Caries is the most frequent cause for tooth loss in adolescents and adults up to the age of 40-45. As a result, regular dental appointments are extremely important, since dental caries can silently spread for an long period of time without any symptoms.

What is Tooth Decay?

Tooth decay (dental caries) is a disorder of the dental hard tissue of the tooth (enamel and dentine).

Timely and targeted prophylactic measures (such as fissure sealants and fluoride) can stop the progression of initial caries. When caries has invaded the dentine it is considered to be fully developed. This requires immediate action, as from that point forward, caries will progress rapidly from the enamel into dentine!

If the affected dentine is left untreated, tooth decay will further advance into the pulp, resulting in deep dental caries (caries profunda), or even penetrating tooth decay (caries penetrans). In the latter, the breakdown has passed through the dentine to the pulp, and is almost always accompanied by severe pain. At that point a root canal becomes inevitable!

Is tooth decay the source of the pain?

Yes, but not always and not in all patients. The beginning of the decay process is very often without any symptoms. Only when the decay has engulfed most of the tooth's substance, and deep dental caries has developed, can temporary pain be triggered by the exposure to sweets or cold.

Only when the deterioration has reached "the nerve" (caries penetrans), can intense, throbbing, stabbing, pain be brought about. Usually, the strongest pain killers are rendered ineffective.

Caries often develops silently in the interdental spaces, from where it slowly advances into the depths of the dental pulp.
Only regular use of dental floss and proper brushing prevents dental caries!

What causes tooth decay?

Tooth decay is caused by continuously lingering remains of sugar and bacteria. The constitution of the tooth structure and the composition of saliva, in addition to genetic factors, are also determinants.

Dental plaque (the soft coating on the teeth) contains many different types of bacteria. Some of them create acid secretions which dissolve the enamel; others produce cytotoxins, which inflame or degrade the gums. All oral bacteria feed off carbohydrates and sugar!

How can tooth decay be prevented?

The best way to prevent tooth decay is to minimize sugar intake. Sufficient breaks between meals are necessary, in order for saliva to neutralize acids and remineralize teeth exposed to bacteria. The frequency and duration of sugar consumption are the biggest factors.

How can it be prevented?

We recommended a 3 point prevention plan:

In addition to a thorough brushing in the morning and evening, proper personal oral hygiene requires also the use of dental floss and/or interdental brushes.

Furthermore, fluoridation and fissure sealants can be applied to prevent tooth decay.

What is fluoridation?

Fluoridation is the local application of fluoride gels, fluoride varnishes, and fluoride-containing mouthwashes, for the purpose of tooth decay prevention.

What are fissure seals?

Dental fissures are furrows located on the occlusal surface of the teeth. They are usually deep and narrow, and retain cavity-causing bacteria even after thorough brushing. Because of the thin layer of the enamel on the occlusal surface, fissure caries can develop rather quickly. Unfortunately, this development is difficult to detect – be it clinically or by x-ray.

Therefore, it is wise to have fissures sealed right after initial eruption. They can be expanded, cleaned, and sealed, even after a slight exposure to deterioration (extended fissure sealing).

What are the consequences of dental caries?

Caries deteriorates tooth structures, which need to be fixed with fillings made out of artificial filling material. If decay penetration is deeper, an inflammation of the pulp occurs and a root canal treatment is needed.

If not treated, it can develop into an apical periodontitis (inflammation of the periodontium at the root tip), or even abscesses and osteomyelitis.

Since an absolutely perfect filling material does not exist, caries may reappear on an previously repaired tooth. It can either trigger a secondary caries (practically a new occurrence of the disease on a healthy tooth), or recurrent caries (the resurgence of inadequately removed caries).