Bacterial dental plaque, which is formed by the addition of bacteria present in the mouth when sugary, floury, starchy foods, milk, fruit juices, cola drinks, fruits and vegetables etc. that we consume during our diet are not cleaned sufficiently, contains acids, which are the waste products of bacteria. These acids cause mineral loss and irreversible destruction on the hard tissue enamel of the tooth.
In fact, bacteria progress very slowly and destroy this layer. However, after the 1.5-2 mm enamel layer, the decay encounters the softer dentin layer and progresses rapidly, approaching the core of the tooth, the pulp layer. During this time, sensitivity to sugary foods is first seen, then cold sensitivity and finally hot sensitivity. Decay always starts from the surface of the tooth and progresses, reaching the dentin layer. Dentin contains more organic matter than enamel. For this reason, decay spreads more quickly in this layer and pierces the dentin like a screw; However, the rate of progression of decay varies greatly from person to person and from tooth to tooth. Sometimes, decay progresses so chronically that your tooth can lose its vitality (necrosis) without feeling any pain.
Another point to remember is that dentin is a defense organ of the tooth. At the end of the canals described in the previous section in the dentin, there are production and repair cells called odontoblasts, and they can plug the decayed dentin with repair tissue. Just like the defenders of a besieged castle repairing the gaps opened by cannonballs... This spontaneous defense can sometimes be insufficient against rapidly progressing decay.
Since we all have bacteria in our mouths, all individuals are at risk of decay. However, this risk rate varies from person to person.
Risk Groups
Those with high sugar content in their diets; It has long been known that eating habits affect the formation of cavities. (For example, Eskimos, who eat hard and fibrous foods, almost never experience cavities.) In contrast, it is easier for soft and sticky foods to stick to the teeth, form plaque and cause cavities.
Those with low fluoride content in their diets (water)
Those with dry mouth (those with diseases or medications that reduce the rate and amount of saliva flow)
Those with many fillings and crowns,Those who do not brush their teeth regularly
Children and the elderly are at higher risk for tooth decay. In young children, the enamel of newly erupted teeth is weak and quite resistant to acids. The type of decay known as baby bottle tooth decay or early childhood tooth decay destroys the enamel rapidly and a cavity is usually seen within a few months.
Chronic cavities can be seen in older adults, the cavities do not get worse or progress very slowly. Teeth with chronic decay appear much darker in color because normal food and drink stains the edges of the cavity. Root caries is also much more common in older adults. In older adults, the root surface is exposed due to hard brushing or gum recession due to periodontal disease. Exposed root surfaces are prone to decay. In addition, dry mouth is also common in these individuals, which increases the risk of tooth decay.
Symptoms of Decay
- Sensitivity to sudden temperature changes (cold-hot) in foods and drinks
- Bad odor and taste
- Discoloration, (darkening, darkening), fractures or cavities on the chewing surface of the teeth, between the teeth and at the gum level.
- Sensitivity to sweet or sour foods.
However, cavities may not always be visible to the naked eye. Tooth decay is often seen on the chewing (upper) surfaces of the back teeth, between two teeth, and at the gum line. The later the tooth decay is treated after it has formed, the more complicated the treatment becomes. Therefore, it is very important to go to the dentist for check-ups. In this way, cavities that have just started can be identified and treated.
Early recognition of tooth decay can prevent or at least delay the loss of teeth. This provides important contributions both in terms of health and social and economic aspects. It reduces the need for dentures. Nothing can replace our own natural teeth. Early loss of permanent teeth also causes nutritional problems. Oral and dental care is very important in the longevity of natural teeth.
Decay Diagnosis Methods
Apart from the complaints of patients mentioned above, there are some diagnostic methods belonging to doctors that will reveal the presence of decay. The first and most important one is of course the oral examination with the naked eye. It is possible to diagnose many of them, from the initial cavities to advanced infectious cavities, with the examination to be performed by a specialist doctor. However, in some cases, it is quite difficult to see the cavities between the teeth, especially at the beginning. Or, in advanced cavities, it may be difficult to understand whether root canal treatment is required, i.e. whether the cavities have spread to the pulp of the tooth. In such cases and if possible, it is necessary to obtain x-ray diagnostic support before starting any treatment.
