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It sounds like an abstract concept, almost like something that could never happen. In spite of this, like all gradual processes, tooth decay (also called dental caries or cavities) does not happen instantaneously and may can go unnoticed for a while, especially at initial stages. This fact makes it necessary to gain more knowledge on the topic of tooth decay: its causes, progression, complications, treatment options, and ways of preventing it.


The enamel is the hard, white outer part of the tooth.

Dentine is the layer below the enamel. It is a hard tissue that contains microscopic tubes. When the enamel is damaged, heat or cold can enter the tooth through these paths and cause sensitivity to pain.

The pulp is the softer, living, inner structure through which nerves and blood vessels run.

How Would I know if I have Tooth Decay?     

When the tooth decay is at the beginning stages, no symptoms might be present at all. As the decay progresses, the following symptoms will begin to be present:

  1. Brown, black, yellow, or white stains on the surface of the teeth
  2. Mild to sharp pain when eating or drinking something hot or cold or sweet
  3. Toothache or tooth pain that occurs without any reason
  4. Pain when biting down
  5. Holes in the teeth

What Causes Tooth Decay?

Despite popular rumours, tooth decay is not caused by worms eating away the surface of the tooth, but rather by one eating a lot of sugars and starchy foods andfailure to clean his or her teeth well.When sugars and starch remain on the tooth, certain bacteria present in the mouth quickly begin to feed on them and form a substance known as dental plaque, a clear sticky acid-containing film that coats the tooth. If this plaque remains on the tooth, it can harden into ‘tartar’ or ‘calculus’ which is more difficult to remove and thus creates a shield for the bacteria.


The acids in plaque remove the minerals in the tooth’s hard outer covering, the enamel. This removal of minerals leads to formation of holes in the enamel (this is the first stage of cavities). Once the enamel has been affected, the acids and bacteria can make their way to the next layer, the dentine. The dentine is much softer than enamel and not as resistant to attacks. The dentine also has tiny tubes that communicate directly with the tooth nerve. Therefore, when acids and bacteria attack the dentine, sensitivity as tooth decay progresses, the bacteria and acids continueto eat through the layers of the tooth, eventually reaching the pulp cavity – which contains blood vessels and nerves. The pulp cavity becomes swollen and irritated, resulting in a lot of pain and discomfort. The discomfort could extend outside of the tooth to the gum, and even to the jawbone.


Tooth decay and cavities are often ignored or go unnoticed. If they are not treated properly, several complications could arise, among which are:

  1. Pain
  2. Tooth abscess (a pocket of pus around a tooth caused by bacterial infection)
  3. Swelling around a tooth
  4. Damaged or broken tooth
  5. Chewing problems
  6. Positioning shifts of other teeth after tooth loss

In severe cases, the person suffering from tooth decay could have loss of appetite, severe weight loss, tooth loss, and these complications could interfere with daily living, affecting self-esteem and ability to carry out tasks normally and effectively.


Treatment of Tooth Decay depends on severity. It is important to visit the dentist at least twice a year (every 6 months) for check up and examination, even when you don’t feel any pain.. The dentist can identify a tooth decay through an oral examination or an X-ray. Treatment options for Tooth Decay include:

  1. Tooth fillings
  2. Crowns: For more severe cases of tooth decay
  3. Root canal therapy: When the tooth decay is so severe that it has caused death of the nerves on the very inside of the tooth.
  4. Tooth extractions: Some teeth become so severely decayed that they cannot be restored and must be removed.


Tooth decay is a common dental problem. However, it is possible to prevent it by doing the following:

  1.   Brush with fluoride toothpaste after eating or drinking: It is important to brush the teeth at least twice a day, not only in the morning but also at night after the last meal and before bedtime. In addition to this, it is also ideal to brush after every meal. To clean between teeth, use dental floss and avoid toothpicks as they can damage the gum.
  2. Rinse your mouth: If the dentist believes that one has a high risk of developing cavities, he or she may recommend using a mouth wash (or mouth rinse) that contains fluoride. Do not swallow the mouth wash.
  3. Visit the dentist regularly: One should aim to visit the dentist at least every six months. Getting professional cleaning (scaling and polishing) and regular oral examinations can go a long way in preventing problems or detecting them early and treating them effectively.
  4. Avoid frequent snacking: Whenever one eats or drinks beverages other than water, bacteria in the mouth produce acids that can destroy tooth enamel. If one snacks or drinks throughout the day without brushing, his or her teeth are constantly under attack.
  5. Eat tooth-healthy foods: Certain foods and beverages are healthier for the teeth than others. Avoid foods that can ger stuck in grooves and pits of the teeth for long periods of time, or brush soon after eating them. Fruits such as fresh fruits and vegetables, on the contrary, increase salivation. Unsweetened coffee, tea and sugar-free chewing gum help to wash away food particles.

By Dr Sylvia Amede


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