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Understanding How Cavity Causing Bacteria Can Attack Tooth Enamel

Everybody’s mouth contains many different species of bacteria and most but not all are benign. Bacteria capable of causing cavities can live in what’s called dental plaque which is a biofilm or sticky, colorless deposit and which builds up when a dental pellicle or a layer of saliva forms a film over teeth.

This pellicle layer contains glycoproteins and begins forming shortly after you clean your teeth. It allows bacteria to attach to it and as bacteria build up, they begin to form micro-colonies that without removal will cause gum disease and tooth decay. They do this by converting starches and sugars into acid which has the effect of removing calcium from tooth enamel, eventually resulting in cavities. However, when calcium is removed from tooth enamel it increases the concentration of calcium in that area, creating an environment that is more hostile to these bacteria.

In a recent study, researchers looked at how these bacteria manage to survive in these more hostile conditions. They thought that somehow the cavity-causing bacteria created from sugar residue were used to create a scaffolding for the biofilm, allowing bacteria to attach themselves firmly to dental plaque. Their study showed that the more calcium dissolved by bacteria, the greater the tolerance of these bacteria for calcium and that their capacity for surviving within the biofilm actually increases.

This is because the bacteria develop mechanisms that help them survive through integrating the dissolved calcium into the plaque biofilm which not only helps to strengthen the structure of the biofilm but which also decreases the toxicity of calcium to bacteria.

It was an important study because it helps researchers understand the role of calcium in the development of tooth decay. Even though dental care has significantly improved over the past few decades, tooth decay is still an extremely common problem.

Factors That Increase Your Risk of Having a Cavity

As plaque builds up over your tooth surfaces, the bacteria within it create acid, using any sugary or starchy foods eaten as fuel. After you’ve eaten these types of foods, your mouth remains more acidic for at least half an hour to an hour, during which time calcium is removed from your tooth enamel which gradually weakens it so that eventually, cavities begin to form.

Factors that increase your risk of developing tooth decay include:

  • Failing to brush and floss your teeth regularly
  • Not seeing your dentist frequently enough for checkups and cleanings
  • Eating lots of foods that are high in carbohydrates and sugars or snacking on these foods in between meals
  • Not getting enough fluoride from toothpaste, foods or from public water supplies
  • Having insufficient saliva, as saliva has a protective effect on your teeth, washing away food and sugars while helping to maintain a more neutral pH level
  • Being diabetic
  • Smoking or using smokeless tobacco products, or even just breathing in second-hand smoke

Children are at higher risk than adults of developing tooth decay and this is because their tooth enamel is not as strong as adult tooth enamel, making it easier for acids to erode it, causing cavities. Babies are also at risk of tooth decay, especially if they are given a bedtime bottle containing formula, milk or juice. The bacteria responsible for tooth decay can be passed on from adults who share utensils or who lick pacifiers to clean them before giving them back to a baby.

Recognizing the Symptoms of Tooth Decay

Unfortunately, tooth decay often doesn’t cause any symptoms until you have a bad cavity, where the tooth has become infected and has begun to ache. The most common symptom of tooth decay is a toothache and it's worth contacting your dentist as soon as you develop this problem, especially if you are overdue for a checkup. Other signs of tooth decay include noticing your gum has swollen near the aching tooth and this is a bad sign because your tooth could have become abscessed.

The gum swelling is caused by the infection trying to escape as it builds up in the tooth and the tooth root. A tooth abscess has the potential to become extremely serious, even affecting your general health and as a result, you may also notice that you feel rather unwell or feverish. Other symptoms of tooth decay include a persistent nasty taste or bad breath, or if you look at the tooth you may be able to see it is discolored or has white, brown or black spots.

Getting a Diagnosis of Tooth Decay

Your dentist will soon be able to diagnose tooth decay, carefully checking your teeth and gums and by taking dental x-rays. Dental x-rays are very useful for showing areas not visible to the naked eye and especially infection that may have traveled deep inside the tooth. Once they have examined your mouth, your dentist will talk to you about possible options for treatment.

Treating Tooth Decay

If you only have tiny lesions in your teeth where a cavity is beginning to form, it may be possible to re-harden the tooth using topical applications of fluoride. This is why it’s so important to see your dentist regularly as catching tooth decay at this early stage is definitely the best option. If you have a cavity, your dentist will need to remove the decayed area before filling the tooth.

Generally, this will be done using tooth-colored composite resin, creating a strong and nearly invisible filling. Larger areas of decay in back teeth can be filled using an inlay or onlay which may be made from porcelain or from gold.

If the infection has reached deep inside your tooth then you will need root canal treatment, an intricate process to remove infected tissue from deep inside the tooth pulp in the central part of the tooth. Afterwards, your tooth will almost certainly need a crown to cover it up completely and to protect it. In the case of a dental abscess and where the infection is very severe, your dentist may have no other choice but to remove the tooth to allow the infection to drain. You could also need antibiotics to help clear it up completely. Tooth removal is always the last resort and is why you should always seek professional dental care as soon as you can for any form of tooth pain. The sooner your tooth can be treated, the better the chance it can be saved.

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