What You Need to Know About Tooth Decay

It’s safe to say that tooth decay is the most common oral health issue in the United States. According to the National Institute of Dental and Craniofacial Research (NIDCR), 92% of adults ages 20 to 64 have had dental caries (tooth decay) in their permanent teeth. But while tooth decay is widespread, it shouldn’t be considered inevitable. Even if you’ve had at least one filling to treat a cavity, preventing future decay is possible when you know the warning signs of early-stage tooth decay — as well as changes to make in your lifestyle and oral hygiene routines.

Should tooth decay already be underway, being aware of signs of its progression can head off more serious consequences when you schedule an appointment with your dentist for timely treatment.

Signs and Symptoms of Cavities

For far too many people, dental pain is the first symptom of a cavity. We’re getting a little ahead of our usual advice, but visiting your dentist for regular twice-yearly examinations will reveal early evidence of tooth decay so it can be treated quickly. In the meantime, be proactive and keep your eyes open for the following changes, which are provided by Mayo Clinic, Healthline, and Fifth Avenue Dental Arts:

Sensitivity to hot, cold, and sweet foods/liquids — Sensitivity that lingers after eating hot or cold food could be a sign of a cavity. When tooth enamel starts to wear away, it can affect dentin, which is the hard tissue layer below the enamel. Dentin contains tubules, which are hollow microscopic channels that travel from the inside of the tooth (where the pulp is) out through the dentin, ending right beneath the enamel. Without enough enamel to protect the dentin, foods that are hot, cold, sticky, or acidic can stimulate the cells and nerves inside your tooth, creating sensitivity. Our blog post — “Tooth Anatomy 101” — provides a detailed illustration of the layers of a tooth.

Staining on the tooth — If you notice a small white spot on a tooth, it could be the beginning of a cavity. As tooth decay becomes more advanced, the stain can become darker. Staining caused by a cavity can be white, brown, or black, and typically appears on the surface of the tooth.

Hole or pit in the tooth — If left untreated, the white spot on your tooth will develop into a hole that you may be able to see when you look in the mirror or feel when you run your tongue over the surface of your teeth. Some holes —especially those between your teeth or crevices - cannot be seen or felt. But you may still feel pain or sensitivity. If you notice a hole or pit in your tooth, make an appointment to see your dentist. This is a clear sign that you have tooth decay.

Floss shredding or breaking — The texture of tooth enamel changes as decay develops. Cavity margins are rough - or even sharp - as decay ruptures through the outermost layer of enamel. This process can create a jagged edge around the cavity. When you floss, you might notice that the floss starts to shred or breaks apart at the same location every time you use it. Make an appointment to see your dentist, and if possible, use a water flosser until the cavity is treated.

Food getting caught between your teeth — Do you notice an area between your teeth where food tends to become caught after meals? If this is a recent development, it may be collecting inside a cavity.

Irritated gums — If you have a cavity between your teeth or along the gum line, the bacterial infection doesn’t just affect your tooth. Your gums may also become irritated. If bacteria, acids, or food debris are consistently building up in the same area because of a cavity, you’ll probably see that the gums around that tooth are also swollen and irritated.

Toothache — Now that you know the early symptoms, tooth decay hopefully won’t reach this stage. A toothache caused by decay can present in several ways. You may feel pressure and/or pain when you bite down on food, or the pain may be spontaneous - seeming to come and go without stimulus. Left untreated, the pain will increase in intensity and duration as the decay advances into the pulp. Not every toothache is caused by decay, but is always serious, and will require treatment.

Most cases of tooth decay are treated with a dental filling. Our blog post — “Everything You Need to Know About Dental Fillings” — describes this procedure in detail. As you may already know by experience, the basic treatment involves removing the decayed portions of the tooth, then filling it with a special material – the type of which will depend upon your particular situation, as determined by your dentist. Our blog post details the treatment method used by Dr. Nilofer Khan — owner and General Dentist of NK Family Dental — so we invite you to read this in its entirety to learn about her approach to ensuring every patient has a comfortable, pain-free experience and a durable, high-quality filling that will last for years to come.

How Does Tooth Decay Progress?

Tooth decay is a gradual process, which is another factor that often makes it easy to go undetected without regular dental checkups. The following stages are provided courtesy of Mayo Clinic:

Plaque forms — Dental plaque is a clear sticky film that coats your teeth. It's due to eating sugars and starches, and not cleaning your teeth well. When sugars and starches aren't cleaned off your teeth, bacteria quickly begin feeding on them and form plaque. Plaque that stays on your teeth can harden under or above your gum line into tartar (calculus). Tartar makes plaque more difficult to remove and creates a shield for bacteria.

