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TOOTH DECAY (Caries; Dental Decay; Cavities)

DESCRIPTION

Tooth decay is disintegration of tooth enamel, allowing injury to the dentin (layer below the enamel) and eventual involvement of the pulp (the layer below the dentin), which contains nerves and blood vessels. Tooth decay and the common cold are the most common human disorders. Dental caries can involve any tooth or possibly all teeth.
Appropriate health care includes:
  • Self-care.
  • Dentist's treatment to remove all decay in your child's tooth and replace it with a restorative material (filling). The filling prevents further decay.

    SIGNS & SYMPTOMS

  • Tooth sensitivity to heat and cold.
  • Tooth discomfort after eating sugar.
  • Darkening on or between your child's teeth (cavity) when the decay has progressed enough to be seen. The most common tooth-cavity sites are the gum line, biting surfaces, and surfaces between adjacent teeth.
  • Unpleasant taste in the child's mouth and bad breath because of stagnant food and bacteria trapped in the cavity.
  • Persistent tooth pain (in the final stages of decay when the pulp becomes inflamed).

    CAUSES

  • Cavities are caused by acid destruction of tooth material. Acid is produced by bacteria in the child's mouth. The bacteria feed on food debris--usually sugar--and produce the acid that dissolves tooth material.
  • The combination of sugars from food debris, bacteria, and chemicals in the child's saliva form a substance called plaque. Plaque becomes a localized site of acid production, which forms continuously at the neck of each tooth. This plaque must be thoroughly cleaned away at the gum line daily or it fosters tooth decay.

    RISK FACTORS

  • Poor nutrition and improper diet.
  • Poor dental hygiene.

    PREVENTING COMPLICATIONS OR RECURRENCE

  • Your child should brush and floss teeth regularly.
  • Consult your dentist about your child using fluoride mouthwash, liquid or tablets, or having fluoride treatments once or twice a year.
  • Drinking fluoridated water or taking fluoride supplements during pregnancy has not proven to protect the unborn child's teeth.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Examination by a dentist. The decayed area feels soft when the dentist probes it with a sharp instrument.
  • X-rays of the child's teeth and mouth.

    POSSIBLE COMPLICATIONS

  • Abscess around a decayed tooth.
  • Death of the tooth, caused by destruction of the tooth pulp that contains the tooth's nerve and blood supply.

    PROBABLE OUTCOME
    Usually curable with dental treatment.

    TREATMENT

    HOME CARE

    No specific instructions except those listed under other headings.

    MEDICATION

  • For minor pain, use non-prescription drugs such as acetaminophen.
  • Your dentist may prescribe stronger pain relievers or fluoride supplements.
  • See Medications section for information regarding medicines your doctor may prescribe.

    ACTIVITY
    No restrictions.

    DIET & FLUIDS
    For 48 hours after your dentist fills the child's decayed tooth, urge the child not to put pressure on the tooth, as by eating apples, hard candy, or raw vegetables, or by chewing on ice. The child should avoid very hot or cold foods. The tooth remains sensitive for 48 hours to 10 days after a cavity has been filled.

    OK TO GO TO SCHOOL?

    Yes.

    CALL YOUR DOCTOR IF

  • Your child has symptoms of tooth decay.
  • The following occurs after treatment: -- Fever. -- Increased pain that is not relieved by non-prescription medication. -- Discomfort with hot or cold food that persists longer than 2 weeks after the filling procedure. -- Brown spots on the tops of any other teeth. ‡
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