Caries:
Symptoms, complaints, causes, treatment

If a tooth is affected by caries, a process is underway that breaks down the tooth structure and ultimately creates a hole that the dentist has to fill with to prevent the disease from progressing.

Caries is probably the most common dental disease. Almost everyone has a tooth with tooth decay over time, whether on the deciduous teeth in childhood or as an adult on the permanent teeth.

Important influences that contribute to the development of tooth decay are dental hygiene, the choice of food and the consumption of stimulants. If tooth decay is not treated, the breakdown process continues. It is symptomatic of tooth decay that teeth turn dark and sometimes painful.

What is tooth decay?

Although caries is generally equated with the well-known "hole in the tooth", it means the change in the tooth substance that protects the tooth externally.

Basically, caries begins before this process begins. Because for the time being, the tooth substance begins to demineralize, i.e. to descale. This is caused by acid-forming bacteria, which only cause a hole in the tooth if the decalcification is not stopped.

Symptoms of tooth decay

The most common symptoms of one or more carious teeth are:

Sensitivity to heat and cold
Sensitivity to sweet and sour foods / drinks
toothache
Accumulation of leftovers between the teeth
kre >What types of tooth decay are there??

In the professional world, a distinction is made between several types of caries, which are primarily determined at the stage at which the tooth structure is broken down by the bacteria, depending on how much tooth structure the bacteria have already destroyed. While the tooth surface is still intact in the case of initial caries because decalcification is still in the early stages, in the case of established caries the surface of the tooth is already damaged.

Further subspecies are distinguished depending on the affected layer of the tooth:

Tooth enamel caries (caries superficialis)

Has damage in the outermost layer of the tooth.

Dentine caries (caries media):

Has damage up to the second layer (the so-called dentin).

Profound caries (Caries profunda):

Shows damage in all layers down to the tooth pulp, where nerves are also located.

Caries sicca that has stopped:

Refers to the standstill of a previously identified tooth decay.

Caries expresses itself differently depending on the age of the patient and the affected area in the mouth.

Caries in toddlers and children

In young children, caries occurs primarily on the incisors and on the gums surrounding them, from where the infection can progress to the tooth edge. This type of caries is also known as a “feeding bottle caries”. Deficiency is primarily due to poor nutrition, such as tea sweetened with industrial sugar or the consumption of fruit juices in baby bottles.

Older children and adolescents have tooth decay primarily on the chewing surfaces of the teeth, although the reasons for the development here too lie in a sugar-heavy diet.

In general: When the first tooth breaks through in your toddler’s mouth, the mouth should be gently cleaned with a soft, special children’s toothbrush. As soon as all milk teeth are in place and the swallowing reflex occurs, brushing your teeth twice a day is recommended. In addition, the same applies to children as to adults: regular check-ups at the dentist help to identify, stop and cure tooth decay early. In addition, children up to the age of eight have to be cleaned by their parents to ensure good oral hygiene.

To explain the development of caries to children, there has been the comic series »Karius und Baktus« since the 1950s, which shows how caries can develop in colorful, easy-to-understand images. The two famous bacteria are still useful today to playfully motivate children at the dentist to keep their milk teeth healthy.

Caries in adults and in old age

Caries of teeth in adults occurs mainly between the teeth. Inadequate oral hygiene can be just as responsible for the disease of the teeth as too many sweet drinks or foods.

From around 60 years of age, the likelihood of caries developing on the tooth necks increases, which is mainly due to the fact that the gums often regress in older people and lead to exposed tooth necks. Because the natural protective layer in this area is not as hard-wearing as in other places, a hole in the tooth is formed more quickly. This type of caries is therefore also called root caries.

How does caries develop?

Because caries means the progressive destruction of the tooth structure, both a single tooth and several teeth can be affected at once. The symptoms of caries are different, depending on the stage of development of the caries.

At the beginning, in the so-called initial stage, it is characterized by changes in the outermost layer of the tooth. Then chalk-like, white stains slowly develop on the teeth, minerals dissolve from the tooth substance, and the tooth enamel also gradually becomes porous. If teeth turn dark, this can also be a sign of tooth decay, as dyes have already been deposited in the decalcified zones.

At this point, however, the mineral loss of the affected tooth or teeth could still be cured: regular, thorough brushing of the teeth would successfully remove the caries bacteria, especially since the fluoride in the toothpaste causes the saliva with its mineral content to compensate for the loss of tooth structure.

