White or brown spots, sensitive teeth or bad breath are warning signs of tooth decay, also called tooth decay. How does this disease, which affects 94 percent of all adults, develop and how can it be prevented?
- In tooth decay, caries bacteria convert sugar into acids that attack the outer layer of the teeth, the tooth enamel.
- The main cause of tooth decay is too high a sugar content in the diet combined with inadequate oral hygiene.
- Neck caries occurs at the enamel-cementum border of the teeth, where tooth necks are exposed due to age-related gum recession or incorrect tooth brushing.
- So the best prevention against tooth decay is good oral hygiene and a reduction in sugar consumption.
What is tooth decay?
Caries or tooth decay caused by the destruction of the tooth structure by bacteria, in particular of bacterial species Streptococcus mutans, in the coating ( plaque ) or tartar lives. The caries bacteria convert sugar into acids through their metabolism, which attack and demineralize the outer layer of the teeth, the tooth enamel. If the process is not interrupted, the substance continues to degrade and the tooth enamel becomes more and more fragile: The first tooth decay stage is initial caries. In the following stages of tooth decay, acid and bacteria get into the softer dentin or dentin that lies under the tooth enamel – and a hole quickly forms in the tooth.
If the tooth decay reaches the pulp, the tooth pulp, the tooth root can become inflamed. The affected person gets a toothache.
Tooth decay is one of the most widespread diseases worldwide, affecting around 94 percent of all adults.
Recognize tooth decay
Brown spots on the teeth and toothache are common symptoms of tooth decay. However, the tooth decay has already advanced a long way. The first signs of tooth decay can be:
- white spots on teeth (not to be confused with fluorosis)
- sensitive teeth with sweet, cold or hot
- bad breath
- loosened fillings
- rough or crumbling areas on the tooth
- swollen lymph nodes
But tooth decay, especially interdental caries, i.e. tooth decay between the teeth, is difficult to detect, so if in doubt, clarify caries symptoms with your dentist and attend check-up appointments twice a year. Early detection is worthwhile, because once the tooth decay has progressed, tooth decay can cause pain in the tooth nerves.
Tooth decay or discoloration
Dyes in luxury foods, foodstuffs or food supplements such as cigarette smoke, red wine, tea, coffee or iron supplements can stain teeth. The enamel then usually becomes evenly darker, the entire tooth or the entire set of teeth is affected. If individual brown or white spots appear on the teeth, however, tooth decay is often the cause. Brush your teeth thoroughly. If the stains are still present, it is mostly due to colored tartar or tooth decay – very rarely, drugs such as antibiotics can also be the cause of brown stains. Make an appointment with the dentist as soon as possible. Incidentally, the diagnosis of tartar is not a real all-clear, as large numbers of caries bacteria live on tartar.
Dental cervical caries is a special form of tooth decay at the enamel-cementum border of teeth. Most often, neck caries (also called root caries) occurs on exposed tooth necks that are caused by age-related gum disease or by incorrectly brushing your teeth. Since the tooth necks, unlike the tooth crowns, are not protected by the hard enamel, the tooth decay can progress quickly and cause massive damage to the teeth. The tooth decay causes pain in no time because the roots are also quickly attacked.
During treatment by the dentist, the drilled neck of the tooth must be sealed with special fillings such as glass ionomer cement.
Tooth decay: causes
The main cause of tooth decay is an excessively high sugar content in food and beverages, which promotes the massive spread of the caries bacteria Streptococcus mutans in the oral flora, especially in the dental plaque. In combination with insufficient oral hygiene, acids – as a waste product of the processing of sugar by the bacteria – attack the tooth enamel and cause tooth decay.
Tooth decay: treatment
Repairing caries damage makes up the largest portion of the cost of dental treatments. Adults aged 35 to 44 years have an average of 15 teeth in their mouth that are decayed or treated or removed for tooth decay.
