Tooth decay in short is nothing but destruction of the tooth enamel. Foods containing carbohydrates/ sugars / starches such as milk, pop, raisins, cakes or candy if left on the teeth result in tooth decay. Bacteria living in the mouth react with these foods thereby producing acids. Acids erode the enamel on your tooth thereby causing tooth decay over a period of time.

Tooth decay in the beginning stages, hardly shows any symptoms. Otherwise, depending on the location of the cavity as well as its severity it might show the following signs and symptoms:

• Tooth pain/ ache normally or on biting
• Pus around the tooth
• Sensitivity of tooth
• Difficultyin eating/ chewing sweet, hot or cold items
• Holes or pits visible in your teeth
• Dicolouration or stains on the tooth
• Unpleasant mouth smell

Tooth decay is mainly caused by the extent of fermentable carbohydrates viz. sugars and starches from the diet and their reaction with the plaque from your mouth. The foods you eat and the liquid you drink contain fermentable carbohydrates and the plaque bacteria in your mouth feed on them thereby converting them to acid. This acid is capable of dissolving the enamel thereby causing a cavity in your tooth. Over a period of time this cavity gets deeper and deeper and reaches the dentine which is the calcareous part of your tooth. As the cavity spreads through the dentine the support for the enamel reduces and the enamel become brittle and breaks. At this stage you will experience severe pain. If you do not treat this on time the dental decay might spread to the pulp and if the pulp gets infected an abscess will be formed.

The tooth decay does not take place in a short period and it takes a long time. Saliva also is useful in washing off some of the bacteria and acid. However, the process accelerates once each layer gets eroded by the decay. Normally the back teeth viz. the molars and premolars are the most affected by tooth decay because they have a number of grooves, pits and fissures to chew food into which food particles collect. Plaque builds up in this and allows bacteria to thrive. This causes acid formation and erosion of tooth.

• When we eat sugar and starch, plaque produces acid which attacks teeth.
• Cavity (hole) develops and the acid attacks the dentine.
• Bacteria attack nerves and blood vessels from soft pulp.
• Root and socket become infected

People do not take cavities and tooth decay very seriously because it is a common occurence. You must understand that these can result in the following problems which might affect not only adults but also children with baby teeth.

• Tooth pain
• Abscess in tooth
• Loss of tooth
• Broken tooth
• Problems in chewing
• Infections

Severe pain due to tooth decay/ cavities might hamper your normal life and you will find yourself absenting from work. Chewing or eating will be painful which might make you avoid your food thereby resulting in weight loss or problems of nutrition. Tooth loss might give you an inferiority complex that you might find difficult to overcome. Abscess in tooth could be life threatening if not treated properly.

Besides a thorough clinical examination your dentist will diagnose tooth decay or cavity by checking for symptoms of tooth pain and sensitivity. Sometimes to check the extent of decay he may use the help of dental X-rays.

There are three types of tooth decay and these are smooth surface decay, pit and fissure decay and root decay. A brief detail of each is as follows.

• Smooth surface decay – this is decay on the flat surface of a tooth wherein the bacteria is likely to remain for a long period and the resultant acid will dissolve the tooth enamel.
• Pit and fissure decay – this is decay affecting the pits and grooves on the chewing surface of your back teeth and it deteriorates if your oral hygiene is bad
• Root decay – this is decay that occurs on the tooth root and is common in people with receding gums.

In the early stages of tooth decay, the lost minerals in the tooth result in small white spots to appear on the tooth. It is possible to reverse this at this stage by brushing twice a day using fluoride toothpaste and also taking measures to improve saliva flow by chewing sugar free gum. Once the breaching of enamel takes place, it is not possible to reverse this process.

The following actions taken regularly by you will prevent the occurrence of Tooth decay.

• Brushing teeth with fluoride toothpaste twice a day
• Rinsing of your mouth with a fluoridated mouth rinse
• Cleaning between teeth with floss or an interdental cleaner daily
• Stop eating snacks between meals
• Avoid sticky foods such as sweets, biscuits, chips etc.
• Have a balanced diet
• Regular professional cleaning and oral exams
• Application of dental sealants to the chewing surfaces of the back teeth which are the starting point for tooth decay

The type of treatment for tooth decay and cavities is mainly dependent on the severity of the problem.The following are some of the options that the dentist will recommend:

• Fluoride treatments – In order to prevent cavities and facilitate the teeth to repair themselves fluoride can be used. If the tooth decay is in the initial stages of development it might be possible to restore the enamel by fluoride treatment. These treatments can be in the form of a liquid solution, a gel, foam or varnish that is brushed onto your teeth.
• Fillings – In order to replace decayed areas of your teeth the doctor might advise you to go in for fillings in case the decay has gone beyond the stage of fluoride treatments. This is also known as the process of tooth restorations. In this process, the dentist will remove the decayed part of the tooth and then fills this gap with certain fillings to restore the shape of the tooth. The materials used for fillings are tooth-colored composite resins, silver amalgam, porcelain or combinations of several materials.
• Crowns – If the decay is bad or if the tooth has weakened the dentist might recommend for going in for a crown than a filling to treat your cavity. In this the tooth is covered with a crownafter the decayed part is removed. Materials used for the crowns are gold, porcelain or porcelain fused to metal.
• Root Canal – If the decay reaches the inner material of the tooth (tooth pulp) you have to go for a root canal treatment wherein the pulp of the tooth is removed and then replaced with an inert filler.
• Tooth Extractions – It is always preferable to save a tooth than extract a tooth and this should be your last option. In this the decayed tooth is removed. The major disadvantage in extracting the tooth is that the teeth around this tooth will start moving. Hence, you must opt for tooth replacement as soon as possible.