Most people are concerned about dental decay when they go to the dentist. It’s an especially big problem for today’s kids. In fact, with the rise of sugar-laden soft drinks, energy drinks and juices, we hear kids saying: “Look Mom, no cavities!” less and less. Not only are these products becoming more available (especially in school vending machines, to the exclusion of milk and water), all of the drinks that have high fructose corn syrup, glucose, sucrose, maltose and fructose are contributing to tooth decay. The rotting of the tooth structure causes a soft, brown, mushy area, which has to be removed before it grows larger and spreads to the underlying nerve of the tooth. If left unchecked, dental decay leads to tooth aches, pain and the need to perform root canals.
Teeth are covered with the hardest substance in the body: enamel. In order for decay to occur, the bacteria present in your mouth must be exposed to sugar.
The bacteria eat the sugar and produce acid. If this acid isn’t removed by brushing and flossing, it demineralizes the enamel matrix, which makes the tooth soft. When that happens, it’s called a “carious lesion,” or cavity.
Preventing Tooth Decay
The first step in decreasing tooth decay is prevention. Here are some ways to prevent rotten teeth and cavities:
- Decrease sugar consumption and drink milk and water.
- Limit sugar drinks and juices, as well as candy and starchy snacks like potato chips that break down into sugars.
- Use a fluoride-containing toothpaste and a prescription-strength fluoride supplement to decrease future decay. Some products on the market such as MI paste have actually been proven to remineralize areas of preliminary decalcification or early cavities.
Dentists use various instruments and techniques to find cavities, including:
Explorers: These are sharp probes, which can detect soft areas in the deep pit and fissures of the enamel. The dentist will push on these areas and if the explorer sticks, there is a cavity.
- Caries detecting lasers: These are devices that will send a laser through the enamel matrix and bounce the energy back to the sensor. The amount of energy absorbed is compared to the bounced-back energy and determines the severity and depth of the decay numerically.
- Caries detecting stains: These flood the tooth and are absorbed by the soft lesion, which makes it look a different color.
- Trans-illumination: Shining a light on the cavity can allow the dentist to see it, since it looks different from a normal tooth structure and will appear to be a shadow or brown spot.
Treating Tooth Decay
Once your dentist spots a cavity, don’t linger: have him fill the tooth quickly so it doesn’t expand and reach the nerve. Small cavities may be treated over weeks or months, but deeper cavities should be filled right away. Here is what you need to know about fillings:
- Sensitivity: Realize that sensitivity after a filling doesn’t mean the nerve has died. After you get a filling, there is a period of time where the tooth may be a bit more sensitive to hot and cold. If this doesn’t subside in a day or two, see your dentist, as your filling might be “high.” Fillings that are not adjusted properly can be “high,” which means you hit them prematurely. This can cause sensitivity and may lead to the tooth breaking. Adjustments are made with a fine drill and are then polished.
- Pain after fillings: If there is lingering pain to hot or cold and it lasts more than six or seven seconds, the tooth might be dying. Your dentist will need to remove the nerve of the tooth in a painless procedure called a root canal. Dentists may prescribe antibiotics when there is pain or swelling prior to performing a root canal; ask them if these are necessary.
- Fracture: When the size of a filling is greater than 50 percent of the width of the tooth, it may be more susceptible to fracture. The dentist may recommend that the tooth receive a “cap” or crown to cover and reinforce the remaining tooth structure.
- Types of fillings: Dentists can discuss the materials used to fill a tooth with you. The longest lasting filling material used primarily for back teeth is gold. There are silver fillings (called amalgams) that are a metal paste that have silver, mercury, zinc and other components, which get hard after they are placed in the tooth. The most popular filling material is white composite resin or “bonding.” This material bonds chemically to the surrounding tooth structure. White porcelain fillings are also used to fill cavities; they are fabricated in the office or at a lab and are cemented into the tooth.