Tooth decay (also known as cavity or dental caries) is an extremely popular disease that can affect any categories of world population. Tooth decay (“decay” derives from the Latin word that means “rotten”) is gradual destruction of the tooth that follows the demineralization of its enamel. According to the most popular scientific point of view enamel demineralization happens as a result of acids impact. Acids are the by-product of bacterial attack - they appear on the tooth surface as plaque and start destructing it.
Usually tooth decay starts when demineralization processes go faster than natural remineralization processes, first it affects the tooth enamel and then develops and goes to the more vulnerable part of the tooth — dentine. This stage may last quite a long period of time, but untreated tooth decay will reach the pulp (the “living” center of the tooth, where large blood vessels and the tooth nerve are located). When the nerve is affected — patients start feeling sharp pain when biting food or just with no visible reason. Often toothache is accompanied with headache, fever and swelling around the affected tooth. Other symptoms of serious tooth decay are: foul smelling breath, taste of pus in the mouth and pulsing gums.
In some cases it may happen that tooth decay starts from the cemental tissue (the part of the tooth that is normally protected by gums), most often it happens in elderly people. In such cases the disease can progress much quicker, as the nerve will be reached faster, so the toothache will start almost immediately.
Photo 1. Tooth structure.
If timely treated the tooth can be either repaired with the filling or extracted and replaced with a tooth implant. But if left without attention tooth decay is most likely to lead to severe complications.
First of all, it is necessary to remember that severe tooth decay is not always accompanied by toothache, as the nerve may already be dead by the time the cavity will reach it.
Therefore make sure you visit your dentist regularly.
As far as tooth decay complications are concerned, advanced cases can lead to abscesses and inflammations in your mouth. In case a thick layer of plaque covers teeth and is not remove by brushing and flossing, bacteria can destroy not only the tooth enamel, but also gums. Normally these tissues have tooth support and protecting functions, but when they are damaged — the tooth is exposed to further destruction.
Photo 2. Periodontal gum disease.
Gum disease is one of possible dental caries complications. It is also referred to as gingivitis. The main signs of gingivitis are: gums inflammations and redness, gums bleeding during brushing or other mechanical impact (even mild).
A more serious stage of gum disease is called periodontitis. In addition to gums inflammation this stage features inflammation of the periodontal ligament (i.e. the tissue that keeps the tooth firm in the special tooth socket) and the inflammation of the alveolar bone (that keeps these sockets tight). Basically as a result of periodontitis the function of these tissues becomes impaired and the teeth aren’t tightly connected to the jaw, and in especially severe cases in may lead to the tooth loss.
Photo 3. Periodontitis.
Gum disease at the early stage can be treated with medications and proper oral hygiene. In first signs of gum disease you should consult your dentist and follow the recommendations. Keep in mind that such a severe gums disease as periodontitis is incurable.
Another problem caused by advanced tooth decay is infection known as dental abscess. Reaching the pulp bacteria can form a “pocket” filled with pus. This process is usually accompanied by severe pain and fever, so it’s difficult not to notice it. To treat a dental abscess you have to go to the dentist clinic, undergo the X-ray procedure and have the pus drained away. After that the dentist will perform the root canal treatment and repairs the damaged tooth. In some severe cases the tooth has to be extracted.
Photo 4. Dental abscess.
Dental caries usually causes foul tastes and bad breath. These manifestations can’t be called complications, but they can be symptoms of progressing disease, so you should take care of that.
The most dangerous tooth decay complications are characterized by infection of the soft tissues around the tooth. For example, cavernous sinus thrombosis or Ludwig angina can be even life-threatening.
In order not to let tooth decay lead to serious complications it is strongly recommended to stick to the basic mouth hygiene rules: brush your teeth twice a day, floss the interdental space at least once in several days, limit sugar intake and visit your dentist regularly for planned checkups.