It is important to recognize tooth decay early, because in the early stages of tooth decay little or no tooth substance needs to be removed. If a hole has already been made in the tooth, the carious material must be removed and replaced. Only the dentist can remove tooth decay; treating tooth decay yourself is only possible as a preventive measure.
Treating tooth decay: early stages of tooth decay
In the case of initial caries, i.e. caries in the early stages, it is often sufficient for the dentist to professionally remove the plaque and treat the small white or brown areas on the teeth with fluoride-containing varnishes or gels in order to store more minerals in the teeth again. Improved dental care with toothpaste containing fluoride and a reduction in sugar consumption can support this early tooth decay treatment as a prophylaxis.
In a newly developed treatment method for early stages of caries, porous tooth areas are filled with liquid plastic by the dentist . The hardened plastic is supposed to block the caries bacteria and prevent the caries from progressing. For the method to be successful, meaningful long-term studies have to be awaited.
Treating tooth decay: advanced stages of tooth decay
The problem with advanced tooth decay: it cannot be cured. If there is a hole in the tooth or even caries under the crown / filling, the rotten areas must be drilled out and cleaned. The tooth is then closed again with a filling made of plastic, amalgam , ceramic or a gold alloy. If a lot of tooth substance has to be removed, the tooth may be sealed with a crown or partial crown . If the tooth nerve has already been attacked, a root canal treatment may be necessary.
It is important that all carious matter is removed during the treatment before the tooth is rebuilt, so that caries does not remain under the crown / filling and the tooth continues to rot undetected.
Prevent tooth decay
Your ally in the fight against tooth decay is saliva. By constantly washing the teeth with minerals, it ensures that the tooth enamel is permanently remineralized and minor damage is compensated for. Frequent sugar consumption disrupts this process because bacteria are constantly producing acids from sugar. If the bacteria are brushed away with plaque at least twice a day, their number and their attacks on the teeth are limited. So the best prophylaxis against tooth decay is good oral hygiene and a reduction in sugar consumption.
- Brush your teeth thoroughly but gently twice a day for at least two minutes without exposing the necks of the teeth. Use a toothbrush with a rather small head so you can go anywhere and a toothpaste that contains fluoride.
- Ultrasonic toothbrushes with special toothpaste clean even more effectively and can even loosen tartar.
- Clean the spaces between your teeth with dental floss once a day.
- You may be able to support this oral hygiene with antibacterial mouth rinsing solutions.
- Have a professional teeth cleaning done twice a year .
- Reduce your sugar consumption or limit your “nibbling time” for sweets to once a day and then clean your teeth.
Tooth decay in children
In children and adolescents, tooth decay has decreased significantly since the 1980s. Today, twelve-year-olds have an average of less than one carious tooth in their mouths; in the 80s there were seven diseased teeth. The progress is probably owed to a widespread fluoride prophylaxis for children, which hardens tooth enamel. Despite these successes, tooth decay is still too widespread in children: 20 percent of all three-year-olds are already affected by tooth decay. According to abbreviationfinder, ECTD stands for Early Childhood Tooth Decay.
Simple measures can have a big impact on children. While strict cleaning rules such as “brush your teeth after sweets or every meal” and a complete ban on sweets are difficult to implement and ultimately unnecessary, brushing your teeth twice a day and restricting the consumption of sugar is sufficient to keep children’s teeth free of caries, as is the case with adults.
- If possible, start brushing your teeth with the first tooth.
- Brush your teeth in the morning after breakfast and in the evening after dinner
- Rule of thumb: until the child can write, parents should brush their teeth.
- 16 hours of sugar-free time is ideal for the saliva to regenerate children’s teeth. Twelve hours overnight and four hours after breakfast until the next meal. Carrots, apples or whole grain bread are allowed as a snack.
- Many small portions of sugar trigger acid attacks every time – it’s better to eat the sweets ration for the day at once than spread them out.
- Practice visits to the dentist