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Tooth Decay

Tooth decay is one of the most widespread diseases affecting humanity and is one of the most common diseases overall. There are many factors that contribute to tooth decay, but it is most often the result of inadequate oral hygiene combined with inappropriate dietary habits.

The main cause of tooth decay is dental plaque, which accumulates on the teeth as a result of inadequate oral hygiene. It is a sticky layer made up of components of saliva, food particles, microorganisms and their by-products. Bacteria in dental plaque, known as cariogenic bacteria, play a key role in the development of tooth decay. These bacteria break down sugars from food into organic acids, which negatively affect the hard tissues of the teeth, leading to the loss of minerals known as demineralisation. During demineralisation, mineral ions are lost from the tooth tissue. When demineralisation exceeds the natural remineralisation process at the tooth surface, tooth decay begins to develop.

Other factors that may increase the risk of tooth decay include sugar consumption, frequent intake of sugary or acidic drinks and foods, individual variations or defects in the teeth, and the amount and composition of saliva.

Tooth decay can be significantly reduced through effective prevention, which is neither particularly demanding nor expensive. Health insurance providers cover two preventive dental check-ups per year, and some also contribute towards visits to a dental hygienist. Looking after your teeth is therefore simple and accessible to everyone.

Symptoms of Tooth Decay

The symptoms of tooth decay can be divided into:

Subjective symptoms (experienced by the patient) – tooth decay may be noticed when pain begins. The intensity of the pain depends on the depth and location of the decay.
Objective symptoms (diagnosed by a dentist) – a dentist most commonly diagnoses tooth decay through visual examination, probing or X-ray examination.

How to Recognise Tooth Decay

The earlier tooth decay is detected and treated, the less severe its consequences are likely to be. Tooth decay can appear in different ways depending on its stage of development.

Early stage: At the beginning, tooth decay appears as a white or grey spot on the tooth surface. It is usually subtle and this stage is generally painless.
Advanced tooth decay: As the decay progresses, it becomes more visible. The affected tooth may develop brown, grey or black spots. It may also become sensitive to changes in temperature and to sweet or acidic foods and drinks.
Caries lesion: If tooth decay is left untreated, holes may develop in the tooth. These can be small and superficial or large and deep if the decay has affected the inner parts of the tooth.
Extensive tooth decay: In advanced cases, tooth decay can cause serious damage to the tooth. The affected tooth may lose part of its structure, and the damage is often clearly visible on the tooth surface.

Interdental cavities: Interdental cavities develop in the spaces between individual teeth, where a regular toothbrush cannot reach. They are not usually visible at first and may cause sensitivity or pain in the affected area. X-rays are used to detect interdental cavities.

Cavities near the gums: Tooth decay can also affect areas close to the gums. If dental plaque and cariogenic bacteria accumulate around the gum line, they can cause gum inflammation and decay in exposed areas of the tooth near the gums. This can lead to gum swelling or bleeding.

Wisdom teeth (third molars, “eights”): caring for them can be difficult, which makes them particularly susceptible to tooth decay. They are located in hard-to-reach areas and can be very difficult to clean even with carefully selected dental care products. There is also a risk that decay may spread to the neighbouring teeth.

Prevention

Prevention of tooth decay is essential for maintaining good oral health.

Regular tooth brushing: Thorough brushing helps remove dental plaque, the main cause of tooth decay. Teeth should be brushed regularly using the correct technique, high-quality dental care products and suitable toothpaste.
Interdental cleaning: Interdental brushes, dental floss and water flossers help remove food particles and dental plaque from hard-to-reach areas that a regular toothbrush cannot reach.
Healthy lifestyle: Consuming sugary and acidic foods and drinks promotes the growth of bacteria in the mouth and contributes to the development of tooth decay.
Fluorides: Fluorides play an important role in preventing tooth decay, particularly in children. They are commonly found in toothpastes, mouthwashes and other dental care products.
Regular dental visits: Regular dental check-ups allow tooth decay to be detected at an early stage and preventive measures to be carried out.
Professional dental hygiene: Visits to a dental hygienist can help remove dental plaque and tartar, reducing the risk of tooth decay.
Limiting smoking and excessive alcohol consumption: Smoking and excessive alcohol consumption may increase the risk of tooth decay.
Teaching children good habits: Teaching children proper oral hygiene and healthy dietary habits from an early age is essential for preventing tooth decay.

Treatment of Tooth Decay

Treatment of tooth decay begins with a consultation with a dentist and involves several steps. First, the affected area is accessed and opened, followed by removal of the damaged tooth tissue and preparation of a cavity. The cavity is then thoroughly cleaned and prepared for filling with a suitable restorative material, such as amalgam, composite or glass ionomer cement. This restores the integrity of the tooth and prevents the decay from progressing further. To minimise pain and discomfort, local anaesthesia may be administered when treating moderately deep or deep cavities.

Connection Between Oral Health and Other Diseases

The relationship between oral health and other diseases has received increasing attention in recent years. Untreated tooth decay and gum inflammation can have secondary negative effects on overall health. They can cause bacterial infections that spread to other parts of the body. For example, oral infections may affect the heart and contribute to cardiovascular disease, as well as potentially being associated with respiratory and joint conditions.