Why early caries treatment is so important

The advanced stage of caries only arises if oral hygiene is incorrect or inadequate. Because only teeth that are poorly cleaned show a progressive demineralization, so that a hole is created in the tooth. Now the disease of the tooth can also become painful, but at the latest when the nerves of the teeth are affected. Then there may also be an increased sensitivity to heat, cold or sweetness.

If it is left untreated, the caries progresses and can attack a whole range from just a single tooth. If this process is not interrupted, the pain will increase.

Causes of tooth decay

Caries is dependent on a variety of factors, the most important being bacteria, dental hygiene and individual eating habits.

Causes of tooth decay: keyword bacteria

On average, there are more than 700 types of bacteria in the mouth. Many of them play a very important role because they stabilize the healthy oral flora. However, there are bacteria that live primarily from sugar and therefore gratefully accept all the sugar found in food, break it down and later excrete some acidic metabolites as waste products. It is precisely these acids that attack the enamel and cause demineralization, which can mean the beginning of caries.

Causes of tooth decay: Keyword dental hygiene

Brushing your teeth thoroughly will reduce the number of bacteria in your mouth. In particular, after eating, a coating gradually forms on the surface of the tooth, which mainly consists of bacteria and constituents of the mouth saliva. This so-called plaque becomes thicker over time if the teeth are not cleaned regularly and carefully.

This dental plaque provides the caries-causing bacteria with ideal environmental factors that they can survive protected here. This also explains why people with inadequate dental hygiene suffer from tooth decay much more often than those for whom regular tooth brushing is routine.

It is only sometimes advisable not to brush your teeth, namely after eating acidic foods such as cola or citrus. Then it should take about 30 minutes for the teeth to be brushed, otherwise the acid can make the tooth enamel rough, making the tooth substance more prone to abrasion when brushing.

Causes of tooth decay: Keyword candy and sugary food

People who eat a lot of sweets generally have a higher risk of tooth decay. Especially the common white industrial sugar (sucrose), glucose (glucose) and fruit sugar (fructose) nourish the bacteria responsible for tooth decay and can therefore be harmful to the teeth.

In contrast, so-called long-chain sugar compounds, such as those found in complex carbohydrates, are harmless. Whole grain products should therefore always be integrated into the menu.

Causes of tooth decay: keyword saliva

If enough saliva is formed, the minerals it contains will replace the loss of tooth structure. Larger amounts of saliva are also useful for making food in the mouth liquid and thus better preparing it for digestion. Instead, less stored food residues would get stuck on the teeth.

On the one hand, saliva contains components that can neutralize acid and, on the other hand, have an antibacterial effect. If the salivation is low, this favors caries development. Because the interdental space and the tooth crown are optimal breeding grounds, on which food that has not been spewed in can adhere.

If caries occurs repeatedly: secondary caries

If a hole has already appeared in the tooth and has been medically filled accordingly, it cannot be ruled out that the tooth will be affected by caries again. On the contrary, it is not uncommon for teeth to have so-called secondary caries.

Over time, tiny gaps can form in the area of the tooth and tooth filling or tooth and crown that are too small to be cleaned by the toothbrush. Unfortunately, they are still large enough to provide a breeding ground for bacteria.

Caries is contagious?

Since caries is a bacterial infection from a medical point of view, the same applies to it as to other bacterial infections: it is contagious. However, there is almost no risk of infection with caries in everyday life, since the caries-promoting bacteria initially have every person in the mouth. Certain individual risk factors must also be added to caries.

For this reason, kisses or eating the same cutlery, for example, are not responsible for infection with caries. The likelihood is slightly higher in young children, since children generally have a lower number of balancing bacteria and microorganisms in the mouth than adults. For this reason, toddlers should not eat the same cutlery or pacifiers should not be "cleaned" by the parents’ mouths to prevent colonization.

Even if it is sometimes said that caries is hereditary, this information is not correct. It is true that caries can occur more often in some families because of other inheritable factors. Deep tooth grooves, so-called tooth fissures, are a risk factor for the development of caries, for example. Habits such as inadequate oral hygiene and lots of sweet food often affect the whole family.

How is caries diagnosed??

