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What happens when your tooth starts to decay? If you let plaque build up on your teeth, then the bacteria in the plaque can turn to acid which erodes the tooth. If this acid erodes the tooth for long enough, then the tooth starts to decay.

Luckily, your teeth are made of strong stuff. They are covered by a tough outer enamel which is designed to protect the teeth against decay. Underneath the enamel, there is also a layer of dentin which is similarly strong and resistant to decay.

Beneath the dentin, however, are the softer parts of the tooth, such as the pulp, nerves and blood vessels. It is not until the decay reaches these parts of our tooth that we start to feel any real pain. In fact, we can have cavities in our tooth enamel which we might never know about until a dentist spots them.

How can you tell if you have tooth decay? As mentioned above, small cavities may go unnoticed. With larger cavities, however, the decay may have broken through the enamel and dentin. If the decay reaches the pulp of the tooth, the bacteria can cause an infection which causes the pulp of the tooth to become inflamed and irritated. One of the problems with the pulp becoming inflamed is that the infection cannot naturally drain away. As the pulp swells, it is trapped by the hard dentin and there is no way to naturally relieve this pressure.

This pressure causes toothache. Typically, you may begin to notice the ache when eating hot or cold foods. It may even begin as just mild sensitivity. As the infection grows, however, you can find that the tooth and even the jaw starts to swell. Your gums and cheek can become tender to the touch. In severe cases, you may even notice some bleeding from the tooth and gum area around it.

This condition is called Pulpitis. If the condition is not given the appropriate treatment, then Pulpitis will eventually cause the pulp to die.

Up to a certain point, Pulpitis is reversible. The decay can be removed, the area around the tooth cleaned and the cavity filled. If this is done early enough (before the infection has become too serious) the pulp is revitalised and the tooth saved.

In cases where the infection has become irreversible, root canal treatment may be required. Your dentist will need to drill into the pulp and remove the infected matter. Once the pulp is removed, the chamber is then filled with an inert material such as ‘gutta percha’, a latex derivative. Once this procedure has been completed, the tooth is essentially dead. Often, a crown is fitted to the dead tooth to afford it extra protection.

In other cases, where the structure of the tooth is no longer sound – for example, if it has split or fractured – then your dentist may be left with no option but to remove the tooth.

Can you protect against Pulpitis? As with many dental conditions, the best type of care is preventative care. If you can reduce the amount of plaque on your teeth, you can reduce the amount of decay. If you can reduce the amount of decay, then you are far less likely to experience severe dental problems.

Removing plaque from your teeth is relatively straightforward. Regular brushing will normally remove plaque. However, plaque builds up on our teeth every single day, so you must ensure that you brush at least twice every day. Regular flossing will also help.

Being careful about what you eat and drink is also important. It is the bacteria in the plaque on your teeth that creates the acid that causes tooth decay. Research shows that this bacteria reacts most effectively with sugary foods and carbohydrates. Smoking will also increase the amount of bacteria present on your teeth.

Saliva is our bodies’ natural way of eliminating bacteria and neutralising acid. However, if you consistently snack on sugary foods, you are not giving the saliva the time it needs to work effectively. So as well as cutting down on sugary foods and drinks, you should also try to only eat them at meal times.