CARIES / TOOTH DECAY

Overview

Caries is a loss of tooth structure (demineralization) by organic acids produced by bacteria in dental plaque. When you develop a cavity (caries) the dentist will remove decayed tooth structure and prepare the tooth to receive a filling. A filling is an inert material which will replace the tooth structure lost through decay.

Causes
Caries is caused by a combination of factors which involve:

• Saliva
• Plaque
• Diet
• Tooth factors

Your tooth is made up of calcium and phosphate ions. There is a dynamic exchange of these ions between your tooth and its surrounding. When any of the above factors are modified to favour the lost calcium and phosphate from your tooth, you will, over time, develop a cavity.

Symptoms
Decay in its early stages do not present with symptoms. As decay progresses you may experience:

• tooth sensitivity on eating cold or hot food
• pitting or a hole developing in your tooth
• food trap
• pain on biting
• toothache which may be spontaneous
• swelling in the gum (see periapical abscess)

Risk Factors

• reduced salivary flow
  -  this occurs when you do not drink sufficient water, or are dehydrated
  -  radiotherapy in the head and neck region can affect salivary glands and the reduce the production of saliva
• poor oral hygiene
  - failure to brush properly results in plaque build up. Bacteria conducive to caries development, thrive in thick plaque
• caries promoting diet
  - diets rich in sugar eg sweet drinks, ice cream, candy enable bacteria to multiply and feed on.
  - acidic food such as cola, juices, directly demineralise tooth structure
  - sticky and starchy food (biscuits, toffee) remain on surfaces of teeth longer and allow bacteria to act on it.
• frequent snacking
  - snacking causes a drop in saliva pH which favours demineralization. Frequent snacking subjects your teeth to frequent acid attack. 
• use of milk bottle (see early childhood caries)
  - lactose in milk is a sugar acted upon by plaque. Sleeping with a milk bottle at night increases a child’s risk of developing a severe form of decay called early childhood caries.
• tooth factors
  - defects in teeth such as poorly formed teeth, increase plaque retention and present susceptible surfaces for decay
  - gingival recession exposes root surfaces which are not protected by enamel.

Prevention
You can prevent decay by dietary and lifestyle changes.

• reduce refined sugar in your diet
• avoid snacking in between meals
• if you must snack, use healthier alternatives eg. a fruit or cheese rather than biscuits
• wean your child off the bottle by age 1 (see early childhood caries)
• brush twice a day with a fluoride toothpaste, and floss nightly
• visit your dentist every 6 months.

Treatment
Restoration is the treatment of choice for decay. The type of restoration varies with the extent of decay. Most decayed teeth can be restored with fillings if there is sufficient tooth structure.

All filling materials have their advantages and disadvantages. You can decide on the filling material for your tooth, in consultation with your dentist.


To book an appointment with this service, please call 6324 8802.