You can have tooth decay without there being a visible hole in your tooth. But how does tooth decay occur, how is it treated and is there anything you can do to prevent it? Read on to find the answers to your questions.
What is caries?
Tooth decay is something most people have either heard of or experienced themselves. In dentistry, tooth decay is known as caries and is characterized as a disease of the hard tooth tissue, enamel, dentin and cementum.
Why do you get caries?
Caries occurs when bacteria are allowed to sit long enough to break down sugars and form acid. The acid dissolves the enamel and then the underlying dentin. At some point, the enamel is so dissolved that a cavity forms. This creates what we colloquially call tooth decay.
However, we all have a protective layer on the outside of our teeth in the form of enamel. Enamel ensures that cavities don't happen overnight, but rather are a gradually evolving process.
How do plaque and bacteria form?
We all have bacteria in our mouths all the time. On their own, bacteria do no harm - in fact, they are part of the normal flora and are necessary to maintain a healthy oral cavity.
The problem arises when they are allowed to multiply and become large collections of bacteria. Then they develop into what we all know as plaque. The bacteria form a glue that holds the plaque together. Over time, the bacteria will stick to each other and to the tooth in a dense layer.
Bacteria need nourishment to live. The bacteria in the oral cavity get their nutrition from saliva and from what we eat. Sugary foods in particular are readily available nutrients for bacteria.
When bacteria convert food into energy, they produce acid. If they also get stuck in a thick and sticky plaque where the acid can come into close contact with the tooth surface, the tooth can be etched away. Slowly, more and more of the tooth's mineral disappears due to the acid etching and you end up with caries.
How can it be seen?
Caries is not always visible to the naked eye. However, it usually starts as discoloration on the teeth. It can be in the form of either white or dark spots and is usually detected by the dentist.
4 stages of caries
- The first stage of caries starts in the tooth surface. At this stage, bacteria have been allowed to multiply and turn into acid. The only symptom that can occur at this stage is that the surface of the teeth becomes chalky. The progression of the situation is very long here. The treatment at this stage is to thoroughly clean the areas with a toothbrush and floss. In some cases, a thin varnish can be applied to the surface of the tooth to prevent the bacteria from being able to feed on the ingested sugar. This stops the caries attack.
- In the second stage of caries, the bacteria have worked their way through the outer layer, called the enamel, which is there to protect the tooth. Here, the bacteria can penetrate and destroy the tooth from the inside. At this stage, the caries attack happens faster. Symptoms may include pain or discomfort when eating something cold or sugary, in which case treatment involves removing the invasive tissues with a drill and creating a filling, where the teeth are instead filled with a tooth-like substance.
- In the third stage, caries has reached the bone of the tooth, also known as the dentine. Once it reaches this stage, it progresses much faster as the dentin itself does not contain as much mineral as the enamel. Here the caries is very close to the nerve. You can see the hole very clearly and sometimes you can also see discoloration on the tooth. The pain and discomfort from eating anything cold, hot or sugary increases, and the treatment involves drilling away the tissues from the decay. The part of the tooth closest to the nerve is then covered with a thin layer of protective material. Finally, a filling is made in the hole.
- The fourth and final stage of a caries attack is when the caries has reached the nerve of the tooth. This can cause a lot of pain that is not just relieved by painkillers. Especially when chewing, it can be difficult to endure the pain. In this case, root canal treatment may be urgently needed. Read more about root canal treatment here. The nerve is completely removed from the tooth and a root canal filling is made. If there is very little tooth substance left due to the etching, drilling into the tooth is required for the filling to be successful.
What does a cavity feel like?
Just as tooth decay can't always be seen, it can't always be felt. The size of the hole in the tooth is also unrelated to whether it can be felt. That's why it's important to visit the dentist regularly to prevent cavities from developing and needing to be drilled.
However, if pain occurs in the tooth, it may be due to caries. When this stage is reached, it's because the caries has reached stage 4 and there is a hole directly down to the nerve.
Typically, you will experience pain when eating sour, sweet, cold or hot foods. This is because it provokes the nerve and can feel like a twinge.
However, there are other reasons for experiencing tooth pain. It can either be due to gingivitis or icing in the teeth.
What can you do to avoid tooth decay?
There are plenty of things you can do to prevent tooth decay.
Regular dental visits
Firstly, it's important to visit the dentist regularly. That way, any cavities can be caught in time and actually treated without the need for drilling.
Brush your teeth frequently
Secondly, it is particularly important to maintain good oral hygiene. As mentioned earlier, tooth decay is caused by bacteria that are given free reign to multiply and form acid. Therefore, brushing your teeth twice a day is the minimum to keep bacteria on a short leash.
