Dental decay is an infectious process whereby bacteria damage the hard tooth structure.
The presentation of dental decay is highly variable. Initially, it can start out looking like a small chalky area but as the lesion progresses, it can turn brown and eventually present as a cavity. As the decay progresses towards the centre of the tooth, it can cause pain. The pain may worsen with exposure to heat, cold or sweet food. At times, the decay cannot be seen directly and radiographs are required to detect it.
Dental decay formation is caused by a combination of factors – teeth, bacteria, sugars and time. Bacteria produce acids when exposed to dietary sugars and this acid diffuses into the tooth, dissolving tooth material over time. Saliva helps to repair such damage by neutralising the acid if the acid attacks are infrequent. However, impaired salivary flow and the acidity of the saliva can increase the risk of dental decay.
Diagnosis involves the inspection of the teeth using a good light source. Large lesions can be detected with the naked eye but smaller lesions may be difficult to identify. Dental radiographs may also detect decay that cannot be visually seen, especially decay between the teeth.
For small early lesions, topical fluoride is sometimes used to encourage remineralisation of the tooth structure. For larger lesions, the progression of decay can be stopped by treatment. The decayed portions of the tooth are removed and a restorative material is placed to restore aesthetics and function. Restorative materials include amalgam, composite, porcelain and gold. In some cases, root canal/endodontic therapy may be required if the pulp in the tooth dies. If the tooth is too far destroyed for effective reconstruction, extraction may be recommended.
Good dental health can be achieved with proper daily brushing and flossing. The goal of brushing and flossing is to remove the bacteria containing plaque. Intake of dietary sugars should be monitored and regular examinations by dental professionals are recommended.
- Prof Chew Chong Lin (Emeritus Consultant)
- A/Prof Keson Tan (Senior Consultant)
- Dr Peter Yu (Senior Consultant)
- Dr Frank Lee (Senior Consultant)