What is tooth decay?

Tooth decay is a loss of minerals from the tooth enamel caused by acid produced by dental plaque. The tooth plaque is the outer layer covering the tooth.

Effects

Cavities are likely to develop in pits on the chewing surfaces of the back teeth or in between teeth and near the gum line. If this is left untreated, tooth decay can destroy the enamel, the dentin and even the pulp of the tooth. The tooth is effectively destroyed.

Causes

Eating habits, quality of oral hygiene, dry mouth problems, and presence of fluoride in water or toothpaste and heredity play a significant role in how susceptible the teeth may be exposed to tooth decay.

Dr. Janet Umurungi is a dentist and works in the stomatology department of Butare teaching hospital. Stomatology is a speciality that deals with tooth and oral or mouth diseases. She says that various conditions can lead to tooth decay attack.

For example after having a meal, snack or drink, the bacteria of the dental plaque start to convert sugar and carbohydrates of foods into acids. The normal mouth pH of 6.2 to 7.0 starts to drop to acidic values that are below PH of 5.

If the mouth becomes too acidic, that is to say pH below 6,0, the acids start to dissolve the minerals such as calcium and phosphate of the tooth’s surface creating microscopic lesions on tooth enamel in a process termed as demineralisation, weakening its structure.

Bacteria known as Streptococcus mutans is the most destructive bacterial strain in the mouth as it attaches easily to teeth and produces a lot of acid. Other common but less destructive acid-producing bacteria are lactobacillus and actinomyces.

After all the sugars are consumed by the bacteria, acid production eventually stops and the tooth has a chance to repair itself (remineralisation) helped by the minerals of saliva and tooth paste’s fluoride.

Dr. Umurungi however points out that if the dental plaque is not removed regularly or if sugar is consumed too often, then the remineralisation periods are not enough to repair the damage. Eventually a small cavity appears on the tooth enamel. The continuous exposure of the tooth to acids is what causes tooth decay.

She adds that tooth decay can then penetrate through the protective enamel down to the softer, vulnerable dentine and continue to the soft tooth pulp and the sensitive nerves within the tooth. At this point of tooth infection, the only prevention measure is up rooting the tooth or surgical removal of the tooth.

Although the metabolic activity of plaque bacteria in our mouth is what actually causes dental decay, the underlying causes of tooth decay are in most cases the poor oral hygiene and high sugar consumption.

Diagnosis

Dr. Umurungi explains that tooth decay begins with a small patch of demineralised enamel at the tooth surface, often hidden from sight in the fissures or in between the teeth. At this phase tooth decay can be identified visually by your dentist.

When the decay has progressed deeper in the enamel, the teeth may be sensitive to sweet foods or to hot and cold temperatures. Later, when the cavity has reached the pulp, the acute pain or swelling will be a clear sign of dental decay.

Prevention

The most common and easier control measure of dental plaque is by regular brushing. A person should brush at least twice a day and floss daily to remove plaque from between teeth and below the gum line.

Plaque removal by tooth brushing cannot alone guarantee tooth decay prevention. Normal brushing inevitably leaves some teeth plaque behind, and even on cleaned tooth surfaces plaque rapidly begins to reform.

Fluoride is the best resource available for strengthening and protecting teeth from decay and healing early acid damage by replacing the lost minerals. Brushing with fluoride toothpaste is the easiest way of delivering fluoride to the teeth.

Other methods of tooth decay control are:

• regular dental check ups and professional teeth cleaning you dentist will detect minor problems before becoming major ones.

• Reduce frequent consumption of sugars or reduce the number of times each day that you eat fermentable carbohydrates or drink sugary drinks. Eat a well-balanced diet that limits starchy or sugary foods.

• Mouth washes can help prevent decay by reducing the number of bacteria in the mouth. Chewing sugarless gums can also help preventing cavities.

• In children, new molars can be protected from dental decay by use of dental sealants as soon as they emerge. Sealants can help adults too, but they are only effective against tooth decay on the biting surfaces of molars and premolars.

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