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Tooth decay, also called caries or cavity is a degenerative oral health condition that results from the destruction of hard tooth structure such as enamel or dentin.

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What causes tooth decay?
Tooth decay or caries is caused by demineralization of hard structures of the tooth by acids. These acids form as a chemical reaction between mouth bacteria, contained in plaque and carbohydrates from sugars. As the bacteria feed on the sugars in the food you eat, they make acids. The acids attack the teeth for 20 minutes or more after eating. These acids wash out the calcium in tooth ( demineralize ) the tooth, break down the enamel, and caries process starts forming cavities.

How to prevent tooth decay?
Understanding the etiology and causes of caries, it is possible to prevent the and reduce the formation of cavities. As it was mentioned before, the interaction of bacteria in plaque and carbohydrates in sugar, lead to the the production of acids leading to the tooth decay. How can we stop this interaction?
Plaque is a sticky, colorless film that constantly forms on your teeth. it is a mixture of food debris and millions of bacteria. Proper home oral hygiene with proper brushing techniques and flossing can reduce number of bacteria presence in many times. See our Home care page for proper cleaning techniques.
Carbohydrates is an important part of our diet and we can not completely eliminate it from diet. What we have to remember that bacteria will feed on sugar and produce the acid, demineralizing the tooth for about 20 min. If let's say you "supply" the bacteria with sugars every 20 min, the acid producing process will never stop and demineralization will exceed remineraliztion of enamel, leading to destruction of tooth structure and formation of cavities. So the main factor in caries decay formation process is not the amount of sugar, but the frequency of exposure to it. Probably the best example of how continiuos use of sugar containing products leads to caries is nursing bottle syndrome.nursingbottle.gifnursingbottle.gif


Nursing bottle syndrome or nursing caries syndrome is a severe form of tooth decay affecting mostly front teeth in children between ages 2 and 5.This tooth decay is a result of use of juices and sweetened milk in nursing children especially during sleep. Another reason for the nursing bottle syndrome is sweetened pacifier in sugar or honey. In both scenarious the continuous flow of high content of sugar leads to demineralization of enamel and leads to caries all around the tooth. 

Very often caries goes unnoticed, not causing any symptoms, till it destroys a big part of the tooth. At this point you can have high sensitivity to hot and cold, or sweets, food may stick in between the teeth.  Caries develops as a funnel affect which means that it starts in a point and expands once it penetrates the enamel surface.  Enamel is the hard substance that covers the outer portion on the crown of the tooth and it is pretty difficult for bacteria to destroy it.  Once the bacteria make an opening through the enamel, it will enter the dentin layer, which is much softer and easier for the bacteria to destroy. This is the reason why people don’t realize that they have a large cavity in their tooth; it is mostly covered by the hollowed out enamel until that piece of enamel breaks off. Frequent exams and check up X-rays can diagnose development of decay at its early stages. The sooner cavity diagnosed, the more healthy tooth structure can be preserved by the doctor using less invasive treatment options, and more chances that decay did not reach the nerve, when the root canal treatment must be done.

How Caries diagnosed ?
Caries can be diagnosed by dentist during routine oral exam with the direct view, with the dental explorer (special dental instrument used to probe the tooth structure), by the x-ray images. Computerized diagnostic becomes also a helpful tool. Caries indicator solutions are available to help dentist in diagnostic of decay. The initial stages of caries can be asymptomatic. From the symptoms which can accompany the development of tooth decay the most important are sensitivity to sweets, cold and hot. This sensitivity should disappear as soon as the factor causing the sensitivity removed. If the pain continues after these factors removed it could be a sign of nerve involvement.

So, how can we restore the decayed tooth?

After you were diagnosed with caries, doctor can offer you different treatment options, depending on the teeth involved, the extent of the decay and you overall conditions in the mouth. After you been num, all the decay and involved dentin have to be cleaned out with the special burs till the sound structure of the tooth reached. Then the doctor will shape the cavity to accept the desired restoration.


The picture above captioned untreated caries in different stages of development. It starts from decalcification ( # 2 ) and progresses to severe tooth decay, requiring extensive treatment. The diagramms below show also how tooth decay progresses if left untreated