Tooth decay- Different types and their treatment

Decayed tooth

Tooth decay, which is also known as dental caries, is the destruction of the outer layer of the tooth surface called enamel. Cavities (holes) can occur on the tooth surface as a result of tooth decay. When this decay progresses to the inner tooth layers called dentin and pulp, it can result in pain and sensitivity. When the treatment of tooth decay is delayed, various dental problems like infections, abscesses, and eventually tooth loss may occur. There will be sensitivity when the decay reaches the dentin and extreme pain when the decay reaches the pulp. Therefore, prompt diagnosis and treatment of the damaged tooth are required.


How can you know if you have a decayed tooth?

There is usually no pain or sensitivity when tooth decay is present on the outer surface (enamel). However, progression of the decay into inner layers such as dentin and pulp may cause symptoms. The following signs and symptoms may be present:

  • Tooth pain– A continuous, dull pain is present at rest, and sharp pain is present while biting or chewing food on the side of the decay.
women in tooth pain
  • Sensitivity– When the dentin portion of the tooth is exposed, the patient might encounter extreme pain and discomfort which occurs mostly while drinking anything hot or cold. This pain is specific to a particular tooth may indicate the presence of a decayed tooth.
women biting ice
  • Holes or pits on the tooth surface- Intake of foods containing excess sugar, and starchy foods and drinks attract bacteria. These carbohydrates are changed to acids by bacteria. A substance called plaque is formed when the bacteria, saliva, acid, and food are mixed. The tooth is covered by this substance. The acids present in the plaque break down the enamel which leads to cavity formation.
cavity in dentist lens
  • Foul breath and unpleasant taste- Due to waste generated by bacteria inside the mouth, a bad breath, and an unpleasant taste usually develop. You must visit your dentist when you have a persistent bad breath.
bad breath men
  • Swollen gums- If the cavity is present adjacent to the gums, and the tooth is infected, this can affect the adjoining tissues leading to swollen or bleeding gums.
swollen gums
  • Noticeable brown/dark areas on the tooth surface- The initial signs of decay are dark spots on the tooth surface which may seem like mild staining. Eventually, this spot becomes larger. Decay might also start as a white spot on the tooth and become a cavity later on.
dark decay tooth

What are the different types of decay?

Tooth decay can progress to all layers of the tooth- enamel, dentin, and pulp. It takes a long time (almost 3 years) for a cavity to form on the outer portion of the tooth (enamel). Progression from the dentin to the pulp (innermost layer) is fast. Different types of dental caries are:

  • Occlusal or smooth surface- In this type, only the enamel is affected. This is a slowly progressing decay and can be prevented, and reversed in some cases. It is commonly present on the molars (teeth at the back of the mouth) as they are difficult to clean.
occlusal surface of teeth
  • Treatment- Toothpaste containing fluorides, treatment with fluoride gels, varnish, and using water containing more fluoride.
toothbrush & tooth paste
  • Pit and fissures- This type of decay is commonly present on the chewing surfaces of the molar teeth. They occur on grooves and fissures of teeth. This type of decay is common in people who do not brush properly or fail to brush regularly. Plaque accumulates in the grooves and fissures of these teeth and leads to tooth decay.
pits and fissures in teeth

Treatment- If pit and fissure decays are identified in an earlier stage, treatment can be done with pit and fissure sealants.

before and after pits and fissures

If the cavity becomes deep and is up to the level of the dentin, the dentist has to remove the decay and restore the teeth with a filling.

cavity filling

If the cavity is up to the level of the pulp, the dentist has to remove the decay, perform a root canal treatment and fix a crown on the tooth.

  • Root decay- This type of decay is present on root surfaces. It is most commonly observed in elderly people as their gums start receding and their tooth surfaces are exposed to plaque and acids. This kind of decay can also occur due to poor oral hygiene.
Root decay

Treatment- Cavities in the root surface can be treated by filling using a material called composite. When the cavity is present at the level of the pulp, the pulp along with the decay is removed; the area is cleaned and then sealed to prevent any infection. This procedure is called root canal treatment.

root canal treatment

As the remaining structure of the tooth is thin and weak, a crown is fixed.

dental crowns

Tips to prevent tooth decay:

In today’s world, dental decay is a common problem. Pain, anxiety, and complex treatments can be avoided when some tips for good oral hygiene are followed:

  • Brushing twice a day and using a mouth wash following every meal.
  • Changing your toothbrush once in three months.
  • Reducing consumption of sugary foods and drinks.
  • Visiting the dentist often (at least twice a year) for checkups and cleaning.

General Dentistry

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