Rotten teeth or otherwise known as tooth decay, is one of the most common diseases in the world affecting upwards of 2 billion people. Teeth are made up of microscopic crystals called hydroxyapatite. These crystals form the first 2 outer layers of the tooth (the enamel and dentine).
Although very durable, these crystals are prone to being dissolved by strong and weak acids. These acids can be present in the foods and drinks we consume (carbonated beverages), or they can be from bacteria present in the mouth. Continuous and prolonged exposure to such acids can slowly decay your enamel and dentine resulting in rotten teeth.
As mentioned above, acid exposure is the main mechanism by which rotten teeth occur. However, it is primarily slow and prolonged exposure to weak acids that tend to drive tooth decay. Weak acids are produced by natural bacteria that live in the mouth as a byproduct of metabolism.
In a healthy mouth, the natural bacteria often serve to protect teeth from decay. The bacteria exist on the surfaces of your teeth on what is known as a biofilm (a layer of bacteria). This natural bacteria can become disease causing or ‘cariogenic’ through two main ways. The first is through diet, as a person's diet changes to include more volumes of sugary food, the bacteria changes as well. Slowly, the bacteria metabolizes the free sugars that remain in the mouth after the consumption of sugars. This in turn leads to an increase in the production of these weak acids and therefore progression of rotten teeth.
Another way natural bacteria can start producing these acids is through poor oral hygiene. Bacteria are a natural part of your mouth and teeth, however the longer a biofilm stays on your teeth, the more the bacteria becomes cariogenic. That is why it is important to brush your teeth twice everyday. The brushing is a way to mechanically remove biofilm before it progresses to a state where it can give you rotten teeth. Once the biofilm is removed, it is quickly replaced by a new healthy biofilm, only for the cycle to begin again.
There are many symptoms that indicate the presence of rotten teeth. Many of these symptoms can even narrow down the severity of the condition. The first and earliest sign of decay is the presence of white spots on the surface of teeth. These spots are most clearly visible near the gum line of teeth. This clinical sign indicates that the tooth is in the early stages of decay and bad bacteria have grown on the tooth.
At this stage there should not be any sensitivity or pain associated with these white spots. However, touching the area may feel rough when compared to other areas of the tooth. From this point on it may take 6 months to a year before cavities begin to form and you start to notice rotten teeth. It is important to note that these white spots are not directly visible between the teeth. Which is an issue because decay between the teeth is the most common location.
Once the decay progresses, you may begin to experience sensitivity. This will be in the form of short, sharp pain due to stimulus such as water, cold foods or sweet foods. At the same time, the decay may have reached the second layer of the tooth being the dentine and you may notice a cavity. From the cavity there also may be a bad taste and it may become discolored (brown and black).
The next stage of rotten teeth is when the decay has progressed all the way into the inner layer of the tooth (the pulp). At this stage you will experience both short, sharp pain from the previous stage as well as random long lingering pain. This long lingering pain will radiate around the mouth and may be intense enough to keep you from sleeping. The bad taste coming from the region will get worse and you may even begin to have bad breath.
The final stage of rotten teeth is where the bacteria have completely killed the tooth and progressed down its roots. At this stage all feelings of pain will have stopped and all that should be left is occasional bad taste and smell. When biting you may also experience an odd feeling in the roots of the rotten tooth. Some new symptoms you may experience is a change to gums surrounding the rotten tooth.
It is important to note, only a dentist will be able to diagnose your rotten teeth, and any other oral related problems you are experiencing. Thus, make sure to attend your routine dental check-ups. By visiting your dentist regularly, you will be able to receive treatment for minor issues before they become major issues.
Tooth decay and rotten teeth have different treatment options depending on the diagnosis. Early decay (which is diagnosed as incipient caries) which is primarily in the forms of white spots can be reversed with the use of special toothpaste and at home medications. The medications will need to be applied over the white spot every day for a period of time for the decay to cease and the damage to be reversed.
