Dental caries or cavities refers to a condition involving destruction of the enamel which is the hard outer surface of the teeth. This occurs when poor oral hygiene allows the bacteria-rich plaques to coat the surface of the teeth. These bacteria release acidic chemicals that degrade the white enamel revealing the yellow-brown dentine which is present beneath.
Dental caries is common in the community, seen more frequently in children, related to their food habits.
Risk factors For Dental Caries
- Poor oral hygiene with inadequate brushing or incorrect method of brushing
- Dry mouth: Saliva is a natural mechanism of protection against the formation of bacterial plaques
- Intake of food with high sugar content: Sugar enhances plaque formation
- Chewing tobacco
Symptoms of Dental Caries
Diagnosis of Dental Caries
The diagnosis of dental caries is based on the history and the clinical examination
- Physical exam: a complete dental exam including neck nodes is performed
- Imaging studies: An X-ray of the jaw is recommended to visualize the exact location of the tooth and to identify if there is the destruction of the root, misalignment, or impaction.
- Culture of the bacterial plaque: The plaque can be scraped off and sent for culture.
Complications of Dental Caries
Dental caries can become complicated if not treated on time. The following are serious conditions that can progress from dental caries
- Complete destruction of the teeth: Dental caries can lead to decay of the teeth and weakening at the roots resulting in loss of teeth.
- Bacterial seeding to the rest of the body: As the infection in the teeth can spread to other parts of the body, sepsis is possible.
- Infective endocarditis: This is a systemic condition marked by the growth of infectious organisms on the leaflets of the heart valves. Bacteria from caries can enter the bloodstream and deposit on the heart valves.
- Gingivitis and periodontitis: These conditions are from inflammation of the gums and other structures surrounding the teeth. They can further aggravate loosening and loss of teeth.
Treatment of Dental Caries
The recommended treatment is based on severity of the disease
- Improved oral hygiene: This includes twice-daily brushing of the teeth and regular flossing, use of mouthwash containing chlorhexidine.
- Fluoride can also help in improvement of caries
- Filling: This is the most common procedure done. The dentist will make some holes in the enamel of the teeth and remove the decayed material. This is followed by filling the holes back up using a resin.
- Crowns: This is considered in extensive dental caries with the involvement of multiple teeth. This involves covering the fragile damaged enamel with a ‘crown’ to prevent disintegration
- Root canal: In severe cases when the core of the tooth is involved, it is necessary to perform a root canal to remove all the debris from within the teeth
- Extraction: this is the last resort for when it is not possible to save the tooth from destruction. A partial denture or an implant may be inserted in its place.
In all procedures mentioned above, the dentist in New York will first examine the individual. Generally, the procedure can be performed under local anesthesia where a spray and injection are given so that there is no pain felt
Prevention of Dental Caries
- Avoidance of food with a high sugar content
- Maintenance of good oral hygiene
- Hanada N. Current understanding of the cause of dental caries. Jpn J Infect Dis. 2000 Feb;53(1):1–5.
- Lee Y. Diagnosis and Prevention Strategies for Dental Caries. Journal of Lifestyle Medicine. 2013;3(2):107-109.