You can classify dental caries as one of three ways based on where they occur in the mouth.

1. Interproximal caries - On the sides of the tooth or in between teeth
2. Pit and fissure caries - In the deep grooves on the biting surface of the teeth
3. Root caries - On the root surface of the tooth or teeth, found most often when a patient has gum recession

Dental caries are irreversible tooth decay where the hard structures of the tooth demineralize from acids in the mouth. The bacteria in plaque on your teeth and gums produce acids that attack tooth enamel. "Rampant caries" is a condition characterized by wide-spread and rapidly growing cavities and is a term used to describe a mouth with dental caries present in more than ten teeth. With proper education and good oral care practices at home, dental caries are preventable.

In early childhood, toddlers can develop rampant caries if they drink formula, milk, or low-pH fruit juice in a bottle or sippy cup right before bedtime. When a child's mouth isn't cleaned before bedtime, the low pH allows the oral bacteria to feed on the sugars in the drink all night long. Demineralization thrives in environments where acid is present to attack the teeth. This process is known as "baby bottle tooth decay."

Adolescents can also be affected if they drink low pH, high-sugar drinks, like soda, sports drinks, or energy drinks. Adolescent caries present a challenge to dental professionals because they often involve permanent teeth. This condition can affect a teenager's confidence in smiling and socializing and can also cause pain and discomfort that prevents the patient from attending school or work. In adolescents, cavities may be a sign of poor nutrition. Teens can improve their oral health by decreasing the amount of sugar in their diet and picking up healthy habits, such as chewing sugar-free gum, drinking plenty of fluoridated water, and improving their oral care routine at home.

Adults and the elderly can also experience rampant caries, especially those affected by dry mouth. When saliva production decreases due to aging, radiation therapy, or certain medications, the mouth's ability to fight demineralization diminishes because saliva acts as a natural cleaner of the mouth. Dry mouth creates a perfect storm for cavities to appear and progress deeper into the tooth.

You can treat dental caries with restorative treatments that include removing the diseased portion of the tooth, then placing a filling to strengthen the tooth. If you lose too much of the tooth to rampant decay, the dentist may choose to place a crown on the tooth to protect it. The type of restoration depends on how much of the healthy tooth remains and the tooth's location.

When it comes to taking care of your teeth, the best course of action to avoid rampant dental caries is prevention. Maintaining a good oral care routine with daily flossing and twice-daily brushing with fluoride toothpaste is the best way to ensure your teeth are set up for success. However, if your rampant dental caries gets ahead of you, there are plenty of treatment options available. Talk to your dentist and they will work with you to find the best course of action for your smile.

What causes rampant caries, and who is more at risk?

Rampant caries can be caused by poor oral hygiene, medication side effects such as dry mouth, acidity, and high sugar intake. Young children are more at risk due to undeveloped or weakened enamel, poor oral hygiene skills, and if they are put to bed with a bottle or sippy cup of milk or juice. Adolescents are also at higher risk due to hormonal changes, lack of good oral hygiene practices and diets that are generally high in sugar and carbohydrates. Older adults may experience rampant caries from wearing dentures, lack of dexterity (which can lead to poor oral hygiene) and reduced salivary flow, according to an article in the International Journal of Dentistry. Lastly, radiation especially of the neck and head can contribute to decay and put cancer patients at a higher risk for cavities. 

How can you recognize the early signs of rampant caries?

If you have more than one cavity at the same time, this can be an early sign of rampant caries. Look for signs of decay such as white or brown spots and discoloration. If this affects several teeth it could be an early sign of rampant caries risk. Remineralizing the teeth can prevent further decay through proper oral hygiene and topical fluoride.

What should you do if you think you have rampant caries?

If you suspect you have rampant caries discuss it with your dental professional. Strengthen weakened enamel with fluoride and by avoiding acidic foods and drinks. Reduce cavity producing bacteria through proper oral hygiene, salt rinses or by taking a probiotic containing lactobacilli. This type of beneficial bacteria helps metabolize carbohydrates and lowers the acids that contribute to demineralization of tooth enamel. 

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.