Overview
Tooth decay is a disease process in which acids produced by plaque bacteria remove minerals from a tooth. Early damage may be stopped or reversed, but once tooth structure collapses into a cavity it generally requires restorative treatment.
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Tooth Decay
Tooth Decay explained in clear patient-friendly language, including what to notice, what a dentist may review, and questions to ask.
Oral Conditions
Cavities develop when bacterial acids repeatedly remove minerals from enamel and dentin.
Evidence-based guidance
Practical steps for tooth decay.
Causes
- Tooth decay develops when plaque bacteria use sugars and starches to produce acids that repeatedly remove minerals from enamel or exposed roots.
- Early mineral loss can progress into a cavity when acid attacks outpace repair by saliva and fluoride.
Contributing Factors
- Frequent sugary drinks or snacks, low fluoride exposure, dry mouth, deep grooves, exposed roots, and plaque-retentive appliances increase risk.
- Past cavities are an important predictor; medicines, reflux, disability, and access to care can also affect risk.
Symptoms
- Early decay may have no symptoms or appear as a white, brown, or dark spot.
- As damage progresses, sensitivity, food trapping, a visible hole, biting pain, spontaneous toothache, swelling, or infection may develop.
Diagnosis
- The dentist combines visual and tactile examination with history and risk assessment.
- Dental X-rays can reveal decay between teeth or beneath restorations that is not visible directly.
Prevention
- Brush twice daily with fluoride toothpaste, clean between teeth, limit the frequency of added sugars, drink fluoridated water when available, and obtain risk-based dental care.
- Fluoride varnish