Tooth decay is an extremely common problem in 21st century society. It is largely the result of heavy consumption of carbohydrates and snacking between meals.

What are dental caries?

Dental caries, or cavities, occur nearly as often as the common cold. In the early stages of decay, they are painless holes in the enamel of a tooth. As they progress, they can become painful, especially once the nerve root is affected.

When people consume sugary and starchy foods, they stick to the teeth and the bacteria present in the mouth forms plaque which adheres to the teeth. If it is not removed, it mineralizes into tarter. The acid in the plaque erodes tooth enamel resulting in cavities.

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Who gets cavities?

Tooth decay is most common in children and young adults, but anyone can get a cavity. It is five times more common than asthma in children ages 5-17. It is also slightly higher in the elderly.

Scientific examination of skulls dating back to prehistoric times indicates the presence of tooth decay. The increase in dental caries has been shown to be directly related to changes in diet. As hominids consumed more carbohydrates in their diet, more tooth decay developed. During the Medieval period, when sugar cane became more widely available, there was a significant increase in tooth decay. A second major increase occurred in the late 19th century with the advent of soda.

There is evidence that ancient man attempted to perform dental work to repair teeth. Skulls, 7,500 to 9,000 years old, found in Pakistan, show evidence of dental drilling. Egyptian, Assyrian, Roman, and Greek writings discuss dental problems.

What are the symptoms of tooth decay?

When cavities first begin they are too small to see with the naked eye and are usually painless. As they develop, a toothache may occur after eating or drinking hot, cold, or sweet foods and beverages. Eventually caries progress to being visible as darkened holes in the tooth.

In the dentist’s office, dental caries may be discovered on examination. When the dentist probes the surface of the tooth with a dental pick, the area of a cavity will be soft. X-rays can also show tiny caries before they are visible to the eye.

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How are cavities treated?

The treatment of dental caries depends upon the severity of the erosion. If they are repaired in the early stages, before they cover large areas of the tooth or compromise the nerve root of the tooth, they can be repaired with a simple filling. The dentist uses a drill to clean out the decay then fills the hole with an amalgam, composite resin, porcelain, gold, or silver. Porcelain and composite resin most closely match the color of a tooth and are used for front teeth. Amalgam is often used for molars however some dentists and doctors belive the mercury in amalgam fillings can be toxic and damaging. There have been many lawsuits about this as well as denture cream lawsuits so make sure you find a dentist you know and trust to do your work.

If the degree of erosion is severe, the tooth may need a crown. The decayed area of the tooth is removed and a false tooth made of porcelain or gold is attached to the remainder of the tooth.

If the nerve root has been affected, a root canal is necessary. The decayed portion of tooth, the pulp of the tooth, and the nerve are removed then the hole is filled. A crown may be placed after.

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How can dental caries be prevented?

There are many ways to prevent the development of cavities. Good oral hygiene is an important first step: brush teeth twice a day, floss at least once a day, and have teeth professionally cleaned every six months.

Reducing consumption of starchy and sugary food helps prevent plaque build up and enamel erosion. It is a good idea to brush teeth, or at least rinse, after eating such foods. It is better to consume sugars and starches with meals rather than alone; this reduces the build up on teeth from these foods.

When brushing teeth, pay special attention to areas that are prone to tooth decay; the pits and groves of molars, near the gum line, around fillings, around braces or bridgework, and between teeth are the most common places for cavities to occur.

The application of topical fluoride, found in toothpaste and mouthwash, helps prevent decay. Chewing gum containing xylitol counteracts acid; there are also natural toothpastes made with xylitol.

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Regardless of age, anyone can get dental caries. With careful attention to the teeth, many if not all caries can be prevented.

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Published November 17, 2011 by