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What is tooth decay?

Tooth decay is the process that results in a cavity (dental caries). It occurs when bacteria in your mouth make acids that eat away at a tooth. If not treated, tooth decay can cause pain, infection, and tooth loss.

What causes tooth decay?

The combination of bacteria and food causes tooth decay. A clear, sticky substance called plaque that contains bacteria is always forming on your teeth and gums. 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. Over a period of time, these acids destroy tooth enamel, resulting in tooth decay.

Symptoms of tooth decay

The symptoms of advanced tooth decay include:

  • toothache
  • tooth sensitivity – you may feel tenderness or pain when eating or drinking something hot, cold or sweet
  • discoloured spots (grey, brown or black) appearing on your teeth
  • Mild to sharp pain when eating or drinking something sweet, hot or cold
  • Pus around a tooth, especially when you press on your gums
  • an unpleasant taste in your mouth

How is tooth decay diagnosed?

Your dentist diagnoses tooth decay by:

  • Asking questions about your past dental and medical problems and care.
  • Examining your teeth, using a pointed tool and a small mirror.
  • Taking X-rays of your teeth and mouth.

    How is it treated?

    Treatment of cavities depends on how severe they are and your particular situation. Treatment options include:

    • Fluoride treatments. Fluoride is a mineral that helps teeth repair themselves at the earliest stage of damage. If your cavity is just getting started, a fluoride treatment may be able to help restore your tooth’s enamel. Professional fluoride treatments contain more fluoride than the amount found in over-the-counter toothpaste and mouth rinses. Fluoride treatments may be in a liquid solution, gel, foam or varnish that’s brushed onto your teeth or placed in a small tray that fits over your teeth. Each treatment takes a few minutes. Your dentist may suggest having periodic fluoride treatments.
    • Fillings. A filling is material that replaces decayed areas of your teeth once damage becomes permanent. Fillings, sometimes called restorations, are the main treatment option when decay has progressed beyond the earliest enamel-erosion stage. Your dentist drills away the decayed part of your tooth, then fills the gap to restore your tooth’s shape. Fillings are made of various materials, such as tooth-colored composite resins, porcelain, or combinations of several materials. Silver amalgam fillings contain a variety of materials, including small amounts of mercury. Some people don’t like using amalgam fillings because they fear possible adverse health effects from the mercury. While medical studies have shown these fillings to be safe and long-lasting, they remain controversial.
    • Crowns. If you have extensive decay or weakened teeth, you may need a crown rather than a filling to treat your cavity and restore your tooth. A crown is a custom-fitted covering that replaces your tooth’s entire natural crown. Your dentist will drill away all the decayed area and enough of the rest of your tooth to ensure a good fit for the crown. Crowns may be made of gold, porcelain or porcelain fused to metal.
    • Root canals. When decay reaches the inner material of your tooth (pulp), you may need a root canal. In this procedure, the tooth pulp is removed and replaced with a filling.
    • Tooth extractions. Some teeth become so severely decayed that they can’t be restored — they must be removed. Having a tooth extracted can leave a gap that allows your other teeth to shift. If possible, consider getting a bridge or a dental implant to replace the missing tooth.