Tooth decay (aka cavities) is the most common dental health issue that both children and adults encounter throughout their lives. If not adequately addressed, tooth decay can lead to serious oral health issues. By better understanding tooth decay, its stages, and how it is treated, you can take better precautions to protect your health by preventing tooth decay from occurring in the first place.
What Is Tooth Decay and What Causes It?
Your teeth are comprised of an interior layer of pulp (connective tissues, nerves, and blood vessels), a porous layer called dentin, and an outer, protective layer of hard tissue called enamel. Tooth enamel consists of a complex crystalline structure embedded with a variety of minerals. Tooth decay is the breakdown of enamel that first causes it to soften and then eventually forms holes (known as cavities or dental caries) in the enamel.
Teeth are naturally covered in a film called plaque. Plaque is a sticky whitish biofilm that contains harmful bacteria, sugars, and acids. The bacteria in your mouth feed on the sugars in your diet and then produce waste in the form of acids. These acids gradually break down the enamel on your teeth, leading to tooth decay which occurs in four stages.
Understanding the Stages of Tooth Decay
1. Demineralization
Demineralization is the earliest stage of tooth decay. Demineralization happens when acids inside the mouth first begin to break down and soften the tooth enamel’s crystalline structure. Although demineralization of teeth can cause sensitivity, this stage is not usually associated with any noticeable symptoms.
2. Enamel Decay
Enamel decay, the second stage, occurs when tooth enamel is allowed to continue to break down through an ongoing demineralization process. In this stage, cavities begin to form in the enamel layer of the teeth. Like demineralization, enamel decay is not usually associated with any major symptoms.
3. Dentin Decay
Once tooth decay has progressed far enough that a cavity has extended beyond the tooth enamel into the dentin (a soft tissue layer of the tooth), the tooth decay has reached the third stage known as “dentin decay.” At this stage, a person experiences tooth sensitivity to hot and cold temperatures and likely some sensitivity to sugar as well as pressure on the tooth.
4. Pulpal Decay
Pulpal decay is the final stage of tooth decay and occurs when a cavity has extended beyond the tooth enamel and dentin, into the tooth’s interior pulp. Once the pulp of a tooth has been reached, a bacterial infection can occur inside the tooth. This stage of tooth decay is typically quite painful and requires treatment with root canal therapy and a dental crown to save the natural tooth. Left untreated, a dental abscess (a pocket of pus) can form. Although they sometimes go undetected, abscesses usually cause severe pain and swelling. They can also cause a fever and lead to life-threatening complications if not treated right away.
How Can You Tell How Deep The Tooth Decay Goes?
Some people have symptoms when demineralization of the enamel occurs. Sensitivity to cold and sweets are the first and most common signs. Once the tooth decay gets into the dentin layer, heat and pressure sensitivity is common. The best way to determine the extent of the decay and the appropriate treatment method is to have your dentist at Smile Hilliard carefully examine your teeth and your current x-rays. To the trained eye, the x-rays will show spots on teeth that indicate decay. The doctor will then recommend the appropriate treatment procedure based on the extent of the damaged tooth structure.
Is It Possible to Reverse Tooth Decay?
The answer to the question of whether or not it is possible to reverse tooth decay is not very straightforward because, sometimes, tooth decay can be remineralized. Tooth decay can never return to pristine enamel, but, if caught early enough, the crystalline structure can be re-built on the molecular level. This can only happen when tooth decay is still in its earliest stage, the demineralization stage. At this very early stage, you can reverse the effects of tooth decay by remineralizing the enamel’s crystalline structure with prescription strength topical applications of fluoride in addition to practicing impeccable oral hygiene. Once tooth decay has created a cavity in a tooth, there is no way to regenerate tooth enamel in order to reverse the decay that has occurred.
How Is Tooth Decay Treated?
There are several treatments for tooth decay, and the treatment that’s right for you depends on the stage of tooth decay you have developed.
Topical Fluoride Applications
In its earliest stage, demineralization, tooth decay can be addressed with professional fluoride applications, an increase of topical fluoride exposure at home, and improved oral hygiene practices. Our dentists might also provide you with prescription toothpaste, containing more fluoride than over-the-counter products. It is the molecular structure of fluoride that helps remineralize the enamel’s crystalline structure. We might also provide you with advice regarding how to better target the problem area in your mouth with your at-home oral hygiene routine.
Dental Fillings
Once tooth decay has progressed beyond demineralization to create a cavity, the most common treatment is a dental filling. This treatment involves using a high-speed drill to remove the dead or infected tissue, cleaning the cavity, and then filling it with a dental filling. Dental fillings are usually made from tooth-colored composite resin.
Silver Diamine Fluoride
Another treatment for tooth decay that has extended beyond the demineralization stage is silver diamine fluoride. This treatment is less common, but it is sometimes recommended for young children with cavities in their baby teeth. Silver diamine fluoride is a chemical that sterilizes bacteria and seals a cavity where tooth decay has occurred.
Silver diamine fluoride is highly effective and requires several applications, but it does leave behind a black mark where there was once tooth decay. For this reason, it is not usually recommended for those with their permanent teeth or for cavities on a child’s front teeth.
Root Canal Therapy
When tooth decay has reached the interior pulp of a tooth, the tooth requires root canal therapy to avoid the need for extraction. Root canal therapy is the process of removing the pulp from the inside of a tooth, disinfecting the canals, then filling the root canals with gutta-percha, a rubbery material that seals the canals from further bacterial intrusion. Placing a crown on the tooth restores it to its natural shape and function.
Preventive and Restorative Dentistry With Our Dentists in Hilliard, Ohio
At Smile Hilliard, we provide comprehensive treatment to restore teeth that have been damaged as a result of tooth decay. However, the best treatment for tooth decay is always prevention. To learn more about tooth decay and how best to prevent it, we welcome you to schedule an appointment with one of our dentists in Hilliard Ohio.
