Tooth Decay (Dental Caries):

Is it reversible?

Tooth decay (dental caries) is one of the oldest and most common diseases found in humans.

The term “dental caries first appeared in literature around 1634 and originates from the Latin word “Caries”, which means decay. This goes as far as 5000 BC where the thinking was that the cause of hole in the tooth was a “tooth Worm”

Dental caries is actually a Chronic infectious disease, caused primarily by certain types of bacteria, called Streptococcus Mutans, Streptococcus Subrinus and Lactobacilli. These bacteria have the ability to stick to the tooth surface and consume the sugar in our diet and turn it to mostly to Lactic acid. The acidic saliva would create small holes in the surface of the enamel (the protective outer covering of your tooth). Having “sweet tooth” by frequent sugar intake, favours bad bacteria to colonise the mouth. The good bacteria decrease at the same time and the balance is disturbed. If the acid attack continues, bacteria penetrate into deeper layer of tooth and causes tooth decay. Left undiagnosed and untreated, this can cause toothache, infection and tooth abscess.

Risk factors for developing dental caries

• The main risks factors are high sugar diet and fizzy drinks, regular snacking, poor oral hygiene and poor interdental cleaning

• Saliva has an integral role of protecting our teeth as it contains many protective agents. Dry mouth caused by medication or radiotherapy of head and neck can drastically increase development of tooth decay in older or sick adults

• Living in low fluoridated water area is also a major risk factor specially in children

• Avoiding dentist and dental hygienist

Is tooth decay reversible?

There is a general misconception in the population about the appearance of tooth decay.

Most people presume dark or brown spot on their teeth is tooth decay. In reality, an active decay lesion is actually white in colour, rough in surface and collects plaque. It also bleeds when probed around the gum. White colour of the enamel indicates the reduced content of calcium and phosphate, the minerals in the tooth dissolves due to acid attack.

If the lesion is contained in the enamel, it can be reversed and arrested by help and advice of dental professionals. So not all tooth decay requires fillings. Tooth may require restoration If the small lesion progress to inner layer of the tooth (called, dentin).

Prevention is always better than cure

Statistic shows that the prevalence of dental caries in children in the UK has reduced dramatically over the past five decades. This is generally attributed to the introduction of fluoride-containing toothpaste in the early 1970s.Change in social attitudes, access to dental care, developments in preventive dental materials, together with health promoting and clinical practices have also contributed to these changes. Yet dental caries, which is largely preventable, remains prevalent and effects mostly low social economic groups in the society.

Surveys of oral health in adults within the UK suggest that more adults will enter older age with some or all of their natural teeth, many of which will be heavily restored. Dental caries is not just a disease of children and young people, new carious lesions can develop at any age.

Tooth decay can occur in pits and gaps of the tooth. Brushing well is very important but hard brushing could cause the gum to recede and expose the dentin. This causes sensitivity and even decay on the root of the tooth. It is therefore paramount for people of all ages to see a dentist regularly.

In my 25 years as a dental practitioner, I have always been passionate about prevention of all dental diseases. Our work typically starts with pregnant mothers to inform and educate so that they could look after their babies’ teeth the correct way. In a similar vein, we see toddlers from the age of one and work with parents to ensure they minimise the risk of developing decay in their milk teeth. It is very important to keep their milk teeth healthy as they have an important role of keeping spaces for the permanent ones to arrive.

At Copper Beech Clinic, I have a team of highly experienced and qualified dental hygienists who help to educate our Patients (adults and children) to stay healthy. Dental X-rays are taken routinely to diagnose any underlying dental diseases.

I have established the correct prevention measures in place for children of my practice, such as fissure sealant of all their first and second molars as they develop, fluoride varnish on regular basis at their examination appointments. I am proud to see them now as adults, many of whom with no fillings or permanent damage to their teeth.

Dr Ella Aslani DDS Stockholm Copper Beech Clinic, Christchurch