A majority of people in India suffer from tooth decay. This can be extremely painful, as most of us have experienced. In fact, decay need not occur at all. This pain, and all the other complications that it may lead to, are avoidable. Our aim is to achieve freedom from cavities. All one needs to do is to follow a few simple steps.

What is tooth decay? and how does it occur ?

Our mouth is full of bacteria. The food we eat combines with saliva and bacteria to form a sticky coating on the teeth called plaque. When sugar is available to the bacteria in plaque, they act on it and secrete acidswhich erode tooth enamel. After repeated acid attacks the enamel breaks down and a cavity is formed. The process by which decay occurs is called demineralization

Where do the acids that cause tooth decay come from?

The acids that cause tooth demineralization (cavity formation) are produced by specific types of bacteria (mutans streptococci and lactobacilli) that live in dental plaque. They utilize sugars (glucose, sucrose, fructose, lactose, or cooked starches) as their food source and release the acids (especially lactic acid) that cause the demineralization of tooth enamel and dentin.

What are the causes for tooth decay?
1. Poor oral hygiene is the main cause for tooth decay. Plaque is the biggest villain behind both tooth decay and gum diseases.
2. Unregulated diet of sweet foods and drinks do not give into the temptation of frequent snacking. Avoid sweets and sticky foods between meals. Longer the time the food stays on your teeth, the greater is the chance of forming a cavity.

3. Genetics may play a major role in how susceptible you are to the formation of a cavity. The structure, size and shape of the tooth may be passed down through generations. A familial history of high incidence of dental caries has shown to produce decreased resistance to carious attack.
4. Saliva has a protective function in the mouth. Salivary flow helps to neutralize the acids produced by bacteria from plaque. Thus a good salivary flow, reduce the chances of cavity formation.
5. Food impaction between teeth results in bacterial growth and production of acids and cavities between the teeth.
6. Supernumerary or impacted teeth extra teeth that erupt out of the arch cause food lodgment between the teeth causing carious lesion of the good teeth. This results in debris and food retention causing decay of the wisdom teeth as well as the adjacent tooth.
7. Misaligned or irregularly placed teeth Irregularly placed teeth cause plaque deposition which results in decay if proper brushing technique is not followed.

Two important factors affecting Tooth Decay are:

• How often you eat: The bacteria take advantage of food whenever it is available. So they become active whether you eat a full meal or just a small snack, and they remain active producing acids that can cause cavities for about 30 minutes after you eat. Thus is how frequent eating contributes to tooth decay, and can be easily modified by exerting a bit of self-control.



How long a particular food stays in the mouth after you eat it: Longer the sticky food stays in the mouth, more chances for the occurrence of decay

Say NO to Soft Sticky FOOD:



Say YES to Healthy Food:

Treatment of Tooth Decay:
Once decay has started and a cavity has formed, it becomes necessary to treat it to prevent the process from extending further

When decay is limited to enamel: Treatment at this initial stage is preventive in nature because it will stop the decay process from extending to deeper areas of the tooth. All that is necessary is a simple filling. It is usually painless at this stage. Dentist will clean out the decayed part of enamel and fill the resulting cavity with either silver amalgam, or preferably, with the newer tooth colored composite material.

When decay has extended to dentin:

Infection reaches bone:

What is an Amalgam filling?
Silver Amalgam is the oldest filling material knows to man. Silver amalgam is most commonly used for fillings on the back teeth, where strength is of utmost importance and the silver color is relatively inconspicuous. Some people are concerned about the toxicity of the mercury used in the filling. There is no evidence showing that it is hazardous to human. Since amalgam has dark metal color, the filling is not esthetically pleasing; this is its only disadvantage. Until recently, it was the only choice of dental filling material.

What is a Composite filling? (Tooth colored)
Composite resins are mainly used in the front teeth, as they are more aesthetic and natural appearing filling materials. Although they have the advantage of being the color of the teeth they are more expensive than silver amalgam and may not last as long. These materials come in a variety of shades so that they will match the color of your own teeth.

Glass ionomer a tooth-colored filling, is formulated to release fluoride once in place, a benefit for people prone to decay at the gum line. Glass ionomer is also used to restore areas damaged by overzealous brushing

Your Tooth maybe damaged You may experience symptoms ranging from occasional sensitivity to hot and cold foods, to constant throbbing or a dull ache, to pain on chewing.

Your Dentist can Help: Dentist can assess the extent of damage by a comprehensive dental examination. Dentist takes a dental history, examines your teeth and gums, and x-rays your teeth to examine the underlying roots and bone. X-rays allow your dentist to see the inside of your teeth and the surrounding bone. With an x-ray, dentist can detect any unhealthy changes in your teeth or bone, irrespective of whether they are causing any symptoms or not.

Root Canal Therapy - RCT

The goal of root canal therapy is to improve the health of your damaged tooth. During treatment, the pulp is removed from your root canals through a small opening in the crown. Then the canals are cleaned and disinfected. The tooth is first numbed.

