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Caries, the biggest enemy of your teeth.

Updated: Jul 4, 2023

Dental caries, also known as cavities or dental decay, is the most frequent of all dental diseases, and it happens when the enamel and dentin of a tooth become softened by acid attack after you have eaten or drunk anything containing sugars. Over time, the acid makes a cavity (hole) in the tooth.

But let’s dissect all these terms for better understanding.

What causes the cavities?

Dental caries are caused by plaque acids that gradually dissolve away the enamel and dentin of the tooth. Decay damages your teeth and may lead to the tooth needing to be filled or even taken out.

Enamel? What’s that?

Enamel is the hard, protective outer coating of the tooth and is the hardest part of the body. It does not contain any nerves or blood vessels and is not sensitive to pain.

What about dentin?

Dentin lies under the enamel, forming most of the tooth, and it can be very sensitive to pain. Dentin covers the central ‘pulp' of the tooth.

Hmm, the pulp?

The pulp is a soft tissue which contains blood vessels and nerves and is in the middle of the tooth.

What is plaque, again?

Plaque is a thin, sticky film that keeps forming on your teeth. It contains many types of bacteria.

Now, all together:

Decay happens when sugars in food and drinks react with the bacteria in plaque, forming acids. Every time you eat or drink anything containing sugars, these acids attack the teeth and start to soften and dissolve the enamel. The attacks can last for an hour after eating or drinking, before the natural salts in your saliva cause the enamel to remineralize and harden again. It's not just sugars that are harmful: other types of carbohydrate foods and drinks react with plaque and form acids. (These are the ‘fermentable' carbohydrates: for example ‘hidden sugars' in processed food, natural sugars like those in fruit and cooked starches).

Always check the ingredients. Generally anything with ‘ose' in the name is a sugar, for example: sucrose, maltose and so on.

Having sugary or acidic snacks and drinks between meals can increase the risk of decay, because your teeth come under constant attack and do not have time to recover. It is therefore important not to keep having sugary snacks or sipping sugary drinks throughout the day.

How can you know if you have cavities?

In the early stages of dental decay there are no symptoms, but your dental team may be able to spot a cavity in its early stages when they examine or x-ray your teeth. This is why you should visit your dental team regularly, as small cavities are much easier to treat than advanced decay.

Once the cavity has reached the dentin your tooth may become sensitive, particularly when you have sweet foods and drinks, and acidic or hot foods.

As the decay gets near the dental pulp you may suffer from toothache. If the toothache is brought on by hot or sweet foods this may last for only a few seconds. As the decay gets closer to the dental pulp the pain may last longer and you may need to take painkillers - paracetamol or ibuprofen - to control the pain. Toothache is a sign that you should visit your dentist straight away, as it is a warning that something is wrong, maybe the pulp is dying, and you may develop a dental abscess if it is not treated. If you don't do anything, this will usually make matters worse and you may lose a tooth that could otherwise have been saved.

How are cavities treated?

In the very early stages of decay, your dentist may apply a fluoride varnish onto the area. This can help stop more decay and help remineralize the tooth. However, it is important to follow the cleaning routine your dental team suggests, using a fluoride toothpaste to prevent decay starting again.

If the decay is not too serious, the dentist will remove all the decay and repair the tooth with a filling. Sometimes the nerve in the middle of the tooth can be damaged. If so, the dentist will need to carry out root canal treatment by removing the nerve and then repairing the tooth with a filling or a crown. If the tooth is so badly decayed that it cannot be repaired, the dentist may have to take the tooth out.

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Dental exam

Prevention is the key!!

As each of the adult molars (back teeth) appears, and if the tooth is free from decay, a pit and fissure sealant can be used to protect the tooth. The sealant is a plastic coating that fills all the little crevices in the tooth surface, creating a flat surface that is easier to clean. Adults can also have this treatment if the teeth are free from decay. Children can also have fluoride varnishes painted onto their teeth twice a year which will help to reduce the chances of decay.

But the best way to prevent dental decay is by brushing your teeth thoroughly last thing at night and at least one other time during the day, with a fluoride toothpaste. Make sure that you brush the inner, outer and biting surfaces of your teeth. Using interdental brushes, or dental floss or tape, also helps to remove plaque and food from between your teeth and where they meet the gums. These are areas an ordinary toothbrush can't reach.

Have sugary and acidic food and drinks less often. Avoid having snacks between meals, to limit the number of times your teeth are under attack from acids.

Chewing sugar-free gum for up to twenty minutes after a meal can help your mouth produce more saliva, which helps to cancel out any acids that have formed.

And lastly, but as important, is to visit your dentist regularly (usually every 6 months) for dental x-rays, exam and professional cleaning.

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