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What Causes Tooth Decay? Who is at Risk for Cavities?

Tooth decay also known as dental caries, carious lesion or cavities. Cavities are holes in the teeth due to bacterial activities. Tooth decay is a common dental problem.

Our mouths are full of bacteria. Hundreds of different types of bacteria live in our teeth, gums, tongue and other places in the mouth. Some are helpful but some are harmful such as those that play a role in the tooth decay process. IF not treated, tooth decay can cause pain, infection and tooth loss.

Tooth DecayWhat Causes Tooth Decay?

There are 4 main criteria required for caries formation

  • tooth surface
  • caries causing bacteria
  • fermentable carbohydrates
  • time

Tooth Surface:-

There are certain diseases and disorders affecting teeth that may leave an individual at a greater risk for cavities. Amelogenesis imperfecta is a disease in which the enamel does not fuuly forms or form insufficient amounts making the teeth more vulnerable to cause decay because enamel is not able to protect the teeth. IN most people diseases and disorders affecting teeth are not primary cause of dental decay. The major component in the enamel is will become soluble when exposed to acidic environment. Enamel begins to demineralize at a pH of 5.5. Dentin and cementum are more susceptible to caries than enamel because they have lower mineral content. Thus, when root surfaces of teeth are exposed from gingival recession or periodontal disease caries can develop more readily

Caries Causing Bacteria:-

Bacteria and food can cause tooth decay. The bacteria form bacterial plaque which is a sticky film that coats your teeth. If you run your tongue along your teeth you may be able to feel this plaque forming. It is slightly rough and it is more noticeable on your back teeth, especially close to your gums. If the plaque is not removed while it is soft, it becomes hard and difficult to remove and it acts as a good place for bacteria to hide. . Most plaque retentive areas are between teeth and inside pits and fissures on chewing surfaces where brushing is difficult. Over 80% of cavities occur inside pits and fissures. When plaque is collected above the gingiva then it is called as supra-gingival plaque and if the plaque is collected below the gums are called as sub-gingival plaque

The bacteria more responsible for dental cavities are the Streptococcus mutans and Lactobacillus species. These organisms can produce high levels of lactic acid following fermentation of dietary sugars. Lactic acid demineralizes the enamel and then cavity is formed. Cementum of root surfaces is more easily demineralized than enamel surfaces. Root caries causing bacteria are Lactobacillus acidophilus, Actinomyces spp., and Nocardia spp and streptococcus mutans.

Fermentable carbohydrates:-

Dental caries is caused by specific types of bacteria that produce acid in the presence of fermentable carbohydrates such as sucrose, fructose and glucose. The mineral content of teeth is sensitive to acids produced by bacteria. Remineralization can also occur if the acid is neutralized by saliva or mouth mash. If demineralization continues over time, enough mineral content may be lost so that the soft organic material left behind disintegrates forming a cavity or hole.

Exposure time:-

The frequency of which teeth are exposed to acidic environment affects the likelihood of caries development. Whenever we eat or drink something that contains sugar or starch, the bacteria use them and produce acids. These acids attack the outer surface of enamel. As time progress, the pH of the oral cavity returns to normal due to the buffering capacity of saliva. Saliva, fluoride from toothpaste, water and other sources help enamel to repair itself by replacing minerals which are lost during an acid attack. Our teeth go through this natural process of losing minerals and regain minerals all day long. When a tooth is exposed to acids frequently, the repeated cycles of acid attacks cause the enamel to continue to lose minerals leading to cavitation.

What are the Risk Factors for Tooth Decay?

Factors which increase the tooth decay are risk factors.

  • Conditions that result in less saliva:-diabetes, Sjogren’s syndrome and some medications decrease the saliva production
  • Not brushing and flossing your teeth
  • High sugar food consumption
  • Not getting enough fluoride
  • Smoking, using spit tobacco
  • Frequent snacking and sipping of drinks
  • Bed time infant feeding
  • Dry mouth
  • Worn fillings or dental devices
  • Eating disorders such as anorexia and bulimia
  • Age
  • Acid reflux disease or heart burn
  • Taking sugary and starchy foods and drinks, particularly between meals or within an hour of going to bed
  • Radiation

Who is at Risk for Cavities?

We all carry bacteria in our mouths so everyone is at risk for cavities. Those with a diet high in carbohydrates and sugar foods and those who live in communities without fluoridated water are likely candidates for cavities.

Those with a lot of fillings have a high chance of developing decay because restored teeth are good breeding ground for bacteria. Children and senior citizens are at higher risk for dental decay.

Find out the Symptoms of Tooth Decay & Treatment Procedures

Dental Health Guide, Providing information on dental care and dental hygiene along with detailing the most common dental diseases with symptoms and treatment methods. Readers should use the dental articles as reference only and consult a dentist and visit a dental clinic for dental health problems.

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