Plaque attacks — The acids in plaque remove minerals in your tooth's hard, outer enamel. This erosion causes tiny openings or holes in the enamel - the first stage of cavities. Once areas of enamel are worn away, the bacteria and acid can reach the next layer of your teeth, called dentin. This layer is softer than enamel and less resistant to acid.

Destruction continues — As tooth decay develops, the bacteria and acid continue their march through your teeth, moving next to the inner tooth material (pulp) that contains nerves and blood vessels. The pulp becomes swollen and irritated from the bacteria. Because there is no place for the swelling to expand inside of a tooth, the nerve becomes pressed, causing pain. Discomfort can even extend outside of the tooth root to the bone.

What Increases Your Risk of Tooth Decay?

While everyone can develop tooth decay, Mayo Clinic identifies the following as particular risk factors:

Tooth location — Decay most often occurs in your back teeth (molars and premolars). These teeth have lots of grooves, pits and crannies, and multiple roots that can collect food particles.

Certain foods and drinks - Foods that cling to your teeth for a long time - such as milk, ice cream, honey, sugar, soda, dried fruit, cake, cookies, hard candy and mints, dry cereal, and chips - are more likely to cause decay than foods that are easily washed away by saliva.

Frequent snacking or sipping — This gives mouth bacteria more fuel to produce acids that attack your teeth and wear them down. Sipping soda or other acidic drinks throughout the day creates a continual acid bath over your teeth.

Bedtime infant feeding - When babies are given bedtime bottles filled with milk, formula, juice, or other sugar-containing liquids, these beverages remain on their teeth for hours while they sleep, feeding decay-causing bacteria. The same occurs when drinking from a sippy cup filled with such beverages for prolonged periods.

Inadequate brushing — If you don't clean your teeth soon after eating and drinking, plaque forms quickly and the first stages of decay can begin.

Not getting enough fluoride — Fluoride is a naturally occurring mineral that helps prevent cavities and can even reverse the earliest stages of tooth damage. Because of its benefits for teeth, fluoride is added to many public water supplies. It's also a common ingredient in toothpaste and mouth rinses. But bottled water usually does not contain fluoride. If your dentist determines you are at increased risk for tooth decay, he or she may recommend a fluoride toothpaste that’s available by prescription only. Prescription fluoride toothpaste contains a higher concentration of fluoride (5000 parts per million) than over-the-counter brands, which is the maximum strength. 

Younger or older age — Cavities are common in very young children and teenagers. Older adults also are at higher risk. Over time, teeth can wear down and gums may recede, making teeth more vulnerable to root decay. Older adults also may use more medications that reduce saliva flow, increasing the risk of tooth decay.

Dry mouth — Saliva helps prevent tooth decay by washing away food and plaque from your teeth. Substances found in saliva also help counter the acid produced by bacteria. Certain medications, some medical conditions, radiation to your head or neck, or certain chemotherapy drugs can increase your risk of cavities by reducing saliva production.

Worn fillings or dental devices - Over the years, dental fillings can weaken, begin to break down or develop rough edges. Plaque builds up and makes it harder to remove. Dental devices can stop fitting well, allowing decay to begin underneath.

Heartburn — Heartburn or gastroesophageal reflux disease (GERD) can cause stomach acid to flow into your mouth (reflux), wearing away the enamel of your teeth and causing significant tooth damage. Exposing more dentin to be attacked creates tooth decay. Your dentist may recommend that you consult your doctor to see if gastric reflux is the cause of your enamel loss.

Eating disorders — Anorexia and bulimia can lead to significant tooth erosion and cavities. Stomach acid from repeated vomiting (purging) washes over the teeth and begins dissolving the enamel. Eating disorders also can interfere with saliva production.

The Take-Home Message

Tooth decay is an insidious process that can advance before you’re aware of it. Being proactive with your oral health will help you recognize its early signs – and will allow your dentist to identify it during your twice-yearly examinations so it can be treated before doing additional damage.

NK Family Dental is proud to offer our patients advanced cavity detection technology during every one of our complete checkups. We utilize DIAGNOdent technology to thoroughly check for the presence of cavities. DIAGNOdent utilizes lasers that are highly effective in detecting cavities. With DIAGNOdent, we are very successful in locating cavities early, allowing our patients to seek quick treatment and prevent serious oral health problems from occurring later.

