Many people avoid treatment for tooth decay because they are afraid of the dentist. Just be strong and find the courage to schedule an appointment, without being ashamed of the fact that you last had your teeth cleaned more than 15 years ago. It is more common than you think, you would not be the first to be in this situation. Many instead prefer to seek ineffective DIY remedies while escaping the noise of the drill at the dentist. You end up in pain and doing nothing until it is too late and the tooth has to be extracted. Sometimes when patients finally come to dentist there are a lot of tooth which need to be extracted, so better grasp the courage with two hands now!
Tooth decay is one of the most widespread pathologies in the dental field. It consists of a destructive process of tooth’s hard tissues due to the action of different kinds of bacteria present in the mouth and found in plaque and tartar, the ideal environment to reproduce. Generally, the most affected teeth are the molars, the premolars and the upper incisors, while the areas most affected by decay are the interdental spaces, where the removing food is more difficult. Dental floss has often not been used for years and this increases the reluctance to turn to a dentist, with the consequences that we all know.
In its initial phase tooth decay is asymptomatic and is manifested as a change of colour in the enamel that shows darker spots. As it progresses and reaches the pulp of the tooth, it causes severe pain in the teeth, which visually presents as a kind of dark “hole” containing softened material. A strong dental sensitivity can be developed. If you have not had the courage to make an appointment with the dentist until this point, it is time to stop feeling ashamed and pick your phone up right now.
It is important to remember that dental pain is not caused exclusively by decay in the advanced phase, then by cavities, but also by gingivitis, abscesses and pulpitis, which is why it is always advisable to overcome the embarrassment and find the courage to consult a dentist to solve this problem permanently.
The carious process begins with the weakening of the enamel by the acids produced by the bacteria, which pierced this barrier, come first to the dentin and then to the pulp rich in vessels and nerve endings.
If for reasons of embarrassment or lack of courage you do not seek a cure at this stage several complications more serious of the classic toothache may occur. Bacteria attacking the pulp can impair tooth’s health causing apical periodontitis, abscesses, granulomas or cysts.
Generally the evolution process of decay is quiete slow and can last over six months.
What causes decay
The causes of decay are still little known. As already mentioned, you know that the bacteria that inhabit our mouth in some cases can become dangerous and start to puncture your teeth with the carious process. The most feared among the bacteria is surely the lactobacillus that nourishing glucose produces as a waste product the lactate, a substance with a high acidity content, which can dissolve and pierce the dental enamel.
These microorganisms become very dangerous when:
- They accumulate excessively on the teeth beacouse of poor oral hygiene, in presence of plaque and tartar
- They have a lot of available nutriment due to a diet rich in simple sugars and carbohydrates
- The amount of saliva decreases. Not everyone knows that saliva is able to exert a protective, antimicrobial and immune function against cariogenic agents thanks to some substances dissolved in it.
- You ignore periodical check-up
Bacteria are not the only responsible for decay. There are several factors and bad habits that contribute to the onset of this pathology.
Foods: good and bad
Foods that favour decay
Everyone knows the relationship between diet and the onset of decay. But if it is true that there are some foods that can affect this process it is equally true that these foods pose a danger the longer they remain in the mouth. To avoid getting cavities from tooth decay, simply remember to brush your teeth thoroughly after each meal, especially before bedtime.
Among insidious foods for healthy teeth there are those containing simple sugars, such as sucrose and glucose, which can be replaced by fructose which has a lower cariogenic power. Also in this category are complex carbohydrates, such as those present in pretzels, crisps and sticky foods such as candies and also jam and some types of dried fruit, such as raisins.
Also beware of fruits such as citrus, strawberries and pineapple as they are quite sour.
There are other types of foods that help to protect the health of the oral cavity such as:
– substances contained in red wine, proanthocyanidins, capable of preventing decay and periodontal diseases;
– mushrooms, for the positive effects of the quinine acid;
– milk and yogurt, for calcium;
-raw vegetables and fruit such as apples,that for their crispy texture help teeth’ self-cleaning;
-propolis, for its antibacterial effects;
-dark chocolate with 80% of cacao which contains natural antibacterials;
-cranberries, because of the presence of procyanidins;
-the wasabi, containing isothiocyanates, which prevent bacteria from adhering to teeth;
-water and tea, for the presence of fluorine.
Some habits promote oral bacteria proliferation. Poor oral hygiene is the most important predisposing condition, but smoking is a risk factor as well. Some types of tobacco, in fact, contain sugars that increase the probability of developing decay, in addiction, smoking can also be responsible for diseases such as pyorrhoea and gingival recession, which leave the dental collars uncovered, conditions that facilitate the attack of the pathogens agents to the dental pulp and the onset of classic cavities in the teeth. These are the conditions which we must not be embarrassed by, but find the courage to put confidence in the work of the dentist, who in any case is not there to judge us, but to do his work, that is to save our teeth.
Decayed milk teeth
Like those of adults, even the deciduous teeth of children can be attacked by decay. This pathology primarily affects four superior incisors and milk molars.
In children the cariogenic process is faster, because milk teeth are smaller in size and have less mineralized enamel.
Among the causes of decay of the milk teeth there are poor oral hygiene and lack of fluoride. Children are not always able to clean the oral cavity properly, so we recommand to use a toothbrush with parental guidance since the eruption of the first tooth and to supplement the diet of smaller children with fluorine (except in areas where the running water is already rich in fluorine).
What should I do if the milk tooth is already decayed?
Erroneously, it is a common thought that the decayed milk tooth should not be treated because it is destined to fall out. In reality decay of the deciduous teeth must be treated, not only because it can be very painful, but potentially damaging for the development of the permanent teeth and the mandible. So it’s important that parents do not neglect this kind of decay.
If the decay is already in an advanced stage and it is not possible to treat the cavity, extraction will be necessary.
Diagnosis of decay
As we said the decay in its initial stage is asymptomatic and difficult to see. To prevent its degeneration, it’s opportune to periodically undergo visits to the dentist so that an early diagnose may be made.
Diagnosis of decay is divided into: diagnosis in presence, activity and risk.
Diagnosis in presence
This is based on the direct observation of the accessible surfaces to evaluate the coloration of the enamel and the presence of any open cavities. At this stage, the dentist can perform several instrumental tests, such as the use of sharp probes, transillumination, electrical conductance, laser fluorescence and digital or traditional radiographs.
The evaluation of carious lesion activity is based on careful observation of the colour and texture of the tooth tissues.
The main risk factors such as susceptibility, the presence of producing bacteria and the type of diet are evaluated. This type of diagnosis afford to implement preventive measures for patients who have high chances of developing a carious process.
Types of decay
Not everyone knows that there are different types of decay with different evolution periods.
- Chronic decay: it has a slow development, about two years, and does not present a strong dental sensitivity;
- Acute decay: Evolves in about six months;
- Secondary decay (or relapsing): the decay has not been treated adequately so that it reoccurs where there is already a filling;
- Interdental decay: it develops on the surface between the teeth.
How to treat decay
The best cure is definitely prevention. With proper dental hygiene, periodic professional cleaning and healthy nutrition, it is possible to decrease the probability of decay. If one of these aspects has not been observed, you should not feel embarrassed when booking a visit to the dentist. This is very important, because embarrassment and inaction produce worse results.
When it is too late and the process has already started, the only thing to do is to contact a dentist. The main treatment for decay is a filling, that seal all the fissures and canaliculus caused by the bacteria. If the carious process has already passed through the enamel and dentin and is attacking the pulp, then it is necessary to devitalize the tooth. The branch of dentistry that treats these disorders is called endodontia.
Curing decay without filling
Some websites talk about alternative techniques to cure decay without using a drill which would be ideal for all patients suffering from particular sensitivity and fear of the dentist. In most cases, these techniques are not supported by reliable scientific publications, so we mention them just as information.
This technique is based on a device that emits aluminium dioxide, a mineral that with its micronized particles uses the kinetic energy to shave the decayed dental tissue. It requires a specific ability to skilfully manage the jet, which is calibrated to remove only the decayed tissue, sparing the healthy dental tissue.
Nigel Pitts and his colleagues of the London Dental Institute at the King’s College of London have developed a new decay removal system based on a technique called Electrically Accelerated and Enhanced Remineralisation (EAER). This technique allows the acceleration of the natural movement of calcium and phosphate in the damaged tooth, thus stimulating the repair.
Often we hear about the use of lasers for treating decay, but less frequently mentioned are the disadvantages that this type of treatment involves. For example, during its operation the tip of the handpiece can reach high temperatures that can overheat the pulp of the tooth causing his necrosis. Moreover it produces loud noise that often frightens patients, making treatment longer and more difficult.
Toothpastes to regenerate the enamel
Another often debated aspect among patients concerns the existence of toothpastes able to counteract the carious process. A question that frequently arises is “are there toothpastes that can regenerate the enamel by closing the holes caused by decay?” We must say that the process of erosion of the enamel is actually irreversible, in fact our organism fails to regenerate it autonomously. However we read about toothpastes containing calcium silicate and sodium phosphate, also quite expensive, that promise an enamel regeneration of 82% and even the filling of any microscopic holes caused by carbonated drinks or sweetened foods. We must to be very clear on this point, saying that there are no toothpastes able to cure decay already present, while they can just help to fortify the dental enamel, so that in most cases it is useless to rely on any particular toothpaste. It is advisable to find the courage to treat decay in the most appropriate way: turning to the dentist.
Prevent decay by taking fluoride
The intake of fluoride from pregnancy and continuing in a child up until seven years, can result in a mineralization that makes the teeth resistant to the acids responsible for decay produced by streptococcus mutans. However, it is important to measure fluoride intake, since an excessive dose may produce stains on the teeth at a deep level, which are not easy to remove, called fluorosis. We must pay attention to fluoride intake by food or water which make the ideal dosage of fluorine more difficult to calculate.
Can you treat decay by yourself?
DIY treatment for decay is quite impossible because softened tissues do not have regenerative abilities, so the only way to stop the evolution of the process is to turn courageously to the dentist who will proceed to the treatment for the elimination of the problem. It may seem absurd that we reaffirm the fail of self-management in dental care, but we hear always more frequently of sale of “DIY dentist kits” that promise excellent results with considerable savings. This “alternative methods” spread thanks to people’s scary and embarassment of facing the idea of showing to dentist their “bad”situation. We suggest to always turn to a specialist. I mean, in layman’s words, you can’t cure the cavities in your teeth by yourself, because self treating of a cavity is impossible. However, as already said, the only way to self treat decay is to prevent it.
Caring for decay with diet and supplements
According to some alternative theories, it would be possible treating decay autonomously by diet. Dr. Price studied teeth of people who had never eaten western food and who did not know oral hygiene practices. He found that although they had never brushed their teeth and that food residues were stuck in the mouth undisturbed for weeks, these indigenous people had a healthy dentition without a trace of decay. Although modern scientific literature disavows this theory, some affirm that enamel erosion process as result of decay may be inverted, remineralizating the tooth with a proper diet, avoiding legumes and sugar-rich foods, thus blocking the supply to the bacteria responsible for decay. Instead, dr. Prince suggests to increase the intake of vitamin A, C and D, which are found in many foods, and minerals, such as magnesium. We should always remember that such decisions should be taken under medical advice and not just from information found on internet sites, so you should contact a nutritionist if you do not dare to make an appointment with the dentist.
Untreated decay, what are the complications?
If ignored, decay can cause pulpits, abscesses, gingivitis, granulomas until the total tooth’s destruction. In these cases also filling the tooth is useless and the only procedure is the removal of the infected pulp.
How much does it cost to treat decay?
The price of treatment depends on the state of the decay. For example, if the problem can be solved with a simple filling, it will cost less than if it is necessary to devitalize the tooth, a much more expensive process. In our studio the cost of a filling goes from 80 euros up to 250 euros for the most complex cases.