Caries: How it develops and how you protect yourself

Caries (dental caries, tooth decay)

The most important facts at a glance

19.10.2016, 13:06 hrs | Ann-Kathrin Landzettel

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Caries is a disease of the teeth. Bacteria in dental plaque decompose tiny components of food residues and form acids. These attack the tooth substance and lead to holes in the enamel if oral hygiene is inadequate.

Causes: How caries develops

Even though enamel is the hardest material in the body, it is not indestructible. There are three main risk factors for tooth decay: frequent sugar consumption, poor oral hygiene and plaque. Plaque is the ideal breeding ground for caries-forming bacteria (especially streptococcus mutans and lactobacilli). If they decompose the food residues and the contained sugar, acids are formed as a waste product. These attack the tooth enamel and lead in the first step to a decalcification of the weakened tooth surface. The affected area shows a light whitish colour and offers the bacteria an additional surface of attack. Without adequate dental care, the enamel becomes softer and softer. Eventually a small hole forms. This must be drilled out by the dentist and provided with a filling. If this does not happen, the caries eats through the tooth crown to the tooth root and finally destroys the dentin bone and the tooth nerve.

Caries: The three stages of dental disease

Initial caries: Initial caries refers to the initial stage of a caries. Here small white decalcified areas are visible which are particularly susceptible to caries bacteria. At this stage only the enamel is affected. The progressive destruction can still be stopped by good oral hygiene and fluoride toothpastes.

Dentine caries: As the disease progresses, the small white area of the enamel turns yellowish-brown and becomes increasingly soft. Bit by bit the caries continues to eat through the enamel and eventually reaches the dentin. There it spreads further and literally undermines the enamel. So it can happen that one day a part of the tooth suddenly breaks off. Usually, the diseased tooth only becomes noticeable as pain at this stage.

Deep caries (caries profunda): In deep dental caries, two thirds of the dentin is already destroyed. If the tooth decay has eaten through to the nerve, the patient suffers from very severe pain. If the deep caries remains untreated, the tooth dies.

Symptoms: In these complaints to the doctor

The earlier tooth decay is treated, the lower the damage to the tooth. Regular check-ups at the dentist help to detect the beginning of tooth decay at an early stage. Even if you notice changes in your teeth or gums or experience pain, you should see a doctor as soon as possible.

One of the main symptoms of caries is a caries:

in the initial stage small whitish, later light to dark brown discolorations on the tooth surface
increased sensitivity to cold and heat (pulling in the tooth when eating ice cream or hot drinks)
soft spots on the tooth surface
swelling of the gums
bleeding of the gums
later pain
chipping tooth parts

Treatment: What the dentist does

The dentist examines the affected tooth carefully. If necessary, he will carry out an X-ray examination to determine the extent of the infestation. The x-ray also shows whether caries has formed under a filling or in the interdental spaces. In the early stages it is often sufficient to brush the teeth regularly with a fluoride-containing toothpaste or to have the dentist apply a fluoride gel to the teeth.

If the enamel is already soft or small holes have formed, treatment is necessary. In order to prevent pain during treatment, an anaesthetic injection is often used. The dentist then drills out the affected area and fills it. Plastic, ceramics or precious metals are usually used for this purpose. Amalgam is criticized because of the mercury load. Many doctors therefore no longer use such fillings and advise their patients to gradually replace existing fillings with other materials. If you have amalgam fillings and are unsure about your personal health risk, it is best to arrange a consultation appointment.

If the tooth is more severely damaged, a crown may be necessary. The treatment is often accompanied by root canal treatment. Sometimes the whole tooth has to be removed. This is then replaced by an implant or a bridge.

First aid: What can relieve toothache?

Toothache usually occurs at the most inopportune moments: on Saturdays before going to bed, on holiday or on a business trip. If it is not possible to go to the dentist quickly, painkillers such as ibuprofen or paracetamol can alleviate the symptoms for a short time. Chewing a clove can help. The essential oil eugenol has a slightly anaesthetic and disinfecting effect.

Prevention: Keeping your teeth healthy

The risk of tooth decay can be reduced by brushing your teeth and removing plaque after meals. Important: Do not grasp your toothbrush until 30 minutes after eating. The acids in the food soften the enamel and too much brushing can rub it off (abrasion). It takes some time for the saliva to neutralize the acids and remineralize the tooth surface.

Dental floss is also an important measure for oral hygiene. It reaches the places where the toothbrush cannot reach. The use of fluoride toothpaste strengthens the enamel and makes it more resistant to acids. In addition, sugary foods should only be consumed in moderation and good oral hygiene should be ensured after consumption.

Regular check-ups at the dentist are also important for dental health. They should be taken twice a year. Not only can tooth decay be detected at an early stage. The regular removal of tartar reduces the risk of tooth decay. Small decalcified areas can be treated with fluoride.

Once a year: Professional dental cleaning (PZR)

As bacterial plaque is the main cause of tooth decay, its removal is one of the most important measures in the fight against tooth decay. Dentists therefore recommend that, in addition to dental hygiene at home, professional dental cleaning (PZR) be carried out once a year. With special instruments, the dentist can remove stubborn deposits and bacterial plaque from places that are difficult to access, thus removing the breeding ground for bacteria. In addition to a powder jet cleaner that works with a salt-water mixture, dental floss and fluoride gel are also used. The treatment takes between 30 and 60 minutes.

Although the medical benefit of dental cleaning is undisputed, the patient has to pay the costs himself. The PZR is not included in the service catalogue of the statutory health insurance funds, but counts as an individual health service (IGeL). The costs are dependent on the expenditure and can amount up to 150 euro. However, some health insurance companies cover part of the costs. It is best to ask your health insurance company before treatment.

Important note: The information is in no way a substitute for professional advice or treatment by trained and recognised doctors. The contents of t-online.de cannot and must not be used to independently make diagnoses or start treatments.