Dental caries (tooth decay) is the destruction of tooth structure and can affect both the enamel (the outer coating of the tooth) and the other layers of the tooth.

Dental caries (tooth decay) remains the most prevalent dental disease in both children and adults, even though it is largely preventable. Although its prevalence has reduced greatly over time due to proper oral hygiene practices, it still remains a big challenge, especially in our developing societies.

Tooth decay occurs when foods containing carbohydrates (sugars and starches) such as breads, cereals, milk, soda, fruits, cakes, or candy are left on the teeth. Bacteria that normally live in the mouth digest these foods, turning them into acids. The bacteria, acid, food products, and saliva combine to form a coating (called plaque), which clings to the teeth. The acids in plaque dissolve the outer coating surface of the teeth, creating holes in the teeth called cavities.

Early dental caries may not have any symptoms. Later, when the decay has eaten through the outer coat, the teeth may be sensitive to sweet, hot or cold foods and drinks.

A dentist will look for caries at his office visit. The dentist will look at the teeth and may probe them with a tool called an explorer to look for pits or areas of damage. The limitation with this is that they often do not catch cavities when they are just forming.

Your dentist may request for an X-ray of your teeth on a set schedule, and also if a problem is suspected. They can show newly forming decay, particularly between the teeth. They also show the more advanced decay, including whether decay has reached in deeper layers of the tooth which would determine the management option.

There are newer devices that can also can help to detect tooth decay. They are useful in some situations. The one most commonly used in dental offices is a liquid dye or stain. The dentist brushes the nontoxic dye over your teeth, and then rinses it off with water. It rinses away cleanly from healthy areas but sticks to the decayed areas.

Some dentists also use high-tech devices such as lasers to detect cavities. Under many conditions, these devices can detect very early tooth decay, which can actually be reversed.

One way in which one can prevent cavities is by reducing the amount of plaque and bacteria in the mouth. The best way to do this is by brushing and flossing daily. You also can use antibacterial mouth rinses to reduce the levels of bacteria that cause cavities. Other rinses neutralise the acid in the mouth to make the environment less friendly to the growth of this bacteria.

One can also reduce the amount of tooth-damaging acid in the mouth by eating sugary or starchy foods less often during the day. The mouth remains acidic for several hours after eating. Therefore, one is more likely to prevent caries if they avoid between-meal snacks.

Another way to reduce the risk of cavities is through the use of fluoride, which strengthens teeth. A dentist can evaluate one’s risk of caries and then suggest appropriate fluoride treatments.

Dr. Ian Shyaka

Resident in Surgery, Rwanda Military Hospital,

iangashugi@gmail.com