Tooth decay is the most commonly encountered oral health problem. The uniqueness of this disease is that, it cannot be reverted back to normal but can only be repaired. 

Reasons for Tooth Decay
For a tooth to decay, many factors play an important role. The food debris gets entrapped in between the tooth and it often remains untouched with routine brushing. This creates a source of food for the bacteria to thrive upon and produce acids and paves a way for cavity formation. Plaque is a thin film that forms over tooth and harbours micro-organisms. If this layer isn’t cleansed, leads to hard mass called calculus. This is another major reason for tooth decay. Poor oral hygiene leads to decay and bad breath. This condition needs intervention by a dentist and a thorough counselling. 
Dry mouth or xerostomia is another cause of cavities. Here there is lack of saliva secretion in the mouth. 
Radiotherapy for head and neck cancers also leads to reduced salivary flow and increasing rate of radiation induced tooth decay. 
Autoimmune diseases also lead to increased susceptibility to dental caries/cavities. Eg. Sjogren syndrome. 
Diabetics have many oral manifestations. They too suffer from dry mouth which leads to caries activity. Therefore, it’s advice to keep the oral cavity moist. 
Periods of stress, eg. Stress due to examinations; fasting leads to decrease in saliva production. The mouth become dry and causative factor for tooth decay. 
In children, nursing bottle tooth decay is common. During night time when the baby is fed milk, it’s mandatory to cleanse the mouth. Else, it leads to initiation of tooth decay and spreads rapidly to other teeth. 
Person undergoing braces treatment called as orthodontic therapy for malpositioned teeth has higher tendency to go into state of cavities due to difficulty in brushing. Special care to be taken in such cases. Plaque control measures by using interdental brushes, specialized tooth brush and regular scaling/cleaning of tooth. 
Tongue also harbours many caries producing bacteria. It’s important to also cleanse the tongue along with routine brushing. 

Importance of saliva in controlling tooth decay 
Saliva and it’s constituents play an important role keeping the tooth decay process in check by maintaining the mouth moist. It has the beneficial anticarcinogenic properties. Dry mouth should be addressed at the earliest and from the patient’s side, it’s important to realize such condition. 

Measure to control tooth decay 
Sorbitol, sugar free gums are advised to be used in order to stimulate salivary flow. 
Food rich in fiber keeps cavity under control. 
Cheese, whole meal food, black tea are known to be good anti-cavity food items. 
Thorough cleansing of mouth after every meal helps to reduce cavities. 
Use of proper brushing method, interdental aids has a vital role. 
Once in six month visit to a dentist and getting oral health check up and scaling/tooth cleaning done helps to address any oral disease at the earliest. 
Parents should take care of their child’s oral health. Cleaning of gums in infants, rinsing the mouth, monitored tooth brushing is mandatory to avoid caries. 
Patients undergoing radiation therapy or other systemic diseases leading to poor oral health, intervention by dentist and medications for the improved saliva flow is a must. 
Take home message 
Tooth decay often neglected which leads to progression of the disease which requires complex treatments when identified late. By knowing all the facts mentioned above, it’s important to maintain a healthy mouth and reduce the disease burden. 

Article by: Dr. Siri P.B.