Everyone has bacteria in their mouths. The bacteria eat sugars that are left on the tooth, which then creates acid. The acid and the bacteria form plaque on the teeth. This plaque clings to your teeth. It holds the acid to the tooth. The acid wears away the tooth. Over time, the acid can lead to tooth decay.
Risk Factors
Everyone has the chance to develop tooth decay. Factors that may increase your risk of cavities include:
Snacking
Having poor dental hygiene
Having high numbers of bacteria in the mouth
Having an insufficient amount of fluoride (some communities in the United States add fluoride to the drinking water)
Taking medicine that contains sugar or causes dry mouth
Eating a diet high in sugar
Being malnourished (such as vitamin and mineral deficiencies)
Having certain conditions that decrease the flow of saliva in the mouth (such as
Sjogren syndrome
or Heartburn)
For children: having caregivers or siblings with severe dental caries
Babies are also at risk for developing cavities. Habits that can increase the risk include giving a bottle between regular feedings or while in bed at night.
Symptoms
Symptoms include:
Tooth sensitivity to hot or cold
Tooth discomfort after eating
Darkening of the tooth surface
Bad breath or a foul taste in the mouth
Throbbing, lingering pain in tooth
Diagnosis
Tooth decay is diagnosed over a period of time. This involves clinical examination as well as x-rays.
A dentist checks for tooth decay by:
Asking about pain in the teeth
Visually inspecting the surface of the teeth
Probing teeth with dental instruments to check for:
Sensitivity
Pain
Softness
Surface defects
Taking x-rays of teeth
Treatment
Sometimes tooth decay will repair itself. This is most likely if it is caught early.
Treatment for more severe decay includes:
Fillings
When decay reaches the dentin, your dentist will treat it by:
Numbing the tooth and surrounding tissue area
Removing the decay with instruments
Filling the hole with a dental filling; the filling can be silver or tooth colored
Root Canal
Tooth decay that reaches the pulp and/or root of the tooth is treated with a
root canal:
The tooth is numbed and a hole is drilled through the top of the tooth.
Pus and dead tissue are removed from the tooth.
The inside of the tooth and the root (nerve) canals are cleaned and filled with a permanent filling.
If you are diagnosed with tooth decay, follow your dentist's
instructions.
Prevention
Measures that help prevent and stop tooth decay include:
Proper dental hygiene, including:
Brushing teeth
with fluoride toothpaste after meals or at least twice per day
Daily flossing
between teeth and gums—Bacteria living between the teeth can only be removed with floss or interdental cleaners.
Getting regular dental check-ups and teeth cleaning
Limiting the amount of sugar and carbohydrates you eat and drink, including:
Honey
Sodas
Candy
Cakes
Cookies
Other sweets
Rinsing your mouth with water after eating sugars
Replacing your toothbrush every 3 to 4 months
Avoiding sugar-containing drinks (including fruit juices), especially in baby bottles
Chewing gum with xylitol or sorbitol (may reduce your risk of developing cavities)
Talk to your dentist about the use of a
sealant. This is a protective plastic covering. It is applied to the chewing surfaces of teeth. Sealants usually last anywhere from 5-15 years.
Prevention is particularly important for children. Supplemental fluoride in early childhood can prevent early decay. Most local water supplies have fluoride. Fluoride can also be applied to permanent teeth as a long acting varnish. Re-varnishing is usually necessary at least twice yearly.
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Last reviewed October 2012 by Michael Woods, MD Last Updated: 10/31/2012