At NK Family Dental, it is our mission to provide the highest quality and most compassionate oral care to our Chicago patients, including both dental and periodontal services. Our practice is trusted for advanced oral surgery procedures and comfortable root canal treatment.

Our team of experienced, dedicated dental professionals will help address your oral health concerns, and determine the best solution for you based on your individual situation. We strive to identify treatment options that fit your needs. Our dental specialists include our general dentist, Dr. Nilofer Khan, our endodontist, Dr. Sabek, and our periodontist, Dr. Amir Danesh. Dr. Danesh is a board-certified periodontist and Diplomat of the American Board of Periodontology. He has contributed to the publication of two books, as well as published over 20 papers in prestigious dental research journals.

We serve the neighborhoods of Logan Square, Bucktown, Humboldt Park, and Wicker Park with the dedication that’s earned us the reputation as the Best Dentist in Chicago!

We understand that the main concern you may have is cost, which is why we accept all major PPO plans for dental insurance and also offer our in-house dental plan. Please see our financing page for more information.

Schedule your visit through ZocDoc, or contact us directly. We look forward to treating you soon!

Fluoride: Myths and Facts

In 1945, Grand Rapids, MI, became the first community in the world to add fluoride to the municipal water supply in order to help prevent tooth decay. When subsequent studies showed a significantly lower rate of cavities in schoolchildren, water fluoridation spread to other towns and cities - including Chicago. The Centers for Disease Control and Prevention (CDC) considers fluoridation of water one of the greatest achievements in public health in the 20th century.

The CDC provides this succinct explanation of fluoride’s effectiveness:

“Fluoride works by stopping or even reversing the tooth decay process - it keeps tooth enamel strong and solid. Certain bacteria in the mouth cause tooth decay. When a person eats sugar and other refined carbohydrates, these bacteria produce acid that removes minerals from the surface of the tooth. Fluoride helps to remineralize tooth surfaces and prevents cavities from forming.”

Although the benefits of fluoride in cavity prevention are well-established, the need for (and safety of) its addition to drinking water remains a subject of debate. Because we at NK Family Dental believe that well-informed people are better able to make good decisions about their dental and overall health, we present the following myths and facts regarding fluoride.

Fluoride is Not Naturally Present in Water

Fluoride is a mineral that occurs naturally and is released from rocks into the soil, water and air. Almost all water contains some fluoride, but usually not enough to prevent tooth decay. The American Dental Association (ADA) recommends community fluoridation to achieve the level necessary to do so. Its guidelines are available at ADA.org/fluoride. The city of Chicago fluoridates its water to approximately 1.0ppm within the guidelines of the ADA (0.7ppm to 1.2ppm).

All Fluoride is the Same

Fluoride is typically used as a generic term, although the facts are more complex. There are three types of fluoride additives typically used in municipal water supplies. The CDC provides the following breakdown:

To complicate matters, oral hygiene products such as toothpaste contain one of two fluoride compounds: stannous fluoride and sodium fluoride. Stannous fluoride is an antibacterial agent that's clinically proven to protect against gingivitis, plaque and tooth sensitivity, while still protecting against cavities. Sodium fluoride protects against cavities, but doesn't provide protection from these other conditions.

Fluoride can also be prescribed as a liquid, tablet or chewable tablet for children and adults in areas that do not have fluoridated water. As our blog post - “What to Look for in a Toothpaste” - covers, your dentist may recommend a fluoride toothpaste that’s available by prescription only. Prescription fluoride toothpaste contains a higher concentration of fluoride (5000 parts per million) than over-the-counter brands, which is the maximum strength. It’s typically prescribed for patients whose teeth are especially susceptible to cavities - as in the case of weak enamel due to being prescribed tetracycline in childhood - or after periodontal surgery that exposes the roots of the teeth.

Fluoridated Water Isn’t Necessary Because Most Toothpastes Contain Fluoride

Although fluoride toothpaste is very effective in preventing tooth decay, fluoridated water provides extra protection. According to Campaign for Dental Health - a program of the American Academy of Pediatrics - the benefits of water fluoridation build on those from fluoride toothpaste. Fluoride toothpaste alone is not enough, which is why pediatricians and dentists often prescribe fluoride tablets to children living in non-fluoridated areas.

Fluoridated Water Does Not Have an Impact on Tooth Decay

Numerous studies conducted over the years have shown that fluoridation reduces tooth decay. Campaign for Dental Health provides the following:

Fluoride is Harmful to Children

In fact, getting enough fluoride in childhood is critical to strengthening teeth over an entire lifetime. Children need fluoride to strengthen their developing and emerging teeth - which include primary (baby) teeth. The use of fluoride to prevent and control cavities is documented to be both safe and effective. According to the Campaign for Dental Health, a 2010 study confirmed that the fluoridated water consumed as a young child makes the loss of teeth due to decay less likely 40 or 50 years later.

