A Guide to Dental Decay

Dental decay is the major source of serious dental treatment in the UK. Most of us tend to think of decay as something not too serious. After all, a dentist can simply fill a cavity and make it better, can’t they? If they spot the cavity early enough, then they can. However, if the decay is left untreated and the cavity is left to grow bigger, then this can lead to much more serious complications. Ultimately, it is going to cause you serious pain and require emergency – and probably costly – dental treatment.

In this article, we will look closely at the damage that decay can do to your teeth and at the kinds of dental emergencies it can contribute to. We will also look at how decay can be removed – or better still, how it can be prevented in the first place!

What causes dental decay?

Every day, plaque builds up on our teeth. Plaque is a thin, sticky film that clings to our teeth. It is made up of a variety of matter, debris and, most importantly, millions of types of bacteria. Because plaque is so sticky, the longer it sticks to our teeth, the more it builds up.

If we leave plaque to build up on our teeth, it can cause a number of problems. The first is that, as layer upon on layer of plaque builds up, it hardens. Hardened plaque is known as calculus. As the calculus becomes solid, it becomes much harder to remove by simple brushing, especially when it becomes trapped in the pockets around the roots of the teeth and the gums. When calculus builds up in these areas, it can cause the gums to recede and for gum disease to develop.

If gum disease is allowed to develop, the gums recede away from the teeth and eventually, the teeth can become loose. Usually, you will need the help of a dentist to remove the calculus, through a technique known as scaling and root planing.

The second problem that plaque causes is due to the bacteria that it contains. This bacteria reacts with sugars in the food that we eat to form acid. This acid then attacks and erodes the enamel on our teeth, which causes cavities and decay.

How does decay damage teeth?

Once the acid in plaque has formed a cavity in a tooth, it creates a space for more plaque and food debris to build up. Of course, this is even harder to remove through brushing. Therefore, the cavity continues to grow and eat through the natural layers of protection that a tooth has, called the enamel and the dentin. Initially, a small cavity may not cause you too much pain – if any. However, once the decay reaches the inner part of the tooth, the tooth can become very sensitive to hot and cold and the pain can be severe.

The inner part of a tooth is known as the pulp. The pulp consists of the blood vessels and the nerve endings which keep the tooth alive. So as you would expect, it is a very soft, sensitive area that can easily become infected. If the inner pulp of your tooth becomes infected, this can lead to an abscess which can be very painful. If untreated, your tooth may need to be extracted.

How is decay treated?

If you start to experience tooth pain, then it is likely that the root cause is decay – especially if it is a dull, throbbing ache that sharpens when you bite down on a particular tooth. Unfortunately, once the decay has reached this stage, there is not much you can do to treat yourself. You need to visit a dentist.

There are some steps you can take in an emergency. For example, many people take an Emergency Dental Kit on holiday with them. These normally include some dental cement so that you can temporarily fill a cavity until you can make is back to the UK. This can help to ease the pain – but it really is only a temporary measure so you should still visit a dentist for proper treatment.

How your dentist treats your decay will depend upon the severity of the case. Hopefully, the cavity will be identified before it reaches the centre of the tooth, which means that it can simply be filled. There are a number of types of materials that dentists can use to fill cavities. Usually, they will use cheaper, more durable materials for the back teeth and more aesthetic materials – such as tooth-coloured composites – to fill cavities that are more visible.

However, if the decay has already reached the centre of the tooth, the pulp may have become infected. In this cases, a cavity would only serve to seal the infection in. Therefore, your dentist has to perform root canal treatment to remove the infected pulp before putting a crown on the tooth so that it is protected against future infection. Removing the pulp means removing the blood supply from the tooth – so obviously, it is much more preferable to identify the decay early and to fill the cavity before any serious damage is done.

What other problems can it cause?

If a tooth has decayed badly, then it can affect the structure of the tooth. If a tooth has a particularly large cavity, this means that the tooth will be weaker than it should be. Even if the tooth has not been infected, a large cavity still means that there is a problem waiting to happen.

If the structure of a tooth is weakened by a large cavity, then that tooth is more likely to split, fracture, break or chip. This can happen when you are simply biting down on some hard food, for example. And unfortunately, it is another example of how dental decay – left unchecked – can lead to more serious emergency dental requirements.

How is decay prevented?

Therefore, the next questions needs to be ‘how can I prevent dental decay?’ Because if you can prevent dental decay from eroding your teeth, you can prevent a whole range of dental problems ranging from small cavities to abscesses, from split teeth to bad breath!

The solution to preventing decay is twofold. First of all, you need to brush your teeth regularly. Plaque builds up on your teeth every day, so it makes sense that you need to brush your teeth every day to remove it. In fact, dentists recommend that you brush your teeth once in the morning and once in the evening.

Brushing your teeth is a skill. If you are not sure that you are brushing your teeth correctly and removing the plaque adequately, you should speak to your dentist. They will demonstrate to you the best way to brush teeth so that you remove plaque but also avoid damaging your gums and the enamel on your teeth. You should brush your teeth quite gently, always brushing away from your gums rather than towards them.

You should also use a flouride toothpaste, as this will help to strengthen the enamel in your teeth and protect against cavities.

As part of your daily hygiene programme, you should also floss regularly – ideally after each meal, or if that is not possible or convenient, at least in the morning after breakfast and in the evening before bed. Flossing is important because it helps you to get right in between your gaps and clear out a lot of the plaque that brushing cannot reach. No matter how regularly or how long you brush for, there will always be some plaque that your brush is unable to reach. None of our teeth are uniform shapes, so plaque and other debris regularly gets caught in the gaps between our teeth. It is the plaque in these areas that can eventually harden into calculus and damage our gums.

Finally, many people simply do not visit their dentist often enough. If you wait until you experience tooth ache or discomfort before you visit your dentist, then you are already limiting your treatment options. As much as possible, decay should be treated early and this will minimise its impact.

You should aim to visit your dentist at least once every six months. On these visits, your dentist will be able to remove any plaque or calculus that regular brushing has been unable to reach. They will also be able to spot any small cavities before they develop. If these small cavities can be identified and filled, then you can avoid a lot of pain and more visits to the dentist in the future.

If you can visit your dentist regularly and maintain a good oral hygiene programme, this will eliminate the majority of dental decay and reduce the need for emergency dental treatments in the future. Most dentists would also recommend that you visit a dental hygienist regularly – perhaps every 12 months or so. They can give your teeth a deeper clean and polish and also advise you on keeping your teeth clean on a daily basis.


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