What is dental caries?

Dental caries refers to a condition when the teeth become decayed. It starts from the surface of enamel and then extends into the deeper structure of the tooth.

Why does a tooth become decayed?

The tooth surfaces are normally covered with dental plaque. The bacteria in the dental plaque will metabolize the sugars or cooked starch in your food to produce acids which will demineralize the tooth surface. If the acid is not adequately neutralized by the saliva, the continuous demineralization will result in dental caries.

Symptoms and treatment methods of dental caries

Early stage of dental caries
Decay occurs at the enamel of the tooth. Early stage of dental caries is usually painless and the tooth seems undamaged from the naked eye. Decay at the proximal surfaces of teeth is even more difficult to notice, and they often need to be confirmed by X-ray.

Treatment:
The early carious lesions can be repaired by application of concentrated fluoride by a dentist.

Dental caries spreads into dentine
When Dental caries spreads into dentine, a cavity appears, and pain is felt when eating.

• A dental filling can be placed when the cavity is small and the bulk of the tooth remains sound.
• Crown and Veneer can be placed when the cavity is wide-spread and the remaining tooth is weak.

Dental caries spreads into the pulp
At this stage, the carious is very obvious and cause severe pain. The pulp tissues are infected by the bacteria and may become necrotic. The bacteria may even spread from the pulp to the surrounding periodontal tissues via the apex of the tooth, leading to the formation of abscess.

• Pulp treatment, and followed by filling, veneer or crown, depending on the condition of the remaining tooth structure.
• If pulp treatment is not appropriate, an extraction will be necessary.
  

Consequence of dentalcaries

Methods to preventdentalcaries

Keep a good dietary habit
Every time when we eat, demineralization occurs at the surface of our teeth and creates a chance for getting dental caries. The more often we eat, the more chances we have to get dental caries. Therefore, having regular meals three times a day with sufficient amount of food during each meal will reduce the frequency of meals, and thus reduce the chance of getting dental caries. If you feel hungry in between meals, you may snack once.

Brush your teeth with fluoride toothpaste
Fluoride strengthens the teeth by increasing their resistance to acid attack. Fluoride also facilitates minerals to re-enter the teeth (remineralization) and helps cure early dental caries. Therefore, you should brush in the morning and before bed at night with fluoride toothpaste.

Regular dental check-up annually
Have regular dental check-up at least once a year so that early dental caries can be diagnosed at an early stage. Preventive dental treatments such as fissure sealants can be applied.

Early Childhood Caries is an infant oral disease. The characteristic of this disease is the fast and widespread development of dental caries. At first, large lesions are found on the surface of the upper incisors. Tooth decay follows the tooth eruption sequence, i.e. a tooth decays soon after it erupts. The decay will then spread to the back of the mouth.

Causes of Early Childhood Caries

Improper feeding habits

• If parents continue to frequently feed the child after he/she is 6 months old, bacteria inside the child's mouth will utilize the sugar or starch in the food to form acid which is harmful to the child's teeth.
  
• Leaving the milk bottle at the child's mouth when he/she is sleeping will allow the teeth to be soaked in milk for an extended period of time, and the teeth are subject to continuous acidic attack.
  
• When toddlers can hold their own bottles after the age of one, if parents allow toddlers to drink milk or other beverages from the bottle ad lib, the bottle feeding time will be lengthened, and the risk of getting ‘Early Childhood Caries' will increase significantly.
  

Poor oral hygiene

• Parents fail to clean dental plaque from the toddler's teeth daily after the teeth have erupted.
  

Consequences of having Early Childhood Caries

Early Childhood Caries can result in pain, loss of appetite and emotional irritation. If parents do not seek treatment for their children, bacterial infection can extend to the pulp, causing infection of the pulp and abscess. The bacteria can also affect the permanent teeth that are growing inside the alveolar bone through the roots of the primary teeth. When the condition gets severe, it can infect the child's cheeks, causing pain and swollen cheeks.

At this stage, the child has to receive complicated dental treatment, which may include removal of the primary teeth. This will seriously affect the child's chewing ability, speech, alignment of permanent teeth and appearance, resulting in the loss of self-confidence.

Prevention for Early Childhood Caries

Good dietary habits

• No more than six regular meals a day should be allowed. After 2 years of age, only let your child eat three meals per day and take sufficient amount of food during each meal. One snack is allowed in between meals if your child feels hungry.
  
• Do not let toddlers sleep with a bottle in their mouth.
  
• Try to use a cup instead of a bottle for feeding when the toddler is 12 months old.
  

Appropriately clean the child's mouth everyday

• Starting from the baby's birth, parents should use gauze, cotton, or towel moistened with drinking water to clean the baby's mouth.
  
• Wipe the front teeth when they are erupted.
  
• Use a soft-bristled toothbrush to brush the teeth daily when the deciduous molars are erupted.
  
• If the child knows how to spit out water, you can let him brush with children's fluoride toothpaste (a pea sized blob) every morning and before bed at night. Every night after the child brushes, parents should supplement his/her brushing.
  

Regular dental check-up annually

A child should have his/her first oral check-up six months after he/she has his/her first tooth or when he/she is one year old. After that, parents should bring their children for regular dental check-up at least once per year.