Tooth decay: prevent the hole in the tooth and heal, casa dentalis

Tooth decay: prevent the hole in the tooth and heal, casa dentalis

Hole in the tooth: recognize, prevent and heal

Hole in the tooth: recognize, prevent and heal

Table of Contents

What is caries??

Most know caries as a hole in the tooth. This description is true, but not really precise.

More specifically, caries refers to the destruction of hard tissue, tooth enamel and dentin. Dentin represents the majority of the actual tooth and is the layer under the enamel.

Bacteria that accumulate in the plaque feed on sugar, which they then excrete in the form of acids. These in turn attack the dental hard tissue, the enamel and the dentin and destroy it.

Often, especially the molars of holes are affected.
No wonder.

They are the hardest to reach for dental care and only poorly visible. They are therefore often neglected and are particularly vulnerable.

The emergence of tooth decay

Plaque, or biofilm, is composed of various bacteria, food remnants and saliva, which combine to form a sticky substance. This then settles on the teeth.

The bacteria contained in the plaque feed on carbohydrates from our diet, mainly sugar. They convert it and excrete it in the form of acids.

These in turn attack the enamel so that it becomes porous and harmful microorganisms can penetrate into the tooth and then destroy it from the inside out.

The saliva contains minerals that constantly remineralize the enamel.

However, this regeneration process can not take place if it is interrupted by the frequent intake of sugary food and drinks.

These supply the bacteria constantly, so that the natural balance is disturbed.

As a result, holes are formed in the teeth.

How fast do you get holes??

It depends entirely on the dietary habits of each individual. The sugar content of the food, as well as the bacteria in the mouth and how long the teeth are exposed to the acid, also influence the development of tooth decay.

Also the condition of the teeth has an influence on it. Wells and crevices are ideal storage places for plaque, at which then unnoticed holes can arise.

These places are difficult to reach with the toothbrush and even with dental floss.

How can you prevent holes??

Fortunately, you are not simply exposed to tooth decay. You can actively do something about you. What these actions look like is explained in this chapter.

The right dental care

Ideally, you should brush your teeth twice a day for 2 minutes. It is best to do this after getting up or before going to sleep.

Try to avoid brushing your teeth immediately after eating, as this can be detrimental.

Part of the proper dental care is that you use dental floss. The floss reaches places you would not be able to reach with the toothbrush alone. For example the interdental spaces.

You can also use a fluoridated toothpaste and an antibacterial mouthwash.

The right diet

As we have already noted, sugar is the biggest health hazard to your teeth. So you should as far as possible sugary foods and drinks such. Avoid chocolate, gummy bears, coke and energy drinks. Even acidic drinks such as red wine or juices have a harmful effect on your teeth.

No one demands that you renounce these things altogether, but you should enjoy them in moderation.

Drink unsweetened tea and plenty of water. These stimulate the salivation and, as already described, support the remineralization of the enamel.

Smoking harms your teeth

The smoking of cigarettes or other tobacco products not only discolors the teeth unpleasantly yellow, but also harms the dental health.
The nicotine inhibits the production of saliva and thus complicates the natural remineralization of the enamel.

The regular visit to the dentist

Regular check-ups at the dentist, as well as the semi-annual prophylaxis are essential to ensure the long-term health of your teeth.

As already mentioned, tooth decay forms especially in tight spaces and is therefore difficult for you to recognize.

Your dentist knows best whether and to what extent a caries risk exists and can initiate appropriate measures.

How can you recognize caries in good time??

Caries does not just pop up suddenly, but builds up over different stages. Often, however, it is recognized much too late, because the holes are formed mainly in hard to reach places and difficult to recognize.

In this section we will therefore explain to you the various stages of tooth decay and the symptoms in which you can recognize them.

1st stage: Caries in the initial stage (initial caries)

The initial stage of caries is usually painless. It is characterized by the demineralization of the enamel, which occurs due to the acid secretions of the bacteria in the plaque.

This makes the teeth more sensitive to cold and heat, as well as sweet and sour. As a result of the attacked enamel also bright, in some cases already transparent, small spots on the teeth form.

Cold and heat sensitivity, as well as an increased sensitivity to sweet and sour foods.
Light or transparent spots on the teeth.

The stains are usually difficult to detect, even for the dentist. If you notice an increased sensitivity of the teeth to cold, heat, etc., tell them to your dentist.

He will take an X-ray of your dentition as it is the most reliable way to prevent holes in your teeth.

2nd stage: Caries attack of the dental bone (dentin caries)

Once the enamel has been destroyed enough, the dentin can be attacked. The dentin makes up the majority of the actual tooth.
If this is now affected by tooth decay, you will feel significant toothache.

The destroyed parts of the enamel will have turned brownish by now. In addition, holes are usually already recognizable in the teeth.
You will feel significant toothache.

3rd stage: Deep dental caries

The tooth decay will continue to feed on the tooth. After the dentin, it usually affects the pulp (Pulpa) in which there are also blood vessels and nerve tracts of the tooth.

If the toothpaste is inflamed, it is noticeable by very strong toothache and can often only be treated by a root canal treatment.

Strong toothache in combination with clearly visible holes and a foul breath (caused by the inflammation of the dental pulp) are clear symptoms.

4th stage: Inflamed tissue (abscess)

If nothing has been done up to this stage, the tooth decay can also attack the surrounding tissue.

Ligaments, bones and gums are at risk in this case.

It can form a Zahnabzess that is incredibly painful and in the worst case can lead to the loss of the tooth.

Extreme toothache, as well as swelling around the inflamed tooth, to the point of tooth loss.

What does a caries treatment look like??


The fluoridation of the teeth is a very effective measure to prevent holes. Already in childhood, it is done preventively.

The regular and thorough cleaning of teeth with a fluoride-containing toothpaste and floss is often enough.

If the caries is already in the early stages, your dentist will seal the surfaces of the teeth with a gel or varnish containing fluoride.

This measure serves to provide the tooth with the necessary minerals, which it needs for the regeneration of the enamel.

The dental seal

The sealant is applied to the tooth in the form of a fine layer of synthetic lacquer by the dentist.

It compensates for unevenness in the tooth and smoothes grooves in the tooth surface. This provides the caries fewer attack surfaces on the tooth.

Although a sealant does not prevent the spread of decay, it can help keep the tooth healthy in the long term, as it acts as a protective coating for the tooth enamel.

The chemomechanical removal

This becomes necessary as soon as the first stage is exceeded and the decay has affected the dentin.

Here, the enamel layer is drilled out to make the caries on the dentin accessible. The affected tissue is then dissolved with a chemical agent and then removed with a hand tool.

No need to worry: this process is usually painless despite drilling, so patients can do without local anesthesia.

The filling

When filling (colloquially also called seal), the tooth must be pretreated with a drill to remove the caries-infected tissue. As little natural tooth substance as possible is removed.

Then you can choose between different filling materials or alternatively between different inlays. These are mostly made of gold or ceramics.


As long as the root of the tooth is intact, but the crown is severely attacked or destroyed, your dentist can put a crown on it for you.

It protects the remaining tooth and allows you to chew it again without restrictions.

First, an impression is taken and then the remaining tooth sanded to make a perfectly fitting crown of plastic, ceramic or metal. A distinction is made between full crowns that completely cover the tooth and partial crowns that only partially obscure the tooth.

The laser treatment

Treatment with a laser has the great advantage that it works without any drilling and is therefore particularly suitable for anxiety patients.

The disadvantage of this treatment method, however, is that it is only possible in certain cases and not every practice has a laser.

Nonetheless, treatment with the laser is virtually painless.
The caries-affected areas are accurately removed and the healthy tissue is not injured.

From case to case, a mechanical treatment in the form of a rinse or disinfection with a solution may be necessary.

Even after a dental treatment, infections may still occur.

For example, if bacteria gather under the filling, the caries may re-spread and cause pain again.

In this case you should not hesitate and should contact your dentist immediately.

More about the secondary caries can be found in the following chapter.

Secondary caries

Secondary caries describes the case of a new caries disease of an already treated tooth. This usually develops on the edges of dental crowns, fillings or inlays and on the actual tooth. Through a gap, bacteria can then easily penetrate and cause a renewed caries disease.

A lack of oral hygiene, as well as insufficiently treated filling margins by the dentist may be the reason for this.

Caries under the filling

This form of secondary caries can not be determined by the naked eye.
When bacteria accumulate under the fill, they unknowingly damage them and are protected from any hygienic measures.

In some cases, they are noticeable by a bluish glow on the rim of the filling, but only an X-ray image provides certainty here.

Caries under a crown

Similar to the caries under the filling, the caries on the crown edges can not be detected with the naked eye. The crown margins are usually at the border or below the gum and therefore can only be detected by scanning or X-ray images.
If the caries infestation lies under the crown itself, it is difficult to recognize on an x-ray.

Tooth decay in children

Even children’s teeth can be affected by tooth decay. In principle, this is possible from the first deciduous tooth. The main reason for the child caries is sugar.

Experts warn against handing out sugary drinks with the vial, as they attack the incisors. Every 10th child up to the age of 3 is already affected by the so-called “Nuckelflaschenkaries”.

If it is not recognized and treated, it can cause life-threatening conditions for the child in the form of fever and abscesses.

To prevent these cases, it is advisable to wipe the first teeth twice a day with a cotton swab or a damp cloth.
From the 6th month then with a fluoride-containing toothpaste.

Children should be taught early to drink from a glass, so they do not get used to the sucking.
In addition, you should visit a pediatric dentist from the first teeth, as the foundation for healthy teeth is already laid in childhood.

Caries is contagious?

The answer is yes, tooth decay can actually be contagious. Especially with the transition from deciduous teeth to permanent teeth there is a risk of infection.

Caries bacteria can also be transferred from the mother to the child, e.g. while licking the pacifier. When kissing infants and adults, however, there is little risk of infection.
The few bacteria that are transmitted during regular dental care can do no harm.


Everyone can be affected by tooth decay. The reasons for a disease are varied, but can mostly be attributed to a sugary diet and poor oral hygiene.

The consequences of a caries disease can in the worst case lead to the loss of one or more teeth. But it never occurs suddenly, but makes itself felt in several stages.
So be careful and do not ignore the hints your body is trying to give you.

Tooth decay can be treated, but it is best if this treatment is not necessary.

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Christina Cherry
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