Dental caries

What are dental caries?

Teeth affect our physical, mental, and social health. Good teeth are needed to chew food into pieces small enough for the digestive system to handle. They also help us look and feel good. Neglected teeth become diseased and cannot perform their function. They may cause bad breath and spoil a smile as well.

How is it caused?

Dental caries is a very common problem. Bacteria normally reside in the mouth. They, however, mix with the proteins present in the saliva (spit) to form plaque and attach to the hard enamel surface of the tooth. The bacteria feed on food sugars and starches and produce an acid. This acid eats into the tooth enamel damaging the tooth.

What are the symptoms?

Initially there may be no symptoms while the enamel is being eaten away. Later, tooth sensitivity may be noticed. There may be discomfort while eating sweet foods and hot or cold drinks or foods. If the cavity becomes very large or a tooth abscess develops which may be accompanied by pain, swelling or fever. This is why it is important to have frequent dental check ups. If it hurts, it is already too late.

How is it diagnosed?

A dentist may identify the areas of decay quite early. Sometimes dental X-rays may be advised.

What is the treatment?

Small cavities are treated by simple fillings. It is possible to have tooth-coloured filling using special compounds to avoid detection. If a part of the tooth has decayed material, it is removed and the resultant hole in the tooth is filled. Fillings are usually made of silver-mercury or resin. If the decay has reached the central portion of the tooth that contains the nerves and blood vessels (pulp), a root canal treatment is advised wherein the decayed pulp is removed, a filling done and the tooth covered by a cap or crown. Most dental procedures are performed under local anaesthesia where the local nerves are numbed.

How can cavities be prevented?

The key to prevention is to remove the plaque and bacteria before the acid gets a chance to eat away the tooth. The mouth must be kept clean. Brushing must be done twice a day with a soft-bristle brush. Toothpastes with fluoride are helpful. The intake of sugars and starches must be limited. Whenever sweet things are eaten, the mouth must be rinsed immediately.

Why is dental care important?

Dental care is very important at all ages, but more so in older people since they have an increased risk of developing tooth cavities. Plaque is a sticky build-up of food particles, mucus, and mouth bacteria around the base of the teeth, commonly seen in neglected teeth. Plaque causes swelling of the gums, known as gingivitis, which can usually be prevented or cured by good dental hygiene. Gingivitis can lead to serious disease and tooth loss if it is neglected.

Good dental care can be achieved by:

• Brushing is the single most effective way of preserving teeth. Brush teeth with a soft or medium brush twice a day, in the morning and before going to bed at night. Brushing after each meal is ideal. If brushing can only be done once a day, then it is best to do it at bedtime.
• Replace the brush every 6 months or earlier if the bristles get frayed. Gentle brushing of the tongue and the roof of the mouth will also help to remove germs and prevent bad breath. The best way to brush the teeth is to follow the small dental ridges and brush along them, i.e., from the base of the tooth to the tip.
• Flossing removes germs and food particles from between the teeth and along the gum line. It removes food particles that are not removed by brushing. The floss should be inserted between the teeth, using a gentle sawing motion. It should then be moved up and down the side of each tooth.
• It is better to use a fluoride toothpaste.
• Use of antibacterial mouthwashes reduces plaque.
• Annual dental checkups are recommended to remove any plaque (which may develop in-spite of daily brushing and flossing), check the teeth for cavities, check the gums for infection or swelling and the mouth for early signs of cancer.