How do teeth get decayed?

Tooth decay is a common problem for many children. It is usually accompanied by pain and severe cases may require tooth extraction. Tooth decay is quite harmful, and the loss of a tooth also affects the appearance. In order to avoid tooth decay, we need to understand the causes of tooth decay and take preventive measures. So, how do teeth get decayed? Let’s take a closer look below.

The currently recognized theory of the etiology of dental caries is the four-factor theory , which mainly includes bacteria, oral environment, host (that is, parasites including parasites, viruses and other organisms that parasitize on it) and time. The basic point is that cariogenic food sugars (especially sucrose and refined carbohydrates) are tightly attached to the tooth surface, forming an acquired film by salivary proteins. This acquired film is not only firmly attached to the tooth surface, but also has enough time and temperature to produce acid deep in the plaque, attacking the teeth, demineralizing them, and further destroying organic matter, resulting in caries. 1. Bacterial tooth decay is a necessary condition for occurrence. It is generally believed that there are two types of cariogenic bacteria. One is acid-producing bacteria, mainly Streptococcus mutans, Actinomyces and Lactobacillus, which can decompose carbohydrates to produce acid, leading to demineralization of tooth inorganic matter; the other is Gram-positive cocci, which can destroy organic matter and form tooth cavities after long-term action.

2. Oral environment The oral cavity is the external environment of the teeth and is closely related to the occurrence of caries, among which food and saliva play the dominant role. (1) Food is mainly carbohydrates, which are related to the formation of plaque matrix and are also the main energy source for bacteria in plaque. Bacteria can use carbohydrates (especially sucrose) to metabolize acids and synthesize extracellular and intracellular polysaccharides. The organic acids produced are beneficial to the growth of acid-producing and acid-resistant bacteria, and are also beneficial to the demineralization of dental hard tissues. Polysaccharides can promote the adhesion and accumulation of bacteria on the tooth surface and provide an energy source when exogenous sugar is lacking. (2) Under normal circumstances, saliva has the following functions: ① mechanical cleaning effect; ② antibacterial effect; ③ anti-acid effect; ④ anti-dissolution effect. Changes in the quantity and quality of saliva can affect the caries prevalence. Clinically, the caries prevalence in patients with xerostomia or salivary secretion is significantly increased. Patients who undergo maxillofacial radiotherapy may have multiple caries due to damage to the salivary glands; on the other hand, an increase in the amount of lactic acid in saliva is also conducive to the occurrence of caries.

3. Host teeth are target organs in the caries process. The morphology, mineralization degree and tissue structure of teeth are directly related to the occurrence of caries. 4. Time: The occurrence of tooth decay is a long process. It usually takes 1.5 to 2 years from the initial stage of caries to the clinical formation of caries holes. Therefore, even if cariogenic bacteria, a suitable environment and a susceptible host exist at the same time, caries will not occur immediately. Only when the above three factors exist at the same time for a considerable period of time can caries occur.

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