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Tooth decay
Pathologies Tooth decay Very few people in their lifetime have been fortunate enough to never visit the dentist because of a severe toothache caused by a deep cavity. 

What is caries?

Caries is a disease that slowly leads to enamel loss and the dentini.e, the hard tissues of the tooth.  Initially the enamel is damaged. At this stage, also it is difficult to realize that caries is present in its initial stage.  Only the dentistthrough a careful analysis, can check for the presence of that small speck which indicates that the tooth has been damaged. 

Causes of caries

The causes of tooth decay are of two types: on the one hand, we have the exogenous factors and on the other the internal factors. 

Exogenous factors

Exogenous factors are those external factors that condition and promote the formation of caries.  The main ones are the microbial factorswhich favor the formation of biofilm, a gelatinous layer formed by microorganisms that affect the teeth, hence the absolute importance of oral hygiene.  Dietary factors are also crucial, especially the high intake of sugary foods and beveragesThe substances are substances that favor the proliferation of cariogenic bacteria.  Another factor that should not be underestimated is smoking. The smoking contributes significantly to plaque and tartar formationfavoring the formation of cavities. 

Endogenous factors

Endogenous factors are those intrinsic to the subjectas constitutional factors characterized by a weak tooth structure.  The type of salivation is also important in the formation and development of caries.  The reduced salivation both quantitativelyreduction of salivary production, as well as qualitativelyThe alteration of the pH, changes in the concentrations of the components of saliva, can be an indirect aid to the caries process.  The saliva has a cleansing function and is capable of buffering acids formed during feeding. It constitutes a protective barrierTherefore, if it is too weak, it cannot adequately protect the oral cavity. 

Symptoms of caries

Acids produced by bacteria when there are leftover food, are the main causes of the caries formation process..  Without a deep cleaning, these acids begin to erode the tooth enamelcausing the first lesions (first degree caries).  A through them, bacteria and acids reach the innermost layers of the tooth. First to dentin, which is less resistant than enamel to the effect of acids, increasing their destructive action (second degree caries).  The progression of caries continues uninterrupted and deeper and deeperreaching the innermost layer of the tooth, the dental pulp, which contains blood vessels and nerves (third degree caries).  At this time, the tooth is seriously infected and if not treated caries can also reach the bonecompromising the entire tooth structure (grade four caries).  Caries then develops from the outside to the inside of the tooth, with a slow and variable time course. On average, the caries process evolves over a period of 6 months to 2 yearsdepending on the influence of various endogenous and exogenous factors. 

Caries treatment

The tissues of which the teeth are made up do not have the capacity for self-regeneration, it is therefore important to go to the odentist to treat cavities.  Treatments carried out depend on the type of caries and its stage of development.  The first thing the dentist en check where the cavity is located y the general condition of the teeth that have been affectedIn most cases, an x-ray will be needed.  The main objective is to try saving the tooth whenever possible, removing the tissue affected by caries.  [card-product id="22745"] Filling is the most common method of used for this purpose, y consists of treating the lesion removing the carious part with a dental drill and filling the cavity with a suitable material.  Depending on the amount of tooth surface involved, more advanced treatments will be required, such as the placement of a prosthetic crown to replace the natural one.  When decay has penetrated deep into the toothaffecting the dental pulp, it is necessary to devitalize the toothIn this case, a pathway is created to the pulp chamber, which is carefully cleaned with the help of dental files and filled with an inert substance called gutta-percha. It is then filled with an inert substance called gutta-percha, the tooth is reconstructed with a filling or a new crownas required.  The most extreme solution is the tooth extraction if the latter is irreparably compromised and even more serious complications are to be avoided.  

