Dental decay or cavities affect most people irrespective of age, sex or social background.

What are cavities or dental decay?

Decay or dental caries is a disease in which the tooth is destroyed by softening as a result of growth of microorganisms on and around the teeth in presence of food particles.


How do cavities form on the tooth?

The microorganisms that exist in mouth along with the food remains form a sticky thin, translucent layer on the tooth called dental plaque. The plaque in initial stages can easily be removed by brushing and flossing. If it is not removed, the plaque gets attached firmly to the teeth and the bacteria multiply and in the process release mild acids that destroy the tooth structure. The enamel gets destroyed layer by layer and the bacteria gradually penetrate deeper into the tooth. The affected part of the tooth gets weakened and breaks during chewing and results in a cavity. The process is slow and continues until proper treatment is executed.


How do you detect decay in initial stages?

The dentist can detect initial decay by examination of the teeth and by taking an X-ray. Usually decay in between teeth can be spotted on a bitewing X-ray and on the grinding surface by probing these areas.

How do you identify decay between teeth?

Initial decay/ caries between teeth can be spotted on bitewing X-rays. In later stages, when more destruction takes place food usually gets impacted between teeth. A dental checkup will confirm the detection.


Does decay spread from one tooth to other?

No, it does not. However, it can start on many teeth simultaneously.


Do all cavities on tooth cause pain?

The pulp of the tooth contains the nerve endings and blood vessels and is protected by the outer enamel and dentin layer. Shallow cavities at the depth of enamel and the surface of dentin are painless. As the depth of the cavity increases in dentin the tooth becomes painful on eating hot, cold, sour or sweet foods. Once the decay reaches pulp the pain is intolerable.


Can a filled or restored tooth get decayed?

Yes, even a cavity filled with a permanent filling can develop dental caries below the filling. Hence, better care by brushing, flossing the restored tooth along with routine checkup will enhance the long-term success.


Does regular brushing keep decay away?

Yes to a great extent, since it controls the formation of dental plaque that predisposes to decay. However, other factors like deep grooves and pits on the grinding surface of teeth, weak teeth with less calcium content can make them more susceptible to decay


Is decay of teeth only due to eating of chocolates and sweets?

Sticky and sweet foodstuff promote plaque and growth of caries causing microorganisms. This predisposes to dental caries. In addition other causes include poor oral hygiene, teeth having deep grooves and pits etc.


Should decay in milk teeth be filled?

Milk teeth are important for the overall growth and development of children and in particular the jaws and face. In addition they maintain the space for incoming permanent teeth. Hence, they need to be saved with restorations until their exfoliation.


Does decay occur in old age?

Yes, it does but less frequently and is commonly seen on the exposed part of the root. Advancing age usually results in recession of the gums resulting in exposure of the root surfaces of the teeth. Food and plaque easily accumulates around these areas leading to decay if the oral hygiene is poor


Is it true that raw vegetables & fibrous food lower the chances of decay.

Refined form of food easily sticks in and around the teeth and enhance formation of dental plaque whereas eating fibrous food helps in cleansing the teeth during chewing. Decay is more frequently seen in urban people who eat more refined foods and hence is known as a of disease of modern civilization.


Does diet help in prevention of decay?

Yes, a balanced diet of essential proteins, carbohydrates, minerals and vitamins keeps the mouth healthier. Reduction of refined food, specially sweet and sticky food, and eating fruits and vegetables and other fibrous food have a big role in reducing decay.


Is it true that some type of chewing gums help prevent decay?

Yes, only sugar free chewing gums containing xylitol has shown promising results in reducing decay, while others that contain sugar do not help.

When is it appropriate to fill a cavity?

Although cavities in teeth need not be treated as an emergency, (unless associated with an abscess), they should be filled as early as possible since, decay is a slow progressive process and without many symptoms until the tooth is grossly destroyed. Sometimes even a small spot may show massive destruction below it. Treating the decay at the intial stage helps conserve tooth structure.


Tooth-Coloured Composite Fillings:

  • Bond to tooth structure, thus can also be used to repair chipped, broken or worn teeth.

  • Wear out sooner than amalgams (lasts on average 5 to 8 years,compared with at least 10 to 15 for amalgams); in addition, they may not last as long as amalgams under the pressure of chewing and particularly if used as the filling material for large cavities.

  • More expensive.

Amalgam Fillings:

Pure silver is mixed with several other metals like copper, tin and mercury to make it into a semisolid form that is packed into the cavity and then allowed to harden. It has been used in dentistry for over 100 years and does function well in the mouth. This type of restorative material is called silver amalgam.

  • Silver coloured fillings don’t match the colour of you natural teeth.

  • Last on average 10 to 15 years and usually outlast white fillings.

  • Strength – can withstand chewing forces. This kind of filling is normally used on the back ‘chewing’ teeth.

Crowns: If a tooth is broken, weakened by decay, or has a large filling, a crown covering the whole tooth would be a stronger alternative. They can be made of porcelain so they can look just as good as a natural tooth.

WHY REPLACE A FILLING?

Fillings don’t last forever. When you chew, your teeth and any fillings in them are subjected to tremendous pressures. Even if no other problems develop, some fillings will wear out over time and will need to be replaced. Fillings that are cracked or leaking can decay underneath them. Decay under a filling can become extensive before you notice it or it causes you pain. This can be prevented by having your fillings checked regularly and getting them replaced when problems are found.