Primary Causes Of Tooth Decay

Tooth decay is becoming prevalent nowadays. Poor dental hygiene and consumption of sugary items can be a big cause of tooth decay. If tooth decay is identified, it is advisable to get it treated in time to prevent the damage from worsening. 

Tooth decay is a preventable condition if proper oral care is maintained. In England, there are a large number of hospital admissions for teeth extraction procedures, which was mainly in children. This shows that preventive strategies and campaigns are not working. The processes related to treating tooth decay can be detrimental to physical and mental well-being at times. A study conducted in England showed the number of college admissions in 2018 at around 26,000 for 5-9 year olds.⁹ 

How to identify tooth decay?

Tooth decay can lead to complications if not treated in time. Tooth decay is the result of the bacteria, Streptococcus mutans attacking the surface of the teeth called enamel. Tooth decay or cavity can be identified by a small hole or brownish patches on any teeth. If these cavities are not treated in time, they might cause infection and eventually lead to tooth extraction. Toothache can be very painful at times, so it is better to prevent it than to treat it. Tooth decay can happen at any age, but children are at higher risk as they consume more sugary substances.¹

Causes of tooth decay

Tooth decay can occur due to a number of reasons. Let's check out various reasons and know how to prevent tooth decay.

Dental plaque

Dental plaque refers to a colourless or yellowish film that builds on teeth especially on the gum margins. It is made up of millions of bacteria. It also comprises of food particles and saliva. Low pH increases the quantity of bacteria leading to demineralisation of the enamel. Proper oral hygiene is required to prevent plaque and tooth decay. The use of Fluoride containing products decreases the growth of acidogenic bacteria by preventing the reduction of pH level.²^,³

Diet and nutrition

Some sugary foods have a high retention rate in the mouth such as sweet biscuits and potato crisps. Sticky foods increase the pH fall. Sugar can be broken down to acid byproducts which will lead to the demineralisation of teeth.⁴ 

Oral hygiene

When bacteria breaks down food particles, acid formation occurs leading to tooth damage. If oral hygiene is not maintained, the acid will damage the enamel coating of the teeth.⁵

Dry mouth

Saliva plays an important role in breaking down food particles and acting as a lubricant to ease swallowing food. Saliva also helps washing away bacteria and food particles from the mouth. Apart from these benefits, saliva is rich in calcium and phosphate which helps in preventing tooth decay. Xerostomia, a condition which refers to dry mouth can be a reason for tooth decay. Suffering from dry mouth regularly is not normal and must be investigated.⁶

Lack of fluoride

Fluoride helps in strengthening the enamel which prevents tooth decay. Dentists recommend to brush teeth twice daily with fluoride-containing toothpaste to prevent tooth decay. For toddlers, it is recommended to use small pea-sized amount of non-fluoride toothpaste and gradually be introduced to fluoride.^5,8

Non-modifiable factors

Factors like age, gender and ethnicity can be a risk factor for tooth decay. The risk of tooth decay increases with age due to exposure to sugary substances and other factors. Some studies have hinted at girls showing more dental caries compared to boys. It can be due to the fact that people assigned female at birth (AFAB) go through hormonal changes during menstruation and pregnancy.

These hormonal fluctuations change the environment of the oral cavity. Another theory suggests that girls have dental eruptions earlier than boys. So, the teeth are exposed to all factors for a little longer time compared to boys making them prone to caries.⁷

Prevention of tooth decay 

As we have discussed the various causes of tooth decay, let's summarise the prevention strategies.

• Hygiene is the most important point in prevention of tooth decay. Brushing teeth twice a day with fluoride toothpaste is good for teeth as it prevents plaque build-up leading to decay
• Consumption of foods and drinks containing high amounts of sucrose is detrimental for teeth. They reduce the pH resulting in the demineralisation of teeth
• Dental sealants are coatings on the surface of teeth that can prevent tooth decay for years. They prevent the colonisation of Streptococcus mutans. This can be a good preventive method for tooth decay. They are mostly put on back teeth, molars. Molars are used for chewing and they have some grooves where food can easily get struck and lead to damage⁸
• Regular check-ups with dentist to identify early stages of tooth damage and regular visits with dental hygienists can remove plaque and tartar to prevent tooth decay

Treatment for tooth decay

Tooth decay has many phases and treatment depends on the situation. Fluoride treatment can be started which will help in preventing tooth decay in initial stages. If the damage has taken the shape of the tooth cavity, then the dentist will need to do filling of the cavity. If the damage has reached the soft tissue, the dentist might need to perform root canal treatment (RCT). An infection in the root canal can be serious and cause severe pain. This treatment can prevent tooth extraction in some cases.

FAQs

What are the primary causes of tooth decay?

Tooth decay can occur due to non-modifiable factors such as age, gender and ethnicity. Other factors include oral hygiene practices, diet and nutrition, genetics or lack of fluoride.

Does sugar really cause dental cavities?

Sugary foods and drinks lower the pH, which results in demineralisation of teeth and eventually causing tooth decay. 

Can tooth damage be reversed?

If tooth damage is in the initial stages, the enamel can be repaired by minerals from saliva. The damage might be difficult to treat if it is left untreated for a long period of time. If a cavity is formed, the dentist will have to treat it.

Is mouthwash effective in cleaning sugar off teeth?

Mouthwash alone is not enough to clean sugar off the teeth. Oral hygiene consists of brushing with fluoride toothpaste and using mouthwash and floss on a regular basis. 

Summary

Tooth decay can be prevented. When the bacteria Streptococcus mutans attack the teeth, tooth decay starts. Tooth decay can be painful and might lead to infection. It can be caused due to poor oral hygiene, nutrition, environmental factors and lack of fluoride. It starts with brown or yellow spots on teeth and at this stage it can easily be treated.

These spots can turn into holes in the teeth known as dental cavities or caries. At this stage, the dentist can perform dental filling and treat them. If it's not treated at this stage, the damage can reach the pulp and cause infection. Root canal treatment or tooth extraction can be performed depending on the condition of teeth.

To prevent tooth decay, it is recommended to brush teeth twice a day with fluoride toothpaste, floss and mouthwash. Try to reduce the consumption of sugary foods and beverages as they reduce the pH, leading to tooth decay. Dry mouth also leads to tooth decay so try to keep yourself hydrated.