Caries prevention

The measures to prevent caries are simple, but they must be carried out regularly: 
  • Brushing your teeth teeth after every meal, at least twice a day twice a day. An excellent way to complement the use of toothbrush and toothpaste is the use of a Mouthwash and dental floss.
  • Perform check-ups at the dentist every 6 or 12 months (depending on the physiology of each person, following the dentist's recommendation). Early detection of caries greatly simplifies the treatment necessary to combat it.
  • In the case of a high propensity to develop cavities, it is possible to use dental sealantssealants, which are protective applied on the chewing surfaces of the back teeth (the most difficult to clean with a toothbrush) to close grooves and fissures (potential plaque accumulation areas). Their use is possible for both children and adults.
  • Limit the consumption of foods that can easily get stuck in the spaces between teeth in the spaces between the teeth and in the grooves of the chewing surfaces (e.g. cookies, jelly beans). and in the grooves of the chewing surfaces (e.g., cookies, jelly beans).
  • Moderate consumption of sugary foods and sugary beverages.

How many types of caries are there?

Cavities are usually classified as follows: 
  • Acutewhen it develops in less than one year.
  • Chronicwhen it develops slowly and steadily for a couple of years.
  • Recurrentwhen it reappears if not adequately treated.
Furthermore, according to the process of caries formation, caries are divided into different classes: 
  1. Dry or arrested caries.
  2. Crown caries.
  3. Cervical caries.
  4. Cement caries or senile caries.
  5. Interdental caries.
  6. Central caries.
  7. Caries of milk teeth.

1. Dry or arrested caries

This type of caries receives its name because its progression stops at the surface layer of the tooth, i.e, only attacks the enamel and does not continue its development in depth.  The damage is essentially aestheticIt is a dark spot, especially when it occurs on the front teeth, and is totally asymptomatic.  In these cases, the organism itself is capable of coping with caries preventing or slowing its progression.  

2. Crown caries

This caries is the most common type of caries, affecting the part of the tooth visible outside the gingiva, the crown, for being the one most exposed to the effect of bacteria from food debris.  In intermediate stages, it is a cavity. easily diagnosableusually visible to the naked eye, usually can be detected in time before it starts its process towards the inside of the dental piece. 

3. Cervical caries

When caries affects the tooth neck areai.e, to the area closest to the gumis spoken of cervical or neck caries.  The main cause of this caries is, without a doubt, the accumulation of food waste in the grooves of the gums, product of a improper oral hygiene.  It is a stealth cariogenic process.not only because it starts in a hidden area of the dental piece, but also because often leads to other pathologiessuch as gingivitis and periodontitis. 

4. Cement caries or senile caries

This type of dental caries affects the tooth root being more frequent elderly people, hence the name senile caries. It can also affect those suffering from gum recession. In these cases, the gingiva does not adequately protect the tooth rootleaving the way clear for plaque and tartar are deposited.  Here, caries has it easy; it does not suffer much resistance from the structure of the tooth and easily and quickly reaches the inside of the tooth. In this case, the damage caused is irreversible, and the tooth extraction is almost inevitable. 

5. Interdental caries

It is undoubtedly the more insidious cariessince affects the interstitial enamelThe tooth is located in the space between two teeth and near the gums, eroding the enamel y delving into dentin and the tooth pulp.  The molar teeth are the more easily attacked by interdental caries due to their delayed position, larger interdental surface area and their greater difficulty to be cleaned in depth.  Difficult to detect with the naked eye, so the patient often comes for consultation when damage has progressed and the pulp has also been compromised. In this case, devitalization of the decayed tooth with reconstruction of the extracted part is necessary. 

6. Central caries

This is a unnoticeable cariessince originates from inside the toothslowly emptying it until the structure can no longer withstand the pressure exerted during chewing and the tooth breaks.  A cavity, therefore, that acts in the opposite way to the others, which start from the outside and extend in depth.  Often, a tooth affected by central caries is destined to be extracted. Only the can be diagnosed by X-rays and should be treated as soon as possible, to avoid the formation of granulomas, periodontitis and abscesses, or before it also affects the bone. 

7. Caries of milk teeth

Unfortunately, tooth decay in children is becoming more and more frequent. A improper nutrition and superficial oral cleaning are the most common errors that favor the appearance of caries.  Baby teeth are notoriously more fragile than the permanent ones. for having a less complex and less resistant structure.  Contrary to popular belief, decayed deciduous teeth should also be treatedeven though they are destined to fall out and be replaced by adult dentition.  This cavity, can cause periodontal damageThe germ of the permanent teeth, which are ready to erupt, is also affected. 

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