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Tooth Decay

(Cavities; Dental Caries; Dental Decay)

Definition

Tooth decay is the destruction of tooth material, which includes:
Tooth Decay
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Causes

Everyone has bacteria in their mouths. The bacteria eat sugars that are left on the tooth, which then creates acid. The acid and the bacteria form plaque on the teeth. This plaque clings to your teeth. It holds the acid to the tooth. The acid wears away the tooth. Over time, the acid can lead to tooth decay.

Risk Factors

Everyone has the chance to develop tooth decay. Factors that may increase your chance of tooth decay include:
Babies are also at risk for developing cavities. Habits that can increase the risk include giving a bottle between regular feedings or while in bed at night.

Symptoms

Tooth decay may cause:

Diagnosis

Tooth decay is diagnosed over a period of time. This involves clinical examination as well as x-rays.
A dentist checks for tooth decay by:

Treatment

Sometimes tooth decay will repair itself. This is most likely if it is caught early.
Treatment for more severe decay includes:

Fillings

When decay reaches the dentin, your dentist will treat it by:
  • Numbing the tooth and surrounding tissue area
  • Removing the decay with instruments
  • Filling the hole with a dental filling; the filling can be silver or tooth colored

Root Canal

Tooth decay that reaches the pulp and/or root of the tooth is treated with a root canal:
  • The tooth is numbed and a hole is drilled through the top of the tooth.
  • Pus and dead tissue are removed from the tooth.
  • The inside of the tooth and the root (nerve) canals are cleaned and filled with a permanent filling.
  • The root (nerve) canal is sealed.
  • A crown is placed on the tooth to protect it.

Tooth Extraction (Removal)

Tooth extraction may be necessary if:
  • Tooth decay and/or tooth infection is too extensive for filling or root canal.
  • A break or crack in the tooth that has allowed for decay is too severe to be repaired.
  • An extensive infection exists between the tooth and gum.
If the tooth is removed, it will be replaced with a:
  • Partial bridge
  • Denture
  • Tooth implant

Prevention

To help reduce your chance of tooth decay:
Talk to your dentist about the use of a sealant. This is a protective plastic covering. It is applied to the chewing surfaces of teeth. Sealants usually last anywhere from 5-15 years.
Prevention is particularly important for children. Supplemental fluoride in early childhood can prevent early decay. The dose can be adjusted for the amount of natural or added fluoride in local water supplies. Fluoride can also be applied to permanent teeth as a long acting varnish. Re-varnishing is usually necessary at least twice yearly.

RESOURCES

Academy of General Dentistry http://www.agd.org

Mouth Healthy—American Dental Association http://www.mouthhealthy.org

CANADIAN RESOURCES

Canadian Dental Association http://www.cda-adc.ca

The Canadian Dental Hygienists Association http://www.cdha.ca

References

Murdoch-Kinch CA, Mclean ME. Minimally invasive dentistry. J Am Dent Assoc. 2003;134(4):412-414.

National Institutes of Health website. Available at: http://report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=129&key=T. Accessed September 30, 2014.

Seal out tooth decay. National Institute of Dental and Craniofacial Research website. Available at http://www.nidcr.nih.gov/OralHealth/Topics/ToothDecay/SealOutToothDecay.htm. Updated August 2012. Accessed September 30, 2014.

Selwitz RH, Ismail AL, Pitts NB. Dental caries. Lancet. 2007:369(9555):51-59.

Statement on early childhood caries. American Dental Association website. Available at: http://www.ada.org/en/about-the-ada/ada-positions-policies-and-statements/statement-on-early-childhood-caries. Accessed September 30, 2014.

Twetman S. Consistent evidence to support the use of xylitol- and sorbitol-containing chewing gum to prevent dental caries. Evid Based Dent. 2009;10(1):10-1.

8/2/2012 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Khadra-Eid J, Baudet D, Fourny M, Sellier E, Brun C, François P. Development of a screening scale for children at risk of baby bottle tooth decay. Arch Pediatr. 2012;19(3):235-241.

5/17/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Moyer VA, US Preventive Services Task Force. Prevention of dental caries in children from birth through age 5 years: US Preventive Services Task Force Recommendation Statement. Pediatrics. 2014;133(6):1102-1111.

7/15/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Yaacob M, Worthington HV, et al. Powered versus manual toothbrushing for oral health. Cochrane Database Syst Rev. 2014;6:CD002281.

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