Dental Cavities.

 Dental Cavities.

Cavities are permanently damaged areas in the hard surface of your teeth that develop into tiny openings or holes. Cavities, also called tooth decay or caries, are caused by a combination of factors, including bacteria in your mouth, frequent snacking, sipping sugary drinks and not cleaning your teeth well.

Cavities and tooth decay are among the world's most common health problems. They're especially common in children, teenagers and older adults. But anyone who has teeth can get cavities, including infants.

Dental decay happens when the enamel and dentine 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. ‘Dental decay' is the same as tooth decay and is also known as ‘dental caries'.

Cavities are more common among children, but changes that occur with aging make cavities an adult problem, too. Recession of the gums away from the teeth, combined with an increased incidence of gum disease, can expose tooth roots to plaque. Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold. It’s common for people over age 50 to have tooth-root decay.

 If you have gum recessions and exposed roots, plaque acids can attack dentin and cause what is known as a root cavity. As a result, nerves in your teeth become exposed and you may feel pain when you eat or drink. If you feel pain near the root of your tooth, chances are you may have some form of tooth decay and should consult with a dental professional.

Decay around the edges, or a margin, of fillings is also common for older adults. Because many older adults lacked benefits of fluoride and modern preventive dental care when they were growing up, they often have a number of dental fillings. Over the years, these fillings may weaken and tend to fracture and leak around the edges. Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay.

Tooth decay is the breakdown of teeth due to acids made by bacteria. The cavities may be a number of different colors from yellow to black.  Symptoms may include pain and difficulty with eating.  Complications may include inflammation of the tissue around the tooth, tooth loss, and infection or abscess formation.

Taking good care of your teeth is an important part of maintaining your overall health and wellness, and that includes preventing the dreaded dental cavity. A dental cavity is one of the most common results of tooth decay and could be a sign of poor oral health and hygiene. 

Causes :

The cause of cavities is acid from bacteria dissolving the hard tissues of the teeth (enamel, dentin and cementum). The acid is produced by the bacteria when they break down food debris or sugar on the tooth surface.  Simple sugars in food are these bacteria's primary energy source and thus a diet high in simple sugar is a risk factor.  If mineral breakdown is greater than build up from sources such as saliva, caries results.  Risk factors include conditions that result in less saliva such as: diabetes mellitus, Sjögren syndrome and some medications.  Medications that decrease saliva production include antihistamines and antidepressants.  Dental caries are also associated with poverty, poor cleaning of the mouth, and receding gums resulting in exposure of the roots of the teeth.

Cavities are caused by tooth decay, a process that occurs over time. Here's how tooth decay develops:

Plaque forms :Dental plaque is a clear sticky film that coats your teeth. It's due to eating a lot of sugars and starches and not cleaning your teeth well. When sugars and starches aren't cleaned off your teeth, bacteria quickly begin feeding on them and form plaque. Plaque that stays on your teeth can harden under or above your gum line into tartar (calculus). Tartar makes plaque more difficult to remove and creates a shield for bacteria.

Plaque attacks : The acids in plaque remove minerals in your tooth's hard, outer enamel. This erosion causes tiny openings or holes in the enamel — the first stage of cavities. Once areas of enamel are worn away, the bacteria and acid can reach the next layer of your teeth, called dentin. This layer is softer than enamel and less resistant to acid. Dentin has tiny tubes that directly communicate with the nerve of the tooth causing sensitivity.

Destruction continues : As tooth decay develops, the bacteria and acid continue their march through your teeth, moving next to the inner tooth material (pulp) that contains nerves and blood vessels. The pulp becomes swollen and irritated from the bacteria. Because there is no place for the swelling to expand inside of a tooth, the nerve becomes pressed, causing pain. Discomfort can even extend outside of the tooth root to the bone.

Poor Oral Hygiene:  Not brushing your teeth regularly allows plaque to build up and attack the tooth enamel. 

Dry Mouth:  Saliva helps wash plaque from the teeth and buffer the acid. If you have a dry mouth with very little saliva, plaque and tooth bacteria may build up more quickly. 

Eating and Drinking:  This is where it all begins. Since we all have to eat and drink to live, there’s no way to avoid this, but it does play a significant role in the formation of cavities. When you eat or drink, carbohydrates remain on your teeth until you brush. Even after brushing, you may not be able to remove all food particles or carbohydrates from your teeth. Foods that tend to cling to your teeth can increase your risk for a tooth cavity. Be sure to brush your teeth regularly, especially after drinking milk or sugar containing soda, or after eating dried fruit, dry cereal, hard candy, caramel, taffy, raisins, sugary cereals, , and cookies.

Frequent snacking or sipping. When you steadily snack or sip sugary drinks, you give mouth bacteria more fuel to produce acids that attack your teeth and wear them down. And sipping soda or other acidic drinks throughout the day helps create a continual acid bath over your teeth.

Bedtime infant feeding. When babies are given bedtime bottles filled with milk, formula, juice or other sugar-containing liquids, these beverages remain on their teeth for hours while they sleep, feeding decay-causing bacteria. This damage is often called baby bottle tooth decay. Similar damage can occur when toddlers wander around drinking from a sippy cup filled with these beverages.

