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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Tooth Decay

Dental plaque may erode the tooth's outer protective enamel so that bacteria can invade the soft dentin and pulp, leading to an abscess.

What is it?

Tooth decay is caused by bacteria that normally dwell inside the mouth. These bacteria combine with food particles and mucus to form dental plaque, a sticky, colorless film that builds up on the teeth. The bacteria in plaque break down sugars to produce acids.Without proper oral hygiene, these acids may gradually erode the tooth's hard protective layer of enamel, forming cavities.Once the acids have penetrated the enamel, they can then attack the softer layers of tissue inside the tooth (the dentin and the pulp, which contain nerves and blood vessels), resulting in a toothache. Eventually, bacteria may invade the pulp, causing an infection that leaves the tooth vulnerable to a potentially dangerous abscess, characterized by severe pain and infection of the jaw. For this reason, tooth decay should be treated promptly.

What Causes It?

  • Poor dental hygiene causes tooth decay.
  • Sugary or starchy foods and drinks may promote tooth decay.

Prevention

  • Brush your teeth at least twice a day, using a soft bristle toothbrush and a fluoride toothpaste. Scrub with a gentle circular motion, then brush vertically, away from the gums. Brush your tongue too; it collects the same bacteria that stick to the teeth.
  • Floss daily. Ease the floss between the teeth, forming a crescent against one side of a tooth. Gingerly scrape up and down, from just under the gum line to the top of the teeth.
  • Fluoride mouth rinses offer additional protection.
  • Ask your dentist about the benefits of irrigation devices such as Waterpik or plaque removal devices such as Interplak.
  • Schedule a dental checkup at least once a year.
  • Limit your consumption of sugary drinks and sweet, starchy, or sticky foods.

Diagnosis

  • A dental examination is performed.
  • Dental x-rays may be taken.

How to Treat It

  • For a toothache, use ice packs, aspirin, or acetaminophen until you receive professional help. (Schedule an appointment with a dentist immediately.)
  • The decayed section of tooth will be removed and then filled with a metal alloy or plastic resin.
  • If a tooth is severely decayed and in danger of being lost, a root canal may be needed. The nerve and pulp of the tooth are removed leaving only the hollow tooth and roots. The cavity is then sterilized and filled with cement, and the tooth is fitted over with a metal or porcelain crown.
  • In the case of extensive decay or an abscess, extraction may be required if the tooth cannot be restored.

When to Call a Doctor

  • See a dentist regularly.Make an appointment promptly if you develop a toothache.