Dental Caries in Youth

Dental Caries is a disease of the tooth caused by bacteria, which results in a loss in tooth structure, and pain if left untreated. It is more commonly known as a cavity or tooth decay.

Imagine a beautiful monument primarily made of minerals like Calcium. Would the monument sustain a strong blow? It probably would. Calcium ensures that the monument strong. But what if one pours acid on it? The structure would readily dissolve. This is exactly what happens during the process of tooth decay. Food that we eat, especially the sticky ones, get lodged in the grooves and pits of teeth. Oral bacteria act on these sugars and liberate acids, which in turn dissolve tooth structure. This discontinuity in the tooth surface further encourages food accumulation. This starts this vicious cycle of dental decay, which leads to deepening of the already existing cavity.

Sugary food is mostly mistaken to be the sole causative agent of dental decay. There are several other factors influencing this process -

  • Unfavourable Tooth Anatomy - If your teeth have deep grooves and pits, greater are the chances of food getting entrapped within
  • Unfavourable Teeth Arrangement - Crowded teeth encourage food retention and resist proper oral hygiene measure.
  • Salivary Flow Rate - Saliva contains antibacterial and buffering elements. It also acts by flushing food away. Patients with decreased salivary flow rate are at increased risk of developing cavities
  • Oral Bacterial Flora - The presence of increased numbers of decay-causing bacteria would be an obvious risk factor

Dental caries can be classified into several types depending on their location and nature of progress. If they develop in the grooves, they are called as Pit & Fissure Caries. If they develop on smooth surfaces, they are called Smooth Surface Caries. Progress of decay can be very fast or slow. Depending on the same, they can be addressed as acute and chronic caries respectively. Decay that occurs in between teeth is called Inter-proximal Caries.

The colour of the decay can vary between a light yellow to dark brown/black. Decayed tooth structure can imbibe pigments from bacteria or from the food we eat.

Not exactly. Tooth structure can get stained. A stained tooth surface may not necessarily imply decay. Hence, how do we differentiate a stained tooth surface from a decayed one? Decayed tooth structure feels softer when explored using a sharp and pointed instrument. The tooth structure is also discontinuous. A dentist uses an instrument called a probe to detect caries.

Other than an aesthetic problem, associated with a discolouration in the teeth, sensitivity is a common symptom. When the decay involves the pulp of the tooth (as happens in deep decay), spontaneous pain may occur.

In the very initial stages, when the decay spot has lost minerals but the surface is still intact, remineralisation is the treatment of choice. Unfortunately, this stage can be effectively diagnosed by only a dental profession. Hence, it often goes unnoticed. A full-fledged decay would require a filling. Very deep cavities that have already involved the pulp of the tooth would require root canal treatment.

The sooner the better. In the initial stages, a simple filling would suffice. Smaller the filling, better is its longevity. Also, tooth structure is conserved and more invasive treatments like root canal can be avoided. If allowed to progress over a greater period of time, decay may weaken the tooth, which may break on chewing and necessitate its removal.

Last updated on 30 November, 2018.

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