Tooth decay refers to the enamel wear that leads to cavities. A cavity is a hole in your tooth enamel (sometimes unseen) that can cause tooth sensitivity and pain. If left untreated, a cavity can lead to an abscess (a serious infection in the center of a tooth) or tooth loss.
It is important to see your dentist regularly for cleanings, which can help prevent the onset of cavities and other serious dental conditions.
The tooth decay process begins with eating. Natural bacteria in the mouth transform food into acids. These bacteria and acids, along with food particles and saliva, combine to form plaque. This sticky substance forms within 20 minutes of eating. While some plaque is washed away with water, much of it sticks on the gum line and your teeth until it is brushed off.
Plaque can become problematic if it is not promptly removed. The acids in plaque can damage your tooth enamel and may eventually lead to tooth decay and cavities.
Young children and teenagers are at the highest risk for tooth decay because they are still mastering oral healthcare skills. Still, anyone who does not brush, floss, or see his or her dentist for cleanings is at risk for developing tooth decay.
Certain foods can also increase your risk of tooth decay. Carbohydrates and sugary foods in particular can increase the acidity level in your mouth, causing more plaque to form. Soda is a common culprit of cavities in people of all ages.
Symptoms of tooth decay vary depending on the severity of your condition. In early stages of decay, you may not experience symptoms at all. Once a cavity has developed, you might experience:
- general tooth pain
- sensitivity to hot or cold beverages
- pain after eating sweets
- aches in the mouth
Once tooth decay has reached advanced stages, the condition may be noticeable by visible holes in your teeth (cavities).
Seeing your dentist regularly is important; you may have a cavity and not even know it. For this reason, annual dental X-rays are used to detect signs of potential tooth decay. A dentist may also be able to see cavities when checking your teeth after a cleaning.
In some cases, pain and general discomfort are enough to send patients to the dentist. At this point, there is likely a problem with your teeth—your dentist just needs to take X-rays and perform a physical exam to pinpoint the issues.
Minor cavities are usually treated with fillings. When a dentist fills your tooth, he or she is removing decayed tooth enamel and replacing it with another material. Silver alloy and gold are still mainstays because of their durability, but now patients have the option of choosing porcelain or resin to match the color of their teeth.
Fillings aren’t recommended for teeth that have undergone extensive decay, which leaves them at risk for breaking or chipping. In this case, a crown is required. For this procedure, your dentist will remove the decayed tooth enamel and will then cap the area with a crown (also called a cap). This crown should prevent further damage.
A root canal is often performed in conjunction with a crown procedure if decay has also killed the tooth’s nerve. In a root canal, the center of the tooth (the dead nerve and blood vessel tissue, or pulp) is removed, along with other tooth decay. The roots and decayed areas are then sealed. If a crown is required, the tooth is then capped.
The effects of tooth decay can be reversed when treated early. Advanced stages often require tooth extraction. Some patients require temporary prescriptions for pain medication to feel more comfortable after dental work.
Failure to see a dentist for treatment can have other oral health consequences, including:
- gingivitis (inflamed, infected gums), caused by plaque that has developed into tartar
- periodontitis (inflammation and infection of the bones and tissues that hold the tooth in place), caused by gingivitis that is left untreated
- tooth fractures
- tooth loss
- inability to use the tooth
- prolonged sensitivity
- extreme pain
Since tooth decay may not cause any obvious symptoms, it is even more crucial to see your dentist for regular checkups. Not only are your teeth cleaned during every six-month checkup, but your dentist also looks for potential tooth decay. Any problem areas are diagnosed immediately.
Home care complements any treatment plan your dentist recommends. To help prevent tooth decay:
- Brush your teeth at least twice a day.
- Use fluoride-enriched toothpaste.
- Floss daily.
- Reduce your intake of sugary foods and soft drinks.
Written by: Kristeen Moore
Medically reviewed by George Krucik, MD