Dental caries, commonly known as tooth decay or cavities, is a widespread condition involving the breakdown of tooth structure. This occurs when bacteria in the mouth produce acids that erode the hard tissues of the teeth, including enamel, dentin, and cementum. If left unaddressed, this acid attack can lead to holes in the teeth and potentially result in pain, infection, or even tooth loss.
What is Recurrent Caries?
Recurrent caries is new tooth decay developing at the edges of or underneath an existing dental restoration, like a filling or crown. Unlike primary caries on previously unaffected tooth surfaces, recurrent caries forms at the tooth-restoration margin. Bacteria, food particles, and acids accumulate in microscopic gaps at this margin, creating a sheltered environment. These bacteria produce acids that demineralize the tooth structure adjacent to or beneath the restoration, leading to new decay.
Why Recurrent Caries Occur
Several factors contribute to recurrent caries. Marginal gaps or microleakage, tiny spaces between the restoration and tooth surface, are a common reason. These imperfections occur if the restoration was not perfectly sealed during placement, or due to shrinkage of certain restorative materials. Even microscopic gaps allow bacteria and acids to infiltrate and initiate decay.
Restorative material degradation also plays a role, as fillings and crowns can wear down or break over time, compromising their seal. Older restorations are more susceptible to breakdown and subsequent decay. Patient habits, including poor oral hygiene around the restored tooth, contribute significantly. A diet high in sugary foods and acidic beverages provides fuel for decay-causing bacteria.
Secondary factors also increase susceptibility. Dry mouth reduces saliva flow, essential for neutralizing acids and washing away food particles. Certain medical conditions or medications can also lead to dry mouth, increasing recurrent caries risk. Habits like teeth grinding can damage restorations, making them prone to leakage and new decay.
Preventing Recurrent Caries
Preventing recurrent caries involves good oral hygiene. Brushing teeth twice daily with fluoride toothpaste and flossing daily helps remove plaque and food particles around restorations. Paying close attention to areas around existing fillings and crowns is important. An antibacterial mouthwash can further reduce bacteria and plaque buildup.
Regular dental check-ups and professional cleanings are important for early detection and prevention. Dentists can identify early signs of decay or issues with existing restorations not visible to the patient. Limiting sugary and acidic foods and drinks is important. Staying hydrated by drinking water helps rinse away food particles and acids.
If dry mouth is a concern, addressing it with a dentist helps manage increased risk. Avoiding habits that damage restorations, such as biting on hard objects or grinding teeth, also helps prevent recurrent caries. These proactive steps maintain restoration integrity and surrounding tooth structure, minimizing new decay.
Treatment Options for Recurrent Caries
When recurrent caries is diagnosed, treatment involves removing the decay and restoring the tooth. Diagnosis often begins with a visual inspection by a dentist, looking for discoloration, roughness, or gaps around the restoration. X-rays are also a common diagnostic tool, revealing hidden decay beneath restorations or between teeth not visible during a clinical exam.
Primary treatment involves removing the existing restoration and all affected decayed tooth structure. After decay is removed, the tooth is prepared for a new restoration.
The choice of new restoration depends on the extent of decay and healthy tooth structure remaining. For smaller areas, a new filling may be placed. If recurrent caries caused significant structural damage, a dental crown may be necessary for protection. If decay reached the dental pulp, a root canal may be required before the tooth can be restored.