Yassin Bayigamba emerges from a dentist’s room with a swollen left cheek whimpering in pain. His rotting molar tooth has just been extracted. 

"The condition was severe and the only option was to do away with his tooth,” says Epimaque Kayiranga, a dental surgeon at the University Teaching Hospital (CHUK) in Kigali, amidst stares from a queue of patients waiting for their teeth to be examined.

Bayigamba is just one of the many people who have problems with their dental health. He says he has been struggling with sharp pains from his molar tooth for the past eight months. He explains that it all started as mere pain he thought would gradually go away, so he did not seek medical attention.

"At first I thought I had eaten hard meat that caused my tooth to ache, but the condition persisted even after stopping to consume hard foods. I could not figure out what the problem was until last Saturday when I went to see a dentist and was diagnosed with dental cavity,” says Bayigamba as he struggles to speak.

According to dentists, the condition is common in both children and adults. They blame it on poor dental care and the consumption of sugary foods.

What is dental caries?

Dental caries occurs due to breakdown of the tooth or supporting material like enamel and root by bacteria. Most risk factors are residual food particles and debris; these are later decomposed by bacteria. The condition manifests as recurrent swelling and pain around the affected tooth, yellow or blackish discoloration of tooth and later formation of cavities.

Dr Kayiranga says the formation of cavities includes three major factors, namely; time, bacteria and the tooth itself.

"Normally, the process of tooth decay may go unnoticed by many people as at first it is painless. With time, when the bacteria continue feeding on the plaque which most of the time consists of starchy and sugary foods, a hole is formed in the tooth and here one can start feeling pains,” says Kayiranga.

Usually, patients with dental cavities experience few symptoms such as sensitivity when taking cold or hot foods as well as toothache.

However, Gonzalue Niyigaba, a dentist at CHUK, says sometimes the signs may be severe depending on how serious the condition is.

"Feeling pain when chewing and the hole inside the tooth at times may cause serious discomfort to the patient.

This is normally after prolonged decaying of the plaque which may take between five and six months without any treatment,” he says.

He adds that the situation is more likely to be different for the kids, since their teeth and the gums are not fully developed; the process of tooth decaying may be a bit faster like only three months for the symptoms to become severe.

Causes

Bacteria are the main cause of dental cavities.

"Poor brushing of the teeth may lead to food particles remaining on the surface of the tooth, especially carbohydrates. When the bacteria feed on it, it decomposes leading to dental cavities. If this condition is left untreated it may affect the jaws and roots of the teeth leading to removal of the whole teeth,” says Ally Kambale of Kabaya Hospital in Western Province.

Kambale adds that if the bacteria have not destroyed the root of the tooth, then the condition can be repaired without removing the tooth.

Dr Rachna Pandey, a specialist of internal medicine at Ruhengeri Hospital, explains that although consumption of food containing too much sugar is the major cause of dental caries, there are other factors behind it.

"High sugar foods like candies, chocolates and sweets are more likely to cause dental caries. Using a toothbrush with worn out bristles does not clean the teeth well which may increase the risk of developing caries,” says Pandey.

Prevention and treatment

Pande says the first form of prevention is cleaning teeth well after every meal.

"One should avoid using worn out toothbrushes; flossing at least once a day is useful as well as using toothpaste that contains fluoride,” she says.

She adds that in case of mild infection, antiseptic mouthwash should be applied. In case of any pain from the tooth, anti-inflammatory drug like ibuprofen should be used.

Some of the interventions used in treating caries include scaling and removal of tartar and the root canal.

However, Niyigaba says dental cavities are normally treated by removing the decomposed food materials and ensuring a healthy dental environment. Removal of the tooth is done only when the bacteria have destroyed the root and other inner parts of the tooth.

CHUK’s stomatology department statistics show that about 30 people seek dental care per day.

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