The stage where cavities and sensitivity appear is more variable. It is generally diagnosed as a cavitated carious lesion with varying degrees of severity (mild, moderate and severe) depending on how far it has spread through the dentine. The short sharp pain that is experienced is diagnosed as reversible pulpitis (or reversible pulp inflammation). Luckily both these issues can be fixed with a restoration (filling). The type and complexity of this restoration depends on the severity of the rotten and how much dental work has been done on the tooth before.
The two final stages of rotten teeth have differing diagnoses however they have the same treatment options. The onset of random long lingering pain that keeps you up at night is diagnosed as irreversible pulpitis (irreversible pulpal inflammation). The ceasing of pain and response of the tooth is known as pulpal necrosis (death of the pulp). The changes to your gums around the tooth and funny feeling when biting down is diagnosed as periapical abscess (an infection near the roots of your tooth). The treatments for all of these diagnoses are either an extraction of the tooth, or to retain the tooth, root canal treatment can be attempted.
Luckily tooth decay is highly preventable, thus you can stop yourself from getting rotten teeth. Simply put, brush twice a day morning and night with fluoride toothpaste. Brush systematically around all your teeth, making sure to angle the toothbrush 45 degrees towards the gumline. I recommend the modified Basse technique of brushing. This just means, between every few strokes flick the toothbrush away from the gumline, this will help clean out any bacteria deep in the gums. After finishing brushing, spit out the toothpaste and leave the remaining in your mouth, rinsing it out will reduce the fluoride on your teeth. Also remember to floss between your teeth everyday at least once.
In terms of lifestyle changes, the first and most important is diet. Rotten teeth only occur when someone consumes sugary foods frequently. Best practice would be to cut out these foods entirely, however this is not always practical. Instead try to substitute these foods with low-sugar or sugar free alternatives. Next increase your overall water intake, staying hydrated ensures that saliva is produced properly to buffer acids in your mouth. Make sure to have a drink and rinse of water after every meal to prevent food and plaque from building up on your teeth throughout the day. Finally avoid anything that could dry out your mouth, like mouth breathing.
Children often experience the same symptoms as described earlier when it comes to tooth decay and rotten teeth. Unfortunately they may lack the communication skills to convey these symptoms. As a parent or guardian be on the lookout for white, brown and black discolorations on children's teeth. Complaining of pain, crying or yelling after eating or drinking that is cold or sweet is also an indication of decay. Of course clearly visible cavities is a sure fire way of identifying rotten teeth. Regardless of the issue make sure to take your child to a consultation with a dentist. A dentist will be able to diagnose any issue and prevent undetected problems from getting worse.
It is often said that the mouth is a mirror to your body. Any systemic problem often manifests first as an oral issue. Thus oral health is indicative of overall health. Many diseases may cause dry mouth which can increase your risk of developing rotten teeth. Even worse, the majority of medications have the side-effect of causing dry mouth. The most prominent disease being poorly controlled diabetes, which can directly impact saliva. Once again, make sure to visit your dentist regularly and update them on your medical history.
Teeth are often the first features people notice about a person. They are a key feature of the face and central to your smile and laugh. If you are affected by rotten teeth or other dental problems such as gum disease and crooked teeth, it is natural to feel self conscious. These issues should never prevent you from smiling and being happy.
However, due to societal expectations, rotten teeth and other dental problems have been shown in the research to dramatically lower the quality of life of a person. So much so, that tooth loss is actually classified as a social disability. It prevents you from eating the food you want, prevents you from laughing, talking and smiling. Rotten teeth can affect every aspect of your life. Therefore, if you are suffering from rotten teeth or other dental problems, it may be worth your time to visit a dentist and make a change.
Rotten teeth can be very expensive to get treatment depending on the diagnosis. As a rule of thumb, preventive medications for early decay is the cheapest treatment. A filling is the next most expensive, however the price can be range depending on the complexity of the filling required. Then an extraction, and finally the most expensive option is root canal treatment.
Once again, make sure to visit your dentist for a consultation and discuss your treatment options. Routine dental check-ups are the best way to prevent small issues from progressing into major problems like rotten teeth. Thus attending routine dental checkups can often save you money in the long run.