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Thursday, April 2, 2020  Spokane, Washington  Est. May 19, 1883
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Ask Doctor K: Prevent tooth decay with hygiene, diet

By Anthony L. Komaroff M.D.

DEAR DOCTOR K: What is tooth decay, and how does it happen?

DEAR READER: Tooth decay is a disease of the mouth that can lead to cavities and infection. But before we start talking about sick teeth, let’s talk about healthy teeth.

Each tooth has one or more roots that are anchored in the bones of the jaw. The part of the tooth that we see, sticking out above the gumline, is the crown.

The crown of the tooth is covered with a hard, whitish material called enamel. The enamel ends at about your gumline, where the root – covered with a layer of hard, bonelike material called cementum – begins.

Inside the tooth are two other types of dental tissue: dentin and pulp. Dentin is harder than cementum but softer than enamel. The core of a tooth is a chamber extending from the crown into the roots. Inside this chamber is the pulp, a collection of loose connective tissue laced with blood vessels.

Tooth decay (also known as dental caries) begins with the development of plaque, the sticky, bacteria-laden film that collects on your teeth between brushings. The bacteria in the plaque “eat” sugar and food that stays in the mouth after eating. When they do that, they give off acid as a waste product. This acid dissolves the outer enamel surfaces of the teeth, causing tiny pits to form.

The earliest stage of decay appears as a white or brown area on a tooth. If decay is caught at this stage, there’s a good chance it can be stopped and reversed. Treatments include limiting sugary snacks and beverages and taking fluoride supplements. Your dentist can also apply fluoride, an antiseptic or a sealant to your teeth to stop the progress of early decay.

Unchecked, bacterial acid will bore a hole in the enamel. This is a cavity. At this point, the tooth may ache. It may also be sensitive to hot, cold or sweet foods. Without treatment, the cavity gets bigger, extending into the soft tissue of the pulp and causing an infection.

The best way to prevent tooth decay is to brush and floss every day, and minimize sugary snacks and beverages.

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