Toothache is the main consequence of decay, which also counts as a widespread disease: only about one per cent of adults do not have it. The condition, also called dental caries, therefore affects almost all of us. How the hole in the tooth comes about, which treatments our practice offers and what you can do to prevent it, you can read in the following article.
What is decay?
Decay is an infectious disease of the hard tissue of the tooth. It is caused by bacteria in the oral cavity. Such bacteria, in particular Streptococcus mutans, break down the hard substance of the tooth with the help of sugar, whereupon decay forms.
How does it come about?
Decay develops on the basis of soft plaque. Dental plaque consists of complex layers of carbohydrates, proteins and bacteria. The deposit forms everywhere the surface of the tooth is not cleaned regularly and where the components of plaque can attach over time. All the bacteria sheltering in the plaque metabolise sugar and produce acid as a waste product. This acid then attacks the hard substance of the tooth, dissolving minerals out of the enamel, the upper layer. If the bacteria are not removed and the destruction advances, the dentine beneath is damaged too.
The formation of decay is multifactorial. That is, the bacteria should not be seen as the only trigger. Rather, the combination of a sugar-rich diet and inadequate oral hygiene drives the process. Other aspects also influence it, among them:
- The condition of the teeth
- Their position
- The composition of saliva
- Diet
- The degree of mineralisation of the teeth
- Plaque formation
- Genetic predisposition
- Malformation of the teeth
What complaints occur with decayed teeth?
The symptoms depend on the stage. When decay is still very superficial and has so far only attacked the enamel, it often causes no pain, because the enamel — the outer layer — is not supplied with sensitive nerve fibres. At this early stage a whitish discolouration forms on the enamel due to demineralisation, known as a white spot, which later takes on a brownish colour. Because decay does not yet announce itself through pain, it is often overlooked at this initial stage.
If it advances into the dentine, it typically causes complaints there. Cold, hot, sweet or acidic drinks and food irritate the nerve endings and cause unpleasant sensations, which are a decisive warning signal for the patient to contact our practice immediately. Visually, a greyish shimmer or yellowish to brown discolouration is a typical sign of decayed tooth substance.
If decay has penetrated into the deep dentine layers, it reaches the root canal and the pulp within. At that stage a large part of the tooth is often destroyed and the decay is clearly visible at first glance. This condition can be entirely painless or cause severe pain. The process of decomposition often produces an unpleasant smell, which is why deep decay is one of the many possible causes of bad breath.
Can decay form faster in certain places?
The spots where the risk is raised are located where plaque is hard to remove. These include in particular the chewing surfaces and the spaces between the teeth, because of their uneven surface. Decay at the neck of the tooth is also not uncommon, because the transition to the gum is often neglected when brushing. In our practice in Cologne we diagnose decay primarily with the most reliable and probably most common means: visual examination.
