Tooth decay is one of the most common issues spoken about by dentists and health professionals. Unfortunately, it remains one of the most prevalent problems that people face. Despite the many warnings and treatments, tooth decay still affects many, and often in very significant and severe ways. But there are many ways to avoid letting your teeth decay and keep them healthy for longer.
How long does it take for a tooth to decay?
The process of decay does not have an exact timeline — it depends on individual levels of oral health and hygiene. Other factors include the type of foods you eat, smoking, and how often you visit the dentist.
In most cases, cavities develop progressively over years. However, they can rapidly form in a matter of months if you have poor dental hygiene practices. You might become aware of a cavity when you notice a persistent white spot on your tooth, even after brushing. Other signs your tooth needs filling or other treatment include lingering tooth pain or sensitivity.
Stages of tooth decay
If not treated early, tooth decay will progressively become more severe and the health impacts more significant. At earlier stages, dental intervention may be minimal and reversing tooth decay might be possible. However, by later stages, you will end up with teeth that need fillings, or teeth so decayed that keeping them in your mouth could be dangerous.
Demineralisation
Tooth decay begins with plaque, the sticky substance that forms on your teeth from leftover food particles. Bacteria builds up when plaque isn’t properly removed, going on to produce acids that attack your enamel.
Minerals make up your enamel, but when acids eat at your enamel, they lose these minerals. When there is enough mineral loss in a particular area, you will see a white spot appear close to the gum line on your teeth.
Enamel decay
Over time, these areas of mineral loss will darken from white into a brownish colour. This is an indication that a lesion has begun to form in the tooth, and your body is unable to remineralise your enamel. If caught early on, your dentist can protect this from progressing further using fluoride treatments or dental sealants.
However, because there are no nerves in the enamel, people typically feel no pain when they have lesions, and therefore aren’t prompted to visit a dentist. If unchecked, small holes known as cavities will emerge in your teeth. Cavities are areas of permanent damage
Dentine decay
Underneath the enamel is the dentine, a slightly softer tissue that forms the main supporting structure of the tooth. While softer than enamel, it is still the second hardest tissue within the body, but is more sensitive to damage from acids in the mouth.
When cavities damage the enamel, acids are able to reach through to the dentine and begin eroding it. Once at this level, tooth decay becomes more rapid. Dentine also contains a connection with the nerve of a tooth. Because of this, you may start to feel some pain or sensitivity at this stage of decay.
Pulp damage
Directly beneath the layer of dentine is the pulp, the innermost layer of the tooth. The pulp contains the blood vessels and nerves of the tooth, meaning that you may feel a great deal of pain when decay reaches this stage.
Pulp starts to swell due to the decay but is unable to expand within the tooth, creating more intense pain. Unfortunately, you will require more extensive procedures at this stage, particularly root canal treatment to remove the infected pulp.
Abscess
When infection of the pulp goes untreated, it can cause an infection of the tooth’s root itself, known as an abscess. This typically creates a pocket of pus at the bottom of the tooth which causes pain and swelling in the gums, face and jaw.
Once decay has developed into an abscess, it is important to get treatment as soon as possible. This infection can spread into the jawbone and then into other areas of the head. Surgery is almost a necessity at this stage, and you may need to have the affected tooth completely removed.
Can you reverse tooth decay
Depending on the level of decay in your tooth, you may be able to have different levels of treatment. Trying to deal with it as early as possible is always the best way to avoid the need for significant intervention from a dentist.
If decay or a cavity is caught early enough, you may actually be able to reverse the damage by remineralising the enamel. Remineralisation includes infusing the enamel with minerals like fluoride, calcium and phosphate, obtained from an improved diet and the toothpaste you use. Special dental remineralizing products like tooth mousse can also be used, but only as directed by your dental team.The deep grooves within the teeth are typically the most cavity-prone, so pay close attention to these when brushing your teeth.
Filling
A dental filling procedure fills a hole or cavity in your tooth to support its structure and prevent more erosion. A tooth filling is typically made from gold, composite resin or porcelain. Your dentist will begin by numbing the area with local anaesthesia and then they will remove any decay or debris. The dentist places and hardens a permanent tooth filling, and finishes by polishing the tooth. Bacteria will not be able to enter the enamel where it had previously decayed.
Root canal
A root canal treatment is used where the inner part of the tooth is exposed and pulp has become infected. Your dentist will observe the shape of the canals in your teeth with an x-ray and then drill a hole into the tooth and remove the infected pulp. Teeth are fixed with a crown after root canal treatment, once the canal has been cleaned and refilled.
Tooth extraction
If decay has reached the innermost tooth areas, sometimes the only way to treat it is by removing a tooth. Your dentist will provide a local anaesthetic to begin the procedure and then use a special tool to loosen the tooth in the gum, before pulling it out. You will not feel any pain, but depending on the position and complexity of the extraction, your dentist may advise doing it under general anaesthetic. Your dentist will then potentially stitch up the wound and use gauze to create a blood clot in the empty space. You may wish to replace the extracted tooth with an implant once the site has healed.
How to prevent tooth decay
The best thing you can do to avoid tooth decay is keep up good oral hygiene practices, including brushing at least twice a day and flossing at least once a day. Other helpful dental care tips include:
- Mouthwash: After brushing and flossing, using a bit of mouthwash can help reduce food particles and plaque, while also preventing bad breath.
- Sugar Limits: Do your best to reduce the amount of sugary foods and drinks you consume, as sugars linger in the mouth and generate acids which cause decay.
- Toothbrush Replacements: Replace your toothbrush every three to four months, or sooner if your bristles become frayed and worn out.
It is important to be very diligent with dental care in children. The enamel of baby teeth is thinner than adult enamel, making it more sensitive and prone to decay from acids. Make sure that you are cleaning their teeth gently and regularly to keep them healthy, and show your children the importance of good oral care.
Avoid permanent damage
While the earliest stage of decay might be reversible, patients will always require treatment in some form beyond that. Get on top of decay early and have a consultation with one of our dentists or oral health therapists. They can help identify what treatment you need, and help you take good care of your teeth going forwards.