When it comes to brushing with a toothpaste containing fluoride, the ADA's guideline for children under three years of age is to brush using a "smear" of fluoride-containing toothpaste, no larger than the size of a grain of rice. Parents should brush their child’s teeth twice a day, once in the morning and once at night. When your child turns three, the ADA recommends that you continue brushing your child's teeth twice a day, but with a slightly larger portion of fluoride toothpaste, the size of a pea.

Drinking Fluoridated Water Can Cause Fluorosis

Fluorosis is a condition characterized by staining, pitting, and/or surface irregularities of tooth enamel caused by overexposure to fluoride during the first eight years of life. This is the time when most permanent teeth are being formed. The concentration of fluoride added to the drinking water supply is very unlikely to lead to fluorosis. However, this is why it is important to follow the guidelines on the appropriate amount of toothpaste to use for children, to supervise children when brushing, and to teach them not to swallow, but to spit when finished.

Drinking Fluoridated Water Causes Cancer

According to the American Cancer Society, the US Public Health Service issued a report on the benefits and risks of fluoride in 1991. When looking at a possible link with cancer, they first reviewed the results of studies done with lab animals. They concluded that the few studies available “fail[ed] to establish an association between fluoride and cancer.” They also looked at population-based studies, including a large study conducted by the National Cancer Institute. They concluded: “Optimal fluoridation of drinking water does not pose a detectable cancer risk to humans as evidenced by extensive human epidemiological data available to date, including the new studies prepared for this report.”

European Countries Do Not Allow Fluoridation of Their Municipal Water Supplies

European countries do have water fluoridation systems in place. Fluoridated water reaches 12 million Europeans, mostly in Great Britain, Ireland, and Spain. At least 70 million Europeans consume fluoridated salt - which is used to reach most of the population in Germany and Switzerland. These two countries have the lowest rates of tooth decay in Europe.

Ask Your Dentist - Your Trusted Partner in Oral Health

The internet can be a valuable source of information on numerous topics, but credible sources dealing with oral health - or general health - can sometimes be difficult to separate from unreliable sources based on “junk science.”

When you have questions about the safety or effectiveness of any matter relating to oral health, the best person to ask is your dentist. Our team of experienced, dedicated dental professionals will help address your oral health concerns, and determine the best solution for you based on your individual situation. We strive to identify treatment options that fit your needs.

We understand that the main concern you may have is cost, which is why we accept all major PPO plans for dental insurance and also offer our in-house dental plan. Please see our financing page for more information.

At NK Family Dental, it is our mission to provide the highest quality and most compassionate oral care to our Chicago patients, including both dental and periodontal services. Our practice is trusted for advanced oral surgery procedures and comfortable root canal treatment.

Our dental specialists include our general dentist, Dr. Nilofer Khan, our endodontist, Dr. Sabek, and our periodontist, Dr. Amir Danesh. Dr. Danesh is a board-certified periodontist and Diplomat of the American Board of Periodontology. He has contributed to the publication of two books, as well as published over 20 papers in prestigious dental research journals.

We serve the neighborhoods of Logan Square, Bucktown, Humboldt Park, and Wicker Park with the dedication that’s earned us the reputation as the Best Dentist in Chicago!

Schedule your visit through ZocDoc, or contact us directly. We look forward to treating you soon! 

Causes of Tooth Decay & How to Stop It

As much as we’d like for it to be so, our teeth are, unfortunately, not designed to last forever. Tooth decay will affect every one of us at some point or another. However, there are many actions you can take to prevent it!You may be aware that tooth decay can cause cavities, but do you know what causes tooth decay in the first place, or what other oral results occur due to decay? In this latest dental blog, we’re helping you understand the common causes and results of tooth decay, how your gums play an important part, and how to prevent tooth decay.

 

Common Causes and Results

The National Institute of Dental and Craniofacial Research defines tooth decay, also known as dental caries, as “damage to a tooth that can happen when decay-causing bacteria in your mouth make acids that attack the tooth’s surface, or enamel.” When the surface of your teeth become worn down by bacteria and acids, a cavity can develop. Anyone from children to senior adults can develop tooth decay for a variety of reasons.

