Tooth decay is a chronic, infectious damage to the hard tissues (enamel, dentin, and cement), which develops into the demineralisation and decay of the hard tissues. In other words, the level of mineral substances (calcium and phosphorus) in the tooth enamel begins to decrease, leading to its decomposition and to the formation of an infectious cavity, often called a ‘hole’, in the tooth structures.
Causes of tooth decay
It is important to mention that the occurrence of tooth decay is influenced by both congenital factors and the individual’s own activities and habits. Since congenital factors cannot be changed, it is very important to adjust what can be adjusted: lifestyle, diet, and oral hygiene habits.
Congenital factors causing tooth decay:
- – The teeth’s anatomical shape, structure, chemical composition, i.e. enamel structure, distribution of fluoride in tissues, and retention areas of the teeth, such as deep grooves, cavities, and irregularly arranged teeth in the dental arch.
- – Biological and biochemical factors: the composition and location of plaque, plaque generation rate, activity of micro-organisms, levels of intracellular and extracellular polysaccharides, and fluorine.
- – Saliva: salivation rate, buffering capacity, immunological and antibacterial factors.
- – Epidemiological and demographic factors: prevalence and intensity of caries in deciduous and permanent teeth. Localisation of initial and already formed tooth decay cavities. Prevalence and intensity of caries in different age, socio-economic, and ethnic groups.
- – Systemic conditions: general diseases that affect the health of the oral cavity either directly or indirectly.
- – Local factors: dental plaque, changes in the composition and properties of saliva (viscosity, pH fluctuations, and salivation rate), occlusal abnormalities.
- – Endogenous factors: weak immunity, genetic predisposition, and the structure and properties of dental solid tissues.
- – Exogenous factors: the influence of climate, influence of water, living conditions, and emergencies.
Acquired factors causing tooth decay:
- – Nutrition: the intake and frequency of high carbohydrate foods products, inadequate nutrition lacking of necessary minerals. Fluorine intake.
- – Poor personal oral hygiene habits, infrequent or no professional oral hygiene, residual carbohydrates in the mouth.
Symptoms of tooth decay
The main symptoms of tooth decay are as follows:
- – Toothache;
- – Darkened teeth;
- – Softened tooth tissues;
- – Tooth enamel crumbling;
- – Tooth sensitivity in the neck area.
Treatment of tooth decay
The first stage of tooth decay treatment is the cooperation between the patient and the doctor to identify and prevent factors influencing the formation of tooth decay. It is followed by a careful clinical examination and selection of the most appropriate treatment for tooth decay. We describe these steps in more detail:
- – Finding the factors of tooth decay. During the initial visit, it is necessary to identify the factors that may be related to the development of tooth decay. This includes the patient’s approach to dental care and treatment and his or her habits. Complaints and medical history are revealed during an interview. The presence, nature and duration of ache as well as its stimuli are carefully clarified.
- – Clinical examination. The clinical examination involves additional means, such as a mirror, light source and dental probe. The focal point of caries is assessed on the basis of visual and tactile criteria: changes due to tooth demineralisation (loss of minerals), colour changes, enamel transparency, and condition of hard tooth tissue. A prerequisite for clinical examination is the isolation of tooth surfaces from saliva and drying with an airflow, especially when finding early focal points of decay. The light source is directed to inspect all surfaces of each tooth. Particular attention is paid to newly germinating tooth surfaces, distal surfaces of molars and, for older people, tooth areas at the gum edge. In our clinic, when planning the treatment of tooth decay, the following factors are assessed: the extent and localisation of the carious lesion; caries risk factors; condition of oral hygiene and periodont; quality and condition of other existing restorations; functional and aesthetic needs; occlusion; age of the patient; need for dental treatment.
CLINIC | DPC applies the following tooth decay treatments:
Conservative treatment is applied in the early stages of the disease and requires considerable effort from both the doctor and the patient. The aim is to stabilise the progression of the disease by promoting remineralisation of hard dental tissues and to preserve the integrity of the tooth surface. It is achieved by using topical remineralising preparations: fluorine solutions, varnishes, and gels as well as sealants.
The radical treatment method of is applied in the case of an active, progressive decay focal point, when conservative measures are not sufficient to stabilise the disease. The aim is to remove damaged, infected, decayed tooth tissue, to apply dental pulp protection means and to restore the tooth surface to recover the lost functions and aesthetics. Put more simply, this therapeutic treatment is applied by cleaning the carious, decay-damaged cavity and restoring the tooth surface by filling. The carious cavity is usually cleaned using a dental drill. We would like to mention that today’s decay removal instruments are modern and extremely effective, while cavity cleaning with ultrasonic, extremely fast vibrating devices and laser is becoming increasingly popular.