Causes and risk factors
A tooth is made up of 3 layers – outer hard layer -enamel, middle dentin and inner pulp which carries blood vessels and nerves. Dental cavity is formed as a result of tooth decay. Dental plaques are formed due to the action of bacteria present in mouth on carbohydrate foods. If plaque is not removed, the acid produce by it destroys the enamel of teeth. This creates cavity and hole in your teeth. If not treated gradually the bacteria enters inner layer of your teeth and affect dentin and next the pulp of teeth. If the infection is severe it results in abscess formation. Tooth decay is mostly seen in children. Contributing factors include bad oral hygiene, brushing techniques, smoking, tobacco chewing, diabetes mellitus, recurrent gum infections.
Clinical presentation
Dental cavity in the initial stage does not produce any signs and symptoms. Appearance of white spots or formations of plaques are the early signs of decay. As the cavity advances and affects deeper structure it may produce symptoms like toothache particularly after consuming sweet, hot, or cold foods and drinks. Teeth become oversensitive. There are visible holes or pits in your teeth. Severe pain and discomfort while biting, chewing. There may be pus around a tooth, especially when on pressing on the gums.
Investigation
Medical history by the patient and Clinical examination by the dentist during regular dental check up helps in diagnosis of tooth decay. A dental X ray is recommended if the cavity is between the teeth.
Treatment
The treatment depends upon the extent of damage. The treatment options are include Fluoride treatment where decay has just started, fluoride treatment can help in restoring the lost enamel. Fillings are advised if the dental cavity has already caused a hole in the teeth. If the hole caused by decay is extensive, one will require custom made crown instead of filling. If the decay has reached to inner most layers of the teeth and is causing pain, one will require root canal. During this procedure the damaged root is removed and filling is done. Tooth extraction is recommended if dental cavity is beyond repair. tooth extraction remains the last option. The extracted tooth can be replaced by false one if desired. Prevention of tooth decay is necessary which is possible by maintaining oral hygiene. This includes brushing twice a day, flossing once a day, preferably at bed time, use of fluoride containing toothpaste, avoid frequent snacking in between meals, regular dental check up, at least once in 6 months.
