According to World Health Organization (WHO), oral diseases are the most common Non Communicable Diseases (NCDs) and affect people throughout their lifetime, causing pain, discomfort, disfigurement and even death.

Tooth decay affects approximately 60 to 90 per cent of school children and almost 100 per cent of adults worldwide, according to the WHO Global Oral Health Database.

WHO states that severe dental disease can result in tooth loss and the occurrence of complete tooth loss is increasing rapidly in low and middle-income countries, while currently about 30 per cent of the world’s population aged 65 to 74 lose all their natural teeth.

The Global Burden of Disease Study 2016 estimated that oral diseases affected half of the world’s population (3.58 billion people) with dental caries, permanent teeth being the most prevalent condition assessed.

Dr Michel Mbonimana, a dentist at Kigali Adventist Dental Clinic, Kacyiru, says that tooth decay or dental caries or cavities, is the destruction of your tooth enamel, the hard, outer layer of your teeth. Tooth decay, is a breakdown of teeth due to acids made by bacteria.

CAUSES 

He states that the cause of cavities is acid from bacteria dissolving the hard tissues of the teeth (enamel, dentin and cementum). The acid is produced by the bacteria when they break down food debris or sugar on the tooth surface. 

Mbonimana explains that simple sugars in food are these bacteria’s primary energy source, thus, a diet high in simple sugar is a risk factor. If minerals’ breakdown is greater than build up from sources such as saliva, caries are a result.

PREVENTION

WHO is working with countries to develop policies to prevent oral health problems to reduce the number of people who develop tooth decay, gum disease and other oral diseases.

Mbonimana advises to brush twice a day with fluoride toothpaste, clean between the teeth daily with floss or inter-dental cleaner, eat nutritious and balanced meals and limit snacking.

"Check with your dentist about the use of supplemental fluoride, which strengthens your teeth, and use dental sealants (a plastic protective coating) applied to the chewing surfaces of the back teeth (where decay often starts) to protect them from decay,” he adds.

He adds to visit a dentist regularly for professional cleanings and oral examination.

According to a recent Global Burden of Disease study, untreated tooth decay is the most widespread of 291 major diseases and injuries, if left untreated, dental diseases can cause severe pain, infection and negatively impact the quality of life, children’s growth, school attendance and performance, it can also lead to poor productivity at work and absenteeism in adults.

TREATMENT

Mbonimana recommends regular checkups to identify cavities and other dental conditions before they cause disturbing symptoms and lead to more-serious problems. The sooner you seek care, the better your chances of reversing the earliest stages of tooth decay and preventing its progression. If a cavity is treated before it starts causing pain, you probably won’t need extensive treatment.

He says, "Treatment of cavities depends on how severe they are and your particular situation. A fluoride treatment may be done, this helps restore your tooth’s enamel and can sometimes turn around a cavity in the very early stages. Fluoride treatments may be liquid, gel, foam or varnish that’s brushed onto your teeth or placed in a small tray that fits over your teeth.”

Mbonimana says that doctors can advise filling your teeth. Fillings are made of various materials, like tooth-coloured composite resins, porcelain or dental amalgam that is a combination of several materials.

According to Mayo Clinic, for extensive decay or weakened teeth, you may need a crown; this is custom-fitted covering that replaces your tooth’s entire natural crown. Crowns may be made of gold, high strength porcelain, resin, porcelain fused to metal or other materials.

Mbonimana adds, when decay reaches the inner material of the tooth (pulp), one may need a root canal; this is a treatment to repair and save a badly damaged or infected tooth instead of removing it.

You can do a tooth extraction as well, some teeth become so harshly rotten that they can’t be restored and the only solution is extraction.

RISK FACTORS

Mayo Clinic states that tooth decay occurs when food clings to the teeth for a long time, such as milk, ice cream, honey, sugar, soda, dried fruit, cake, as they are not easily washed away by saliva. When you gradually snack or sip sugary drinks, you increase bacteria to produce acids that attack your teeth and wear them down. If you don’t clean your teeth soon after eating and drinking, plaque forms quickly and the first stages of decay can begin.

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