What is tooth decay?

You often hear the term "decay," but what does it really mean? Well, tooth decay is basically when bacteria attach to your tooth due to plaque being left behind for various reasons, which I will explain later. This process causes the enamel of the tooth to start deteriorating, leading to the breakdown of the tooth. As the bacteria penetrate the tooth, they make it very soft, and eventually, if not treated, it can cause the tooth to break and lead to pain. So, tooth decay is essentially the deterioration of the tooth layer by layer.

What causes dental decay?

Dental decay is a multifactorial disease, meaning it has different contributing factors. I'll try to make it simple, but one of the main factors I see in my patients is plaque not being removed properly through brushing. When we don't brush or floss properly and leave plaque behind, bacteria attach to it and start the process of tooth decay. We also have bacteria that naturally live in our mouths, known as our oral flora, which includes both good and bad bacteria. Some people have a higher concentration of the bacteria that produce decay, making them more prone to it than others. For those individuals, brushing and flossing need to be even more thorough because of their higher risk for tooth decay. Another factor is diet. Eating a lot of sweets, carbonated foods, or acidic foods can lower the pH in our mouths. The pH level determines how acidic or basic our mouth is, and when it becomes acidic, it's easier for bacteria to penetrate the tooth structure and start the decay process.

What are signs of tooth decay?

Initially, it's hard to tell because tooth decay starts in a very small, incipient stage, beginning on the outer layer of the enamel and then progressing through the different layers of the tooth. The process varies depending on the individual. In younger people—such as kids, teenagers, and even young adults—the decay process is more aggressive and travels quickly, often becoming deep before it's noticed. In this population, one sign of tooth decay is the appearance of white lesions or spots on the teeth. They may also notice a small hole or experience sensitivity to hot, cold, or sweet foods, which are indications that something is wrong. In older adults, the process is often slower and more chronic, sometimes taking years to develop. They may have larger holes but without pain, and sometimes they don't even realize they have decay until they see it. The best way to detect tooth decay is through regular dental check-ups every six months or at least once a year. Decay can also occur between the teeth if you're not flossing properly, and by the time it becomes painful, it may be too late, requiring more than just a filling.

What are the effects of tooth decay and can they lead to other complications?

Tooth decay primarily causes the deterioration and degradation of the tooth structure. Gradually, you'll start losing tooth structure, which can lead to pain, bad breath, sensitivity to hot, cold, and sweet foods. In severe cases, the pain can become unbearable and may keep you up at night. When this happens, it can be very serious, and you might need a root canal to remove the nerve. The severity of the decay will determine the symptoms you experience.

Can it lead to other complications?

Regarding whether tooth decay can lead to other complications, the answer is yes. Any disease in our mouth can lead to complications elsewhere in the body because our mouth is the main gateway to the rest of our body. Our overall health is closely linked to the health of our mouth. If you have tooth decay, not only can it cause pain, but the bacteria present in your mouth can travel through your bloodstream to other parts of your body, potentially causing issues with other organs. Studies have shown that certain types of bacteria from the mouth can attach to the valves in your heart, leading to a condition called endocarditis, which is the inflammation of the inner layer of your heart. So, having tooth decay can cause more than just pain and bad breath; it can also pose a risk to your overall health and be transmissible to others. For instance, when kissing someone, even your kids, you can pass the bacteria to them, which may cause issues with their oral health. Therefore, addressing tooth decay is crucial for maintaining your health.

Can tooth decay return to normal, or at what point is it irreversible?

Our teeth have different layers. The outer layer is the enamel, which is white, followed by a second layer called dentin, which is yellower, and then the nerve, called the pulp, which is protected by the other layers. When decay occurs on the enamel, it can still be reversed. For example, if we notice a white spot lesion on your teeth, we know that's the starting point of decay. At this stage, we can intervene by brushing more, using a higher concentration of fluoride toothpaste, and allowing it to strengthen the enamel, preventing deeper decay. However, if decay progresses to the second layer, we typically need to clean the decay and place a filling in the tooth. If left untreated, the decay will reach the nerve in the center of the tooth, causing severe pain. At this point, the damage is irreversible, and a root canal is necessary to remove the nerve, followed by placing a crown on the tooth. Decay will continue to progress until it reaches the nerve, making early intervention critical.

How do I stop tooth decay from spreading?

The best approach is to see your dentist and address any decay as soon as it's detected. If decay is left untreated, the bacteria can spread to other teeth, causing further damage. Additionally, it's essential to reinforce good oral hygiene practices, such as brushing at least twice a day—once in the morning and again before bed. Ideally, you should brush more often, especially after eating, because food left on your teeth starts the deterioration process. Flossing is also crucial, as decay often starts between the teeth where brushing alone cannot reach. I've seen many people rely solely on water picks without flossing, or not use a water pick at all, leading to decay between their teeth. Flossing is vital for preventing decay in those hard-to-reach areas.

When should I see a dentist about treating tooth decay?

As soon as possible. Don't wait! Schedule an appointment with your dentist right away if you suspect decay. Problems in your mouth won't resolve on their own, and they only get worse, becoming more invasive and expensive to treat. Addressing decay early can prevent further issues and save you from more extensive treatments later on. If you're interested in becoming one of our patients, I'm more than happy to see you at Olean Dental Studio. You can reach us at (941) 269-1332.