Starches and sugars in your diet react with decay-causing bacteria to form acids that attack the enamel, or outer layer of your teeth, which causes a breakdown of important minerals that help keep your teeth strong. Consuming food and drinks high in starches and sugars put your teeth at greatest risk for more frequent attacks on your enamel from these acids.

Foods to avoid or consume in moderation, always followed by proper oral care, include - but are not limited to —  sugary cereals, pop or other sugary drinks, hard candy, dried fruits and cookies. Tobacco products should also be avoided.

Over time, plaque will develop from the bacteria and cling to the enamel of your teeth, further wearing them down. This process eventually leads to cavities when the enamel is completely worn away.

Other causes of cavities and tooth decay include dry mouth, not maintaining proper oral hygiene and certain medical conditions. When your mouth is dry and experiences a lack of saliva, bacteria and plaque buildup do not wash away as easily, causing a faster buildup of that same plaque and bacteria. Not maintaining proper oral hygiene such as brushing and flossing your teeth daily and in the correct manner can also speed up the development of bacteria, acids and plaque. Finally, some medical conditions or treatments can promote tooth decay. These include conditions and medications that cause dry mouth, as well as some radiation treatments for cancer that change the chemical makeup of saliva which encourages an increase in oral bacterial growth.

So, what happens when you have tooth decay? Untreated tooth decay can lead to tooth pain, infection or, at the most extreme, permanent tooth loss. You may experience a toothache, pressure when chewing or biting, or tooth sensitivity to cold, hot or even sweet food or drink. Signs of an infection from tooth decay include the development of an abscess that can lead to pain, fever or swelling of the face. An infected oral abscess is considered a dental emergency, and you should contact your dentist as soon as you develop signs of an infection.

To detect a cavity and signs of tooth decay, your dentist will examine your teeth for any sticky or soft areas, as well as likely take x-rays to detect any cavities and areas of decay not visible to the naked eye.

 

What About Your Gums?

Tooth decay and cavities affect your teeth - but your gums also play an important role! Buildup of bacterial plaque causes both gum disease and tooth decay. So, the same sticky plaque full of bacteria and acids that breaks down enamel also irritates your gum line and causes it to recede. This happens when plaque hardens over time into what is known as tartar, which makes it even easier for bacteria to grow.

Gum disease comes in many stages, starting with gingivitis. Plaque built up near your gums will cause them to become irritated, inflamed, swollen or to bleed easily. Further progression of plaque and tartar will lead to bacteria reaching underneath the gum line and attacking the supporting structures of your teeth which keep them in place. This advanced gum disease is known as periodontitis. To learn more about the relationship between tooth decay and gum disease, read our blog post, “What Is Periodontal Gum Disease?”

 

How to Stop Tooth Decay

The best way to stop tooth decay is to prevent it in the first place. Fortunately, most tooth decay is easily preventable. Here are the three primary ways you can prevent tooth decay:

  1. Maintain properly daily oral hygiene. - At minimum, thoroughly brush your teeth twice per day with a fluoridated toothpaste. You should also floss at least once per day and use a mouthwash after every time you brush.
  2. Watch what you eat and drink. - As previously mentioned, sugary food and drinks like pop make it much easier for bacteria and plaque to build up in your mouth. In general, aim for a balanced diet with limited intake of food and drinks high in starches and sugars. Snacking between meals should also be kept to a minimum.
  3. See your dentist regularly for routine check-ups. - Daily oral hygiene is important, but our teeth still need professional cleanings by a dentist to remain as clean and healthy as possible. Seeing your dentist semi-annually ensures that plaque and tartar buildup are removed and that any cavities or other oral conditions can be diagnosed and treated.

Once tooth decay has caused a cavity to form, the emphasis of treatment changes from prevention to restoration. This is because cavities are irreversible. The only option is for the dentist to repair the tooth by cleaning out the affected area and providing a filling after the decayed part of your tooth has been removed. The filling consists of a strong material compatible with your tooth structure. Dental crowns and root canals may also be required to restore the tooth in the case of an advanced cavity.

 

Looking for a Chicago Dentist to Treat Tooth Decay?

The best way to prevent tooth decay is by seeing a dentist for early detection, treatment and preventive measures. Located between the border of Bucktown and Logan Square in Chicago, NK Family Dental provides a wide range of services, including periodontics and root canal treatment. Our complete checkups include professional teeth cleaning, digital x-rays, oral cancer screenings, DIAGNOdent cavity detection and fluoride applicators - along with examination for diagnosing your overall oral health.

Schedule your next visit with NK Family Dental through ZocDoc, or contact us directly to schedule an appointment or for any questions you may have.