Tooth Decay

What is tooth decay?

From: MedlinePlus, National Library of Medicine

Tooth decay is damage to a tooth's surface, or enamel. It happens when bacteria in your mouth make acids that attack the enamel. Tooth decay can lead to cavities (dental caries), which are holes in your teeth. If tooth decay is not treated, it can cause pain, infection, and even tooth loss.

What causes tooth decay?

From: MedlinePlus, National Library of Medicine

Our mouths are full of bacteria. Some bacteria are helpful. But some can be harmful, including the ones that play a role in tooth decay. These bacteria combine with food to form a soft, sticky film called plaque. The bacteria in plaque use the sugar and starch in what you eat and drink to make acids. The acids begin to eat away at the minerals on your enamel. Over time, the plaque can harden into tartar. Besides damaging your teeth, plaque and tartar can also irritate your gums and cause gum disease.

You get fluoride from toothpaste, water, and other sources. This fluoride, along with your salvia, helps the enamel repair itself by replacing the minerals. Your teeth go through this natural process of losing minerals and regaining minerals all day long. But if you don't take care of your teeth and/or you eat and drink lots of sugary or starchy things, your enamel will keep losing minerals. This leads to tooth decay.

A white spot may appear where minerals have been lost. This is an early sign of tooth decay. You may be able to stop or reverse the decay at this point. Your enamel can still repair itself, if you take better care of your teeth and limit sugary/starchy foods and drinks.

But if the tooth decay process continues, more minerals are lost. Over time, the enamel is weakened and destroyed, forming a cavity. A cavity is a hole in your tooth. It is permanent damage that a dentist has to repair with a filling.

Who is at risk for tooth decay?

From: MedlinePlus, National Library of Medicine

The main risk factors for tooth decay are not taking care of your teeth and having too many sugary or starchy foods and drinks.

Some people have a higher risk of tooth decay, including people who:

• Don't have enough saliva, because of medicines, certain diseases, or some cancer treatments
• Don't get enough fluoride
• Are very young. Babies and toddlers who drink from bottles are at risk, especially if they are given juice or get bottles at bedtime. This exposes their teeth to sugars for long periods of time.
• Are older. Many older adults have receding gums and more wear on their teeth. These raise the risk of decay on the exposed root surfaces of their teeth.

What are the symptoms of tooth decay and cavities?

From: MedlinePlus, National Library of Medicine

In early tooth decay, you usually don't have symptoms. As tooth decay gets worse, it can cause:

• A toothache (tooth pain)
• Tooth sensitivity to sweets, hot, or cold
• White or brown stains on the surface of a tooth
• A cavity
• An infection, which can lead to an abscess (pocket of pus) forming. The abscess can cause pain, facial swelling, and fever.

How are tooth decay and cavities diagnosed?

From: MedlinePlus, National Library of Medicine

Dentists usually find tooth decay and cavities by looking at your teeth and probing them with dental instruments. Your dentist will also ask if you have any symptoms. Sometimes you may need a dental x-ray.

What are the treatments for tooth decay and cavities?

From: MedlinePlus, National Library of Medicine

There are several treatments for tooth decay and cavities. Which treatment you get depends on how bad the problem is:

• Fluoride treatments. If you have early tooth decay, a fluoride treatment can help the enamel to repair itself.
• Fillings. If you have a typical cavity, your dentist will remove the decayed tooth tissue and then restore the tooth by filling it with a filling material.
• Root canal. If the damage to the tooth and/or an infection spreads to the pulp (inside of the tooth), you might need a root canal. Your dentist will remove the decayed pulp and clean inside the tooth and root. The next step is to fill the tooth with a temporary filling. Then you will need to come back to get a permanent filling or a crown (a cover on the tooth).
• Extraction (pulling the tooth). In the most severe cases, when the damage to the pulp cannot be fixed, your dentist may pull the tooth. Your dentist will suggest that you get a bridge or implant to replace the missing tooth. Otherwise, the teeth next to the gap may move over and change your bite.

Can tooth decay be prevented?

From: MedlinePlus, National Library of Medicine

There are steps that you can take to prevent tooth decay:

• Make sure that you get enough fluoride by Brushing with a fluoride toothpaste Drinking tap water with fluoride. Most bottled water does not contain fluoride. Using fluoride mouth rinse
• Practice good oral health by brushing your teeth twice a day with a fluoride toothpaste and regularly flossing your teeth
• Make smart food choices by limiting foods and drinks that are high in sugars and starches. Eat nutritious, balanced meals and limit snacking.
• Do not use tobacco products, including smokeless tobacco. If you currently use tobacco, consider quitting.
• See a dentist for regular check-ups and professional cleanings
• Make sure that your children get sealants on their teeth. Dental sealants are thin plastic coatings that protect the chewing surfaces of the back teeth. Children should get sealants on their back teeth as soon as they come in, before decay can attack the teeth.

Which doctor should you see?

The suggested department for discussing Tooth Decay is Dentistry, with a dentist / relevant dental specialist as the relevant type of clinician. Dentist / Relevant dental specialist; paediatric services for children as appropriate.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Which teeth, gum tissues or oral structures are affected?
• What is the purpose of any proposed dental imaging or procedure?
• What oral-care routine is suitable while the problem is being treated?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.