The causes of dental caries formation

Written by Li Bao Hua
Dentistry
Updated on September 23, 2024
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The causes of dental caries include bacterial factors, dietary factors, the tooth's own factors, and time factors, also known as the four-factor theory of dental caries. Dental caries initially result from bacterial infection. Under such infections, the hard tissues of the tooth undergo a chronic destructive deterioration; over time, this results in cavity formation. That is to say, the formation of dental caries primarily occurs under bacterial infection. Additionally, diet is a main cause of dental caries, especially sugary foods. Bacteria use glucose to produce acid, leading to tooth demineralization and cavity formation. Moreover, congenital calcium deficiency in teeth, leading to incomplete enamel development, is also an important cause of dental caries. Furthermore, the formation of dental caries requires a certain time factor.

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How to prevent cavities in children

Prevention of tooth decay in children should first encourage them to develop good tooth-brushing habits, reducing bacteria and plaque on the tooth surface, and include brushing in the morning and evening, as well as rinsing after meals. Enamel is the hardest substance in the human body but is susceptible to cracking. Acidic or sugary substances are harmful to teeth, so it's best to avoid sweets and acidic foods in the evening and to brush teeth before going to bed. Brushing teeth before sleeping is crucial and some anti-cavity treatments should be done, such as fluoride application or dental sealants. It's also important to develop a habit of regular dental check-ups to detect and treat cavities early.

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If a cavity doesn't hurt, is it better not to treat it?

Cavities are primarily caused by poor oral hygiene and the effects of bacteria in the mouth, among other factors, leading to chronic progressive destruction of the hard tissues of the teeth. Generally, the progression is slow, initially appearing as yellowish-brown spots or defects on the tooth surface without causing any pain symptoms, making the treatment fairly straightforward—simply removing the decay and filling it can often be completed in one session. However, many cavities are not treated during this optimal period and progress to the dentin, causing sensitivity to hot and cold and leading to toothache. If not treated promptly, the cavity will enlarge, and in severe cases, lead to pulp infection, causing spontaneous pain, episodic pain, and pain from temperature stimuli. At this stage, the treatment becomes more complex and painful, requiring root canal therapy, typically needing three to four follow-up visits, and thus, costing more than a simple one-time treatment. If the condition is not controlled, it may develop into apical periodontitis or apical abscess, leading to space infections. The treatment then becomes even more complicated and painful, requiring incision and drainage, along with systemic anti-inflammatory treatment. If the tooth is severely damaged, the remaining roots and crowns can become a focal point for bacterial infection, potentially inducing other diseases. Therefore, it is crucial to detect and treat cavities early—the smaller the cavity, the better the treatment outcome, also saving time and money.

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Will cavities improve after changing teeth?

Cavities in baby teeth can heal when they are replaced by permanent teeth, but cavities in baby teeth still need to be treated. Because the decay can deepen, leading to premature loss of the tooth, which can affect the development of the permanent teeth. Severe cavities can lead to abnormal development of the permanent teeth, and even after the child's teeth are replaced, the new teeth may not be in good condition. For example, if the root of a baby tooth becomes inflamed and the inflammation is not treated and cleared, the alveolar bone around the tooth root can also become inflamed. Below the alveolar bone is the germ of the new tooth, and prolonged inflammatory stimulation can affect the germ of the permanent tooth. Additionally, premature loss of baby teeth can lead to the loss of adjacency between teeth, which can affect the growth and development of permanent teeth. Therefore, it is important to detect and treat cavities in baby teeth early, and ideally perform pit and fissure sealants before cavities form.

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If cavities that do not have holes are not filled, how will they develop?

In such cases, it is recommended that patients seek timely treatment at a dental clinic. Generally, the treatment might involve cleaning the area around the cavity. If the cavity is deep but not painful, a temporary filling with zinc oxide eugenol may be used. If there is no pain after about a week, a permanent filling can be placed, and root canal therapy may not be necessary. Specifically, it is best to go to the hospital for an X-ray to examine the condition properly. If there is food impaction in the teeth, it might indicate the presence of cavities. It is advisable for the patient to undergo some examinations to fill these cavities. Considering the sensitivity of the teeth, active treatment should be pursued.

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Can cavities be detected in an X-ray?

In clinical practice, not all cavities require X-rays, nor can all cavities be detected through X-rays. The purpose of taking X-rays is to understand the depth of the cavity and the distance between the cavity and the dental nerve. Some cavities occur on the surfaces between teeth which cannot be seen with the naked eye; in these cases, X-rays can provide a clear diagnosis. However, early-stage cavities only involve changes in the enamel, showing as chalky changes or small black dots and lines on the tooth surface. For these superficial changes, X-rays will not show any abnormalities. Therefore, it is important to maintain oral hygiene by brushing teeth morning and evening, and rinsing after meals to detect and treat cavities early, to prevent other complications.