Not getting enough fluoride. Fluoride, a naturally occurring mineral, helps prevent cavities and can even reverse the earliest stages of tooth damage. Because of its benefits for teeth, fluoride is added to many public water supplies. It's also a common ingredient in toothpaste and mouth rinses. But bottled water usually does not contain fluoride.

Heartburn. Heartburn or gastroesophageal reflux disease (GERD) can cause stomach acid to flow into your mouth (reflux), wearing away the enamel of your teeth and causing significant tooth damage. This exposes more of the dentin to attack by bacteria, creating tooth decay. Your dentist may recommend that you consult your doctor to see if gastric reflux is the cause of your enamel loss.

Eating disorders. Anorexia and bulimia can lead to significant tooth erosion and cavities. Stomach acid from repeated vomiting (purging) washes over the teeth and begins dissolving the enamel. Eating disorders also can interfere with saliva production.

Medical Problems:  Some types of cancer treatment that expose the head and neck to radiation can promote a tooth cavity by changing the makeup of the saliva to promote increased bacterial growth.

 

Signs, Symptoms and complications : 

In early tooth decay, there are not usually any symptoms. As tooth decay advances, it can cause a toothache (tooth pain) or tooth sensitivity to sweets, hot, or cold. If the tooth becomes infected, an abscess, or pocket of pus, can form that can cause pain, facial swelling, and fever.

Pain: A toothache is one of the most common cavity symptoms. 

Pressure: Both increased tooth sensitivity and pain when biting down can indicate a cavity. 

Pits: Cavity symptoms may include a noticeable hole or pit in the affected tooth. Sometimes the holes are only visible on a dental x-ray.

Other common signs of a cavity that you will likely notice on your own include a toothache or sensitive teeth—particularly when eating sweet, hot or cold foods or drinks. These signs of a cavity are usually associated with advanced tooth decay and therefore require immediate attention from a dental professional. 

Complications of cavities may include:

-Pain

-Tooth abscess

-Swelling or pus around a tooth

-Damage or broken teeth

-Chewing problems

-Positioning shifts of teeth after tooth loss

When cavities and decay become severe, you may have:

-Pain that interferes with daily living

-Weight loss or nutrition problems from painful or difficult eating or chewing

-Tooth loss, which may affect your appearance, as well as your confidence and self-esteem

-In rare cases, a tooth abscess — a pocket of pus that's caused by bacterial infection — which can lead to more serious or even life-threatening infections

Prevention :

Good oral and dental hygiene can help you avoid cavities and tooth decay. Here are some tips to help prevent cavities. Ask your dentist which tips are best for you.

Brush with fluoride toothpaste after eating or drinking. Brush your teeth at least twice a day and ideally after every meal, using fluoride-containing toothpaste. To clean between your teeth, floss or use an interdental cleaner.

Rinse your mouth. If your dentist feels you have a high risk of developing cavities, he or she may recommend that you use a mouth rinse with fluoride.

Dental Floss: Flossing on a regular basis is very important. By removing food particles from your teeth, flossing can help prevent dental cavities. Many people find that flossing, particularly in tight spaces, is facilitated with a floss.

Visit your dentist regularly. Get professional teeth cleanings and regular oral exams, which can help prevent problems or spot them early. Your dentist can recommend a schedule that's best for you.

Consider dental sealants. A sealant is a protective plastic coating applied to the chewing surface of back teeth. It seals off grooves and crannies that tend to collect food, protecting tooth enamel from plaque and acid. The Centers for Disease Control and Prevention (CDC) recommends sealants for all school-age children. Sealants may last for several years before they need to be replaced, but they need to be checked regularly.

Drink some tap water. Most public water supplies have added fluoride, which can help reduce tooth decay significantly. If you drink only bottled water that doesn't contain fluoride, you'll miss out on fluoride benefits.

Avoid frequent snacking and sipping. Whenever you eat or drink beverages other than water, you help your mouth bacteria create acids that can destroy tooth enamel. If you snack or drink throughout the day, your teeth are under constant attack.

Eat tooth-healthy foods. Some foods and beverages are better for your teeth than others. Avoid foods that get stuck in grooves and pits of your teeth for long periods, or brush soon after eating them. However, foods such as fresh fruits and vegetables increase saliva flow, and unsweetened coffee, tea and sugar-free gum help wash away food particles.

Consider fluoride treatments. Your dentist may recommend periodic fluoride treatments, especially if you aren't getting enough fluoride through fluoridated drinking water and other sources. He or she may also recommend custom trays that fit over your teeth for application of prescription fluoride if your risk of tooth decay is very high.

Ask about antibacterial treatments. If you're especially vulnerable to tooth decay — for example, because of a medical condition — your dentist may recommend special antibacterial mouth rinses or other treatments to help cut down on harmful bacteria in your mouth.

Combined treatments. Chewing xylitol-based gum along with prescription fluoride and an antibacterial rinse can help reduce the risk of cavities.