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.
In its early stages, dental caries can also be stopped and reversed. Fluorides can be one of the prevention methods that help a tooth in the early stages of tooth decay to remineralize. Once a break appears in the enamel and caries worsens, one must knock on 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.
Dentists use Dental amalgam and composite resins in filling. Amalgam is a silver-grey material made of 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 large, the remaining tooth may not be able to support sufficient filling material to fix it. The practitioner may eject the decay and cover the teeth with only an artificial crown or ceramic inlay.
It sometimes happens that bacteria may infect the pulp inside the teeth even if the teeth’s part stays relatively intact. In 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.