The Greek meaning of this word ‘Ker’ is death. In the Latin the meaning is decay. A formation of hole on the tooth surface due to germs is known as cavity. This cavity is formed on the exposed surface of tooth that is the crown of tooth. It is an astonishing phenomenon that the hardest tissue in the body, that is enamel of tooth, is dissolved by tiny germs of oral cavity. There are various theories of formation of caries on teeth. The germ theory, the mechanical and the chemical theory and auto-immune theory, are said to be responsible for caries. The exact mechanism is still unknown.
To form a cavity on a tooth surface, that is on the enamel, all these factors must be present. A funny part is that not only their presence is important but the teeth, the saliva, the food and the germs must interplay with each other. The tiny germs play the most important role in formation of cavity. They form an acid that dissolves the enamel of tooth surface and forms a cavity.
We eat varieties of foods everyday. We eat rice, chappatis, pulse and vegetables. We also have food containing sticky materials like bread, biscuits and chocolates.
They adhere to the tooth Q surface and do not get washed Germs away with saliva. The saliva, food and tooth surface provide umbrella to the bacteria present in mouth to settle and form a colony. The sticky material and the germ form a deposit, it is known as plaque. The food does not cause cavity and main culprit is germ-bacteria. Even educated and health conscious people believe that sugar and sweets are the main factors. That is an incorrect yardstick; the biggest threats come from the sticky foods whose particles remain in the mouth after a meal. They have “cling-on” property.
Clustered into colonies that form sticky plaque on the teeth are bacteria waiting for the food-that will produce a substance called enzyme. The body’s defence watches all these activities and acts accordingly. It increases the quantity of saliva to dilute the effect of enzyme produced by bacteria. Normally it is washed away but if the individual has lowered defensive power owing to general disease, the germs multiply faster.
They grow in size and thickness and harden. Later on it is difficult task for saliva to wash away the germs. The second stage is when food and bacteria form an enzyme is converted into acid. This acid has ability to dissolve the hardest tissue that is enamel of tooth. The enamel is the outermost covering of the crown of a tooth. This acid makes tiny holes in the tooth surface and ultimately a large hole (black-hole) is formed. This is cavity. Upto this state the process is painless. By and large it deepens further and cavity enlarges and touches dentin.
This dentin is extremely sensitive to cold, heat and toxic product produced by acid. The nerves which are present alarm the danger signal that something is wrong…beware, take action. The individual response is careless thinking that this is a transitory phase and it will disapper. But as ill-luck would have it, the internal structure of tooth, that is vital portion of toothpulp gets damaged. The end result is sudden, severe pain and lost of a tooth.
Who Gets Cavities
They occur most often in children between age 5 to 18 months but children of any age can have it. The children who sleep with bottles (bottom-up) in their mouth may suffer extensively in their milk teeth. The old people have broken roots, root caries. The handicapped children have caries. Watch for brown yellow spots on tooth which don’t get cleaned after brushing, and the teeth are sensitive to cold or hot drink. These are the signs of tooth decay.
The Role of Dentist In Caries
An examination of the teeth reveals dental caries (cavities). Most dental caries are discovered in the early stages during routine check ups. The surface of the tooth may be soft when probed with a sharp instrument. Pain may not be present until the advanced stages of tooth decay. Dental X-rays may show some cavities before they are visible to the eye.
(A) Destroyed tooth structure does not regenerate. However, the progression of dental caries can be stopped by treatment. The goal of treatment is to preserve the tooth and prevent complications.
In filling teeth, the decayed material is removed (drilling) and replaced with a restorative material such as silver alloy, gold, procelain, or plastic.
Porcelain and plastic caps closely match the natural tooth appearance, and maybe preferred for front teeth. Silver amalgam (alloy) and gold are stronger and are often used on back teeth.
Crowns are used if decay is extensive because fillings increase the risk of the tooth breaking. The decayed or weakened area is removed and repaired and a covering jacket (crown) is fitted over the remainder of the tooth. Crowns are often made of gold or procelain.
(B) A root canal is recommended if the nerve (pulp) in a tooth dies from decay or from a traumatic blow. The centre of the tooth, including the nerve and vascular (blood vessel) tissue (pulp), is removed along with decayed portions of the tooth. The roots are filled with a sealing material. The tooth is filled and a crown may be placed over the tooth.
Treatment often preserves the tooth. Early treatment is less painful and less expensive than treatment of extensive decay. Anaesthetics (local, nitrous oxide gas, or other general anaesthetic) may be required in some cases for drilling or other treatment of decayed teeth.
This is actually a time consuming treatment and expensive. This treatment requires a couple of X-rays and skilled dentist to perform.
The Goal of Treatment
Elimination of pain
The elimination of pain is the primary goal as the person is in great agony. The swallowing of antibiotics and analgesics will relieve him of his pain. If this remedy fails or he is unable to swallow then intramuscular injection will be the mode of drug administration.
The cleaning of mouth with antiseptic or the cleaning of cavities and application of cotton plug with astringent, clove oil will give him relief. Normally, the infection of tooth abscess is curable with this treatment.
Prognosis
Most of the cases of root canal treatment are successful. But if the abscess recurs then removal of tooth may be necessary because improper treatment of tooth abscess may spread to the neighbouring bone causing bone disease. In severe cases, cellulitis or brain abscess may occur.
What can relieve my sensation?
Enamel which is hardest covering of the crown of tooth, due to hard brushing and betal nut chewing, exposes the most sensitive part of the tooth i.e. Dentin. This causes sensation after taking cold or hot drink.
Cementum is the outermost covering of the root portion which is exposed due to gum disease. This also gives sensation.
Help from dentist
The sealant is a thin plastic coating, a safe, painless and low-cost way to help protect your children from tooth decay. This coating is bonded to the chewing surfaces of the molars and premolars by a dentist. The sealant forms a hard shield that keeps food and bacteria from getting into the tiny grooves on the surfaces of the molars and premolars by a dentist. The sealant forms a hard shield that keeps food and bacteria from getting into the tiny grooves on the surface of teeth.