Alternative names Return to top Caries; Tooth decay; Cavities - tooth Definition

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Cavities are holes that damage the structure of teeth. Causes, incidence, and risk factors
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Tooth decay is one of the most common of all disorders, second only to the common cold. It usually occurs in children and young adults but can affect any person. It is the most important cause of tooth loss in younger people. Bacteria are normally present in the mouth. The bacteria convert all foods -- especially sugar and starch -- into acids. Bacteria, acid, food debris, and saliva combine in the mouth to form a sticky substance called plaque that adheres to the teeth. It is most prominent on the back molars, ust above the gum line on all teeth, and at the edges of fillings. !laque that is not removed from the teeth minerali"es into tartar. !laque and tartar irritate the gums, resulting in gingivitis and ultimately periodontitis. !laque begins to accumulate on teeth #ithin $% minutes after eating &the time #hen most bacterial activity occurs'. If this plaque is not removed thoroughly and routinely, tooth decay #ill not only begin, but flourish. The acids in plaque dissolve the enamel surface of the tooth and create holes in the tooth &cavities'. Cavities are usually painless until they gro# very large inside the tooth and destroy the nerve and blood vessels in the tooth. If left untreated, a tooth abscess can develop. (ntreated tooth decay also destroys the internal structures of the tooth &pulp' and ultimately causes the loss of the tooth. Carbohydrates &sugars and starches' increase the risk of tooth decay. )ticky foods are more harmful than nonsticky foods because they remain on the surface of the teeth. *requent snacking increases the time that acids are in contact #ith the surface of the tooth. Symptoms
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Toothache -- particularly after s#eet, hot, or cold foods and drinks +isible pits or holes in the teeth
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Signs and tests

,ost cavities are discovered in the early stages during routine checkups. The surface of the tooth may be soft #hen probed #ith a sharp instrument. !ain may not be present until the advanced stages of tooth decay. -ental .-rays may sho# some cavities before they are visible to the eye. Treatment
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-estroyed tooth structure does not regenerate. /o#ever, the progression of cavities can be stopped by treatment. The goal is to preserve the tooth and prevent complications.

In filling teeth, the decayed material is removed &by drilling' and replaced #ith a restorative material such as silver alloy, gold, porcelain, or composite resin. !orcelain and composite resin more closely match the natural tooth appearance, and may be preferred for front teeth. ,any dentists consider silver amalgam &alloy' and gold as stronger, and these materials are often used on back teeth. There is a trend to use high strength composite resin in the back teeth as #ell. Cro#ns are used if decay is e.tensive and there is limited tooth structure, #hich may cause #eakened teeth. 0arge fillings and #eak teeth increase the risk of the tooth breaking. The decayed or #eakened area is removed and repaired. 1 covering acket or 2cap2 &cro#n' is fitted over the remainder of the tooth. Cro#ns are often made of gold, porcelain or porcelain fused to metal. 1 root canal is recommended if the nerve in a tooth dies from decay or from a traumatic blo#. The center of the tooth, including the nerve and blood vessel tissue &pulp', is removed along #ith decayed portions of the tooth. The roots are filled #ith a sealing material. The tooth is filled and a cro#n may be placed over the tooth if needed. Expectations (prognosis)
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Treatment often preserves the tooth. 3arly treatment is less painful and less e.pensive than treatment of e.tensive decay. 1nesthetics -- local &novacaine', nitrous o.ide &laughing gas', or other prescription medications -- may be required in some cases to relieve pain during or follo#ing drilling or other treatment of decayed teeth. *or those #ho fear dental treatment, nitrous o.ide in combination #ith anesthesia may be preferred. Complications
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tooth abscess fractured tooth discomfort or pain tooth sensitivity inability to bite do#n on tooth
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Calling your health care provider

Call your dentist if you have a toothache. Call your dentist for a routine cleaning and e.amination if you have not had one in the last 4 months to 5 year.
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revention

6ral hygiene is necessary to prevent cavities. This consists of regular professional cleaning &every 4 months', brushing at least t#ice a day, and flossing at least daily. 7-rays may be taken yearly to detect possible cavity development in high risk areas of the mouth. Che#y, sticky foods &such as dried fruit or candy' are best if eaten as part of a meal rather than as a snack. If possible, brush the teeth or rinse the mouth #ith #ater after eating these foods. ,inimi"e snacking, #hich creates a constant supply of acid in the mouth. 1void constant sipping of sugary drinks or frequent sucking on candy and mints.

-ental sealants can prevent cavities. )ealants are thin plastic-like coating applied to the che#ing surfaces of the molars. This coating prevents the accumulation of plaque in the deep grooves on these vulnerable surfaces. )ealants are usually applied on the teeth of children, shortly after the molars erupt. 6lder people may also benefit from the use of tooth sealants. *luoride is often recommended to protect against dental caries. It has been demonstrated that people #ho ingest fluoride in their drinking #ater or by fluoride supplements have fe#er dental caries. *luoride ingested #hen the teeth are developing is incorporated into the structure of the enamel and protects it against the action of acids. Topical fluoride is also recommended to protect the surface of the teeth. This may include a fluoride toothpaste or mouth#ash. ,any dentists include application of topical fluoride solutions &applied to a locali"ed area of the teeth' as part of routine visits.

!pdate Date" #$%&$&''(

(pdated by8 9ohanna 9acobs, -.-.)., :eneral and Cosmetic -entistry, ;e# <ork, ;<. =evie# provided by +eri,ed /ealthcare ;et#ork.