When examining your teeth, the dentist can usually quickly find a caries infection using a mirror. Caries is clearly visible on the surface of the teeth, and the degree of damage to the tooth can also be quickly determined. After a relatively short examination, your dentist knows whether the caries has already penetrated deeply into the tooth.

In addition, by answering a few questions, you will be able to help shed light on your caries infection. Such questions can include:

How long have you had complaints?
Do relatives of yours have similar dental problems?
Have you had problems with your teeth before??
How often do you brush your teeth every day?

In contrast to advanced caries, the infection is rather difficult to detect in the initial stage. Therefore, it is often only discovered by chance, for example after X-rays, because carious spots are often clearly visible on X-rays.

There are also other methods that are used in modern caries diagnosis. For example, electrical resistance can be measured and different fluorescence methods can be used:

When it comes to electrical resistance measurement, healthy tooth enamel conducts electrical current. If the tooth is affected by caries, the conductivity increases so that the electrical resistance decreases measurably. Fluorescence methods, on the other hand, are based on the fact that hard tooth substance glows in the dark under certain conditions. However, this fluorescent property depends on the condition of the tooth structure, because tooth structure affected by caries fluoresces differently than healthy ones.

How can caries be combated successfully??

If caries is detected in the early stages, the underlying mineral loss can still be compensated for by the body. However, if a hole has already formed in the tooth, professional caries treatment is necessary.

Once the caries has been identified and successfully treated, there are usually no more complaints to worry about. However, caries treatment is no guarantee that there will be no new symptoms. The most important thing is regular, careful oral hygiene: if it is neglected, the caries will be given a new breeding ground. Milk teeth in particular tend to have repeated caries infections.

In general, it is usually more difficult for children to change their food and hygiene habits. Therefore, parents should keep an eye on their improved habits after caries treatment for their children. Whether in children or adults – routines that are beneficial to health are the prerequisite for the prevention of tooth decay.

Early caries treatment

If caries is still in its early stages, only slight changes can be seen on the surface of the teeth, but a hole in the tooth has not yet formed at this point. Dental treatment is not necessary at this stage.

Instead, you should pay attention to the most thorough oral hygiene and also rethink your eating habits. Because those who eat foods and beverages with a high sugar content increase the risk of caries infection. Fruit sugar (fructose), which is mainly found in fruit and pastries, can also damage the teeth.

Caries bacteria can be successfully combated by thorough brushing of teeth. And with its fluoride content, toothpaste means that the body’s saliva, thanks to its mineral content, can compensate for the loss of tooth structure.

Caries treatment in advanced stages

As soon as the caries infection has penetrated beyond the surface into deeper layers of the tooth, professional caries treatment is necessary. Depending on where the damage is and how far it has progressed, there are different options to stop and remove the caries.

As a rule, this requires drilling on the tooth. Local anesthesia can be used for this, which enables painless treatment. The purpose of drilling is to remove softened tooth substance from the tooth. The area around the borehole is then cleaned, filled and sealed from the outside.

If a lot of tooth substance has already been lost in the course of caries infection, the tooth shape must first be restored. On the other hand, if the caries is close to the tooth nerve, another therapy must be carried out. Because if the nerve tissue is possibly damaged, it has to be removed in some cases, which is done with a root filling. For this supply, the root canal system is filled with a special substance that stimulates the formation of new substances. After the root filling, the regular tooth filling can easily follow.

Caries treatment with one tooth filling

Which filling is used to treat a carious tooth depends on the choice of material and the costs incurred, some of which are not borne by the statutory health insurance companies. Possible materials for a tooth filling are:

ceramics
Plastics / composite
metal alloys
amalgam

How to prevent tooth decay every day

If you manage to adopt a few rules for your everyday life, you will have almost no chance of tooth decay.

Above all, this means thorough, regular oral hygiene and the selection of your food. Drinks and foods that are heavily sugary should only exceptionally end up on the menu. If they have been consumed, it is advisable to brush your teeth thoroughly after eating. Incidentally, this also applies to any other meal: when brushing your teeth, food residues on the teeth and in the gaps are removed, and the bacterial build-up also decreases.

If you are unable to brush your teeth, chew gum with xylitol after eating. Xylitol is a sugar substitute that stimulates the formation of saliva and can balance the acids formed by the harmful bacteria.

In addition, regular dental checks help to detect, stop and cure tooth decay early. Professional dental cleaning carried out twice a year also makes an important contribution to this aspect of dental health.

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