An opening is made in your tooth and any existing fillings or decay is removed. Then your dentist removes unhealthy pulp with tiny, flexible files. Using delicate, up-and-down motions, your dentist gently cleans and smoothen root canals to disinfect them and prepares them for filling.

The canals are then sealed with an inert material that occupies the space vacated by the removal of the pulp.

After the inside of your tooth has been treated, the outside will be restored to protect your tooth's underlying structures and to bring the tooth back into function. Your dentist will usually cover the tooth with a ceramic or metal crown. After root canal therapy, your tooth continues to be nourished by the surrounding gums and bone.

Also, have regular dental checkups, cleanings, and any other dental work you may need so that your teeth last as long as you do!

Prevention of Tooth Decay

1. Brush thoroughly twice daily: Brushing removes the plaque that has formed on the surfaces of the teeth through mechanical disruption, thus reducing bacterial activity in the mouth

2. Flossing is an adjunct to brushing. Floss is like a tape, made of multiple fibers, used to clean the spaces in-between the teeth. Take about 18 inches of floss and wrap it around one finger of each hand and gently ease it between the teeth with the aid of the fore-finger and thumb. Curve floss around each tooth and use an up-and-down motion to remove plaque. 

3. Fluoride: We need sufficient fluoride to prevent decay. This chemical combines with enamel of the teeth and makes it less soluble to acid attack from bacteria. The incidence of decay is thus reduced. Sources of fluoride are toothpastes and mouthwashes.
4. Sealants: The chewing surfaces of the back teeth contain deep pits and fissures, where decay usually begins. These pits cannot be reached by your toothbrush bristles, as shown in the diagram. These pits and fissuers can be sealed by your dentist. A sealant is a plastic material that is applied to the chewing surfaces of the back teeth.       
5. Dietary control: Limit the number of times you eat in a day. The more often you eat, the more decay you will have. And do not allow food to remain in the mouth for a long time by brushing soon after eating.

6. Regular dental checkups: Too much emphasis cannot be placed on this step. Most dental problems can be identified in the early stages and treated quickly and painlessly. Future complications are thus avoided. It should be emphasized that there is no pain in the early stages of tooth decay. By the time pain occurs, it may be already too late

Sensitivity

Sensitivity may be loosely defined as the short sharp pain felt when something touches the affected tooth. It usually occurs in response to cold, hot, sweet, sour or touch. It is usually the response of the exposed dentin to some irritant.

Sensitivity can be treated by your dentist:

• Any decay found in your teeth can be cleaned and filled to seal the underlying dentin.
• If the cause is improper brushing habits, then a change in brushing method coupled with repair of the defect should solve your problem.
• If the root of the tooth is exposed then a desensitizing paste could help.
• Gum disease can be treated if that is the cause of your problem.
• Bruxism is not so easy to treat. Occlusal correction along with a bite plate can control the damage, but total cure will require mental conditioning.
• If there is any interference in your occlusal scheme, then correcting that high point should make the tooth comfortable.
• Erosion of enamel caused by aerated drinks will require a change in lifestyle (diet) followed by veneering the affected teeth. Desensitizing pastes may help in less severe cases.

FRACTURE

A damaged tooth can be saved and repaired to look and feel like the original. The choice of treatment varies by the extent of injury.

Cosmetic Contouring is done when the chip is very small. The rough edges are rounded and polished. This procedure can change the size of a tooth, and hence is limited to very small fractures, or areas not visible when talking and smiling.

Bonding has revolutionized the process of repairing broken teeth. Now a new contour can be re-created simply by applying moldable resin to the remaining structure. It can be achieved quickly, but may need to be repeated every 2-3 years due to staining and wear of the material. It can serve as a long-term temporary, particularly for young people.

Crowns are the last resort for a tooth that does not have sufficient structure remaining for a veneer to bond to. A crown needs tooth reduction, as the restoration will cover the entire tooth

   
Before Treatment            After Treatment

Tooth Whitening
Want whiter, brighter teeth? One option for you may be tooth whitening, also called bleaching. The teeth must be cleaned and polished, to ensure that the whitening gel comes into direct contact with the teeth. Possible side effects include increased sensitivity to cold during the treatment, tongue and lip soreness, and possibly throat irritation.

Before Treatment             After Treatment

Before Treatment             After Treatment

It is possible to whiten your teeth in 7 to 14 days. But how much does all this cost? Prices vary substantially, depending on the shade we have to begin with and the time it is likely to take. However, whitening one's teeth has now become more affordable.
VEENER
A veneer is a thin shell, usually made of a ceramic material that is chemically bonded to your teeth to improve their appearance. Ceramic veneers are the most aesthetic means of creating a more pleasing smile. Whenever possible, we would choose a veneer over a crown, as they require minimal tooth reduction (as little as 0.5mm).

Before Treatment           After Treatment

Before Treatment           After Treatment

A ceramic veneer can fulfill your aesthetic needs in most cases. With proper care, they should give you a long lasting and beautiful smile!