Remember to floss
Most people usually stick to brushing their teeth and do it regularly. However, there are some other steps you can add to your daily routine if you want to give your teeth the best chance of not getting cavities.
Caries can also settle between the teeth. This means that toothbrushing can't always reach between teeth. Flossing can be the solution. If you floss regularly, you're guaranteed to catch all the bacteria hiding and potentially developing into a cavity.
Alternative measures?
If you are part of the population prone to tooth decay, it might be a good idea to also think about what you expose your teeth to. Both in terms of what you consume and when you consume it.
There are certain solid and liquid foods that should be avoided if you want to be on the safe side.
You can therefore keep that in mind:
- Avoid sweets
- Avoid sugary drinks
- Avoid sticky foods - especially caramels and sweets
- Brush your teeth after consuming starchy foods.
Besides avoiding certain foods, it's also about when they are consumed. It's a good idea to brush your teeth after you've eaten breakfast. That way, you remove the night's plaque and leftovers from breakfast.
Always choose toothpaste with fluoride
Most toothpastes today contain fluoride. Fluoride is extremely good at protecting against tooth decay and strengthening the mouth's own defense, the enamel.
Even in the early stages of tooth decay, fluoride can stop the development and repair the damage that has already been done.
Therefore, the recommendation is to make sure your toothpaste contains fluoride. Most natural toothpastes do not. Fluoride is originally a chemical substance in the periodic table, but in the small amounts added when you brush your teeth, fluoride in toothpaste is not dangerous.
Treatment of caries
If you have cavities in your teeth, it may be necessary to have a filling (sealant) placed. The aim is to remove the bacteria from the area to stop the decay and remove the damaged tooth tissue and replace it with a filling.
Today, most fillings are made of plastic. The color of the filling is chosen according to the color of your teeth. The plastic is built to reproduce the original shape of the tooth as much as possible. That way, it can fit in the bite and is comfortable to chew with.
Bacterial acid can't make a hole in the plastic material, but a filling doesn't make the rest of the tooth immune to acid. That's why it's important to remember to brush thoroughly after you've had a filling.
Do you have a broken molar due to caries? Read more about it here.
If you want to know how much it costs to have a cavity filled, you can read more on our → prices page.
Are you a member of Sygeforsikring Danmark? Depending on which group you belong to, there are discounts available.
What does it cost to have a cavity repaired?
The price of a cavity filling can vary depending on the location of the tooth and the size of the hole. At Tandliv we offer plastic fillings at the following prices:
Fortand:
- Small filling: 468 kr.
- Large filling (2 surfaces): 1,560 kr.
Small molar:
- Small filling: 1,175 kr.
- Large filling (2 surfaces): 1,475 kr.
Large molar:
- Small filling: 1,275 kr.
- Large filling (2 surfaces): 1,685 kr.
Treatment involves removing the decayed tissue and replacing it with a plastic filling that restores the function and appearance of the tooth. Contact Tandliv for a consultation and an accurate estimate of what your treatment will cost.
Root canal treatment of teeth with large gaps
If the decay in the tooth has grown so large that it reaches the nerve of the tooth, you may need root canal treatment to avoid unnecessary toothache.
The dentist always assesses whether a root canal is necessary.
FAQ - Tooth decay
Yes, some people are more prone to tooth decay. Genetics, oral hygiene, diet, and saliva production affect the risk. People with weak enamel, more frequent sugar intake, poor oral hygiene and decreased saliva production have a higher risk of developing cavities. Regular dental visits and good oral care can reduce this risk.
To treat tooth decay, dentists often use a filling, where they remove the damaged tooth tissue and replace it with a filling material such as amalgam, composite, glass ionomer or porcelain. In more advanced cases, a root canal, crown or tooth extraction may be necessary. Prevention through good oral hygiene and regular dental visits is important.
Untreated tooth decay can cause pain, increased tooth sensitivity and infections. If left untreated, it can lead to deeper decay, destruction of tooth structure and tooth loss. Furthermore, infections can spread to the jaw, bloodstream and other parts of the body, which can result in serious health complications.
Contact us and get advice
If you have any doubts or questions, don't hesitate to contact us.
- I look forward to meeting you in the clinic.
- Dentist
Born in 1988 and graduated from Copenhagen Dental School in 2012.
Matthias has also written an article in Tandlægebladet about Keratocysts. In addition, he has expressed his opinion on increased user fees for red patients in an article in Tandlægebladet, which you can read by clicking on the link.
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