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Tooth Decay

Tooth decay, also known as dental decay or dental caries, is when acids produced by bacteria in your mouth dissolve the outer layers of your teeth.

Tooth decay is one of the most widespread health problems in the UK. More than half (55%) of adults in the UK have one or more decayed teeth.

Tooth decay is also a problem for children. It is estimated that between 52% and 77% of children aged 8 to 15 have some obvious tooth decay in their permanent teeth.

What causes tooth decay?

Your mouth is full of bacteria, which combine with small food particles and saliva to form a sticky film known as plaque, which builds up on your teeth.

When you consume food and drink that is high in carbohydrates (sugary or starchy), the bacteria in plaque turn the carbohydrates into the energy they need, producing acid at the same time.

Over time, the acid in plaque begins to break down the surface of your tooth. Left untreated, the plaque can completely destroy the outside of the tooth and expose the nerves inside. Once this happens, you will have toothache.

4 stages of tooth decay

Stage 1 The dull spot on the tooth's surface may be decay. Brushing with a fluoride toothpaste and flossing may prevent it from becoming a cavity.

Stage 2 The decay is now a cavity. It has gone through the tooth's hard surface layer.

Stage 3 Now that the cavity has reached the softer layer of the tooth, it will get bigger faster.

Stage 4 If the decay is left untreated the nerve of the tooth may become infected and die resulting in an abscess.

What are the signs of tooth decay?

There is a common misconception amongst the public that your tooth will alert you as soon as there is a problem such as decay (by becoming sensitive or painful), but this is not the case.

In early stages of tooth decay it is common for there to be a complete absence of symptoms, but your dentist may be able to spot a cavity in its early stages when they examine or x-ray your teeth.

Patients are often left confused when their dentist advises them that they have decay in a tooth and require a filling – the tooth may be pain-free and not have any hole in the surface!

  • The lack of pain may be because the decay is too small to reach the nerve in the inner part of the tooth or because the decay is so large that it has caused the nerve to die. Therefore there is an entire spectrum of treatments that a tooth may require even though it is pain free, ranging from a simple filling to root canal treatment or even extraction!
  • The abscence of a hole in the surface of a tooth is because when decay is in its early stages, the surface of the tooth often remineralises (re-hardens) leaving the decay underneath the surface which will enlarge until the surface of the tooth is sufficiently undermined to break and leave a cavity

This is why you should visit your dentist regularly, as small cavities are much easier to treat than advanced decay!

Preventing tooth decay

To prevent tooth decay you should:

  • Visit the dentist regularly
  • Visit the hygienist regularly
  • Maintain very good oral hygiene
  • Reduce the amount of sugar in your diet
  • Monitor how often each day you have food or drink containing sugar

Limit sugary foods to mealtimes and make sure you don't have food or drinks containing added sugar more than four times a day.

Eating a healthy balanced diet is important too. As well as preventing tooth decay, this will help you to stay healthy.

Treating tooth decay

If tooth decay is detected early enough it can be reversible and not require a filling. However, if allowed to progress further the tooth will require at least a filling and may require any of – root canal treatment, crowns, veneers, inlays/onlays, extraction. This is another good reason for maintaining regular dental check-ups!

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