The Causes of Tooth Decay

Tooth decay, also named caries or cavities, is the breakdown of a tooth due to the acid produced by bacteria. The bacteria produce this acid as a by-product when interacting with carbohydrates present in the food that we consume. The pain and severity of tooth decay depend on how far it is spread, from enamel to dentine, and then to the pulp.

The mouth is an important part of the body that usually expresses or reveals many chronic diseases, directly or indirectly in the form of dental, gum, and soft tissue diseases. Tooth decay, or cavities, are warning signs of having an underlying chronic disease that needs to be taken care of in addition to the dental treatment.

Following are the few of the known diseases that are usually linked to the tooth decay/cavities

1) Diabetes

Diabetes is a disease in which the sugar levels in the blood are elevated due to a decrease in insulin levels. It affects dental health in two ways

- The bacteria in the mouth feed on sugars and produce acid. Greater levels of sugars in the blood, the higher the supply of sugars to the mouth, and the higher the degree of bacterial activity as well. The acid produced by bacteria then dissolves the tooth layers one by one causing cavities.

- One of the symptoms of diabetes is dry mouth. Dry mouth is a condition in which there is less production of saliva in the mouth. Saliva is of great importance when it comes to cleaning and cleansing the bacteria. It washes away the bacteria and its by-products decreasing the risk of tooth decay. If the production of saliva is less as in diabetes, the acid produced by bacteria freely destructs the tooth structure.

Not only does diabetes limit the capability of the body to fight against the oral bacteria, but it also increases the chances of destroying the gums (with help of plaque build-up and calculus) surrounding the teeth and bone. Moreover, gum disease triggers the increase in blood sugar levels, which in turn worsens the severity of diabetes. It is hence a cause and effect cycle that needs to be addressed and managed properly.

2) Sjögren’s syndrome

Sjögren’s is an autoimmune syndrome that is commonly identified with symptoms such as the dry mouth and dry eyes. This syndrome affects the mucous secreting glands of eyes and mouth and results in significantly low production of tears and saliva. The decreased levels of saliva in the mouth result in less cleaning of the mouth hence greater bacterial activity, which then eventually leads to initiation of caries, which turns into tooth decay if not taken care of.

3) Bulimia and Anorexia

Bulimia and anorexia are severe forms of eating disorders. These eating disorders are connected to psychological disorders where individuals fear being fat or overweight. Bulimic and anorexic individuals either eat less, binge or purge the food, mainly unhealthy food. Eating less food means less intake of nutrients that are essential to keep the body healthy and strong. This less intake of nutrients causes low immunity and hence less capability to fight against oral bacteria that cause cavities. Also, during the process of binging and purging, the acids from the stomach flow into the mouth affecting the teeth. The acid wears away the teeth surface making them more susceptible to tooth decay over a while.

4) Cancer

Although there is no direct relationship between cancer and tooth decay, individuals going through radiation are at greater risk of getting cavities known as radiation caries. One of the side effects of radiation is dry mouth (transient xerostomia). The radiation affects the salivary glands, due to which the mouth is unable to produce a sufficient amount of saliva necessary for cleansing effectively and lowering the mouth PH that eventually leads to radiation caries. Therefore, it is necessary to consult the dental professional and the concerned oncologist before going through the phase of radiotherapy. The dental professional will evaluate the preexisting condition of the mouth and teeth and suggest suitable actions accordingly.

In addition to all the above-mentioned diseases, dental home care plays a crucial role in the development of tooth decay. The dental plaque formed on the gingival margins continues to multiply and grow beneath the gums (gingival pockets) and onto the tooth surface. This dental plaque contains various types of bacteria and food particles that mineralized to form tartar/calculus. This plaque and tartar destructs the tooth structure and gums to form cavities and gum diseases respectively. The good news is, regular oral hygiene regimens decrease the amount of plaque and tartar build-up. Brushing twice a day and flossing following a proper technique significantly reduces plaque and tartar load. Besides, regular dental checkups should be followed to treat tooth decay at its earliest stages.

It is best to provide a thorough and inclusive medical and dental history to the dental professionals to rule out the cause of tooth decay and then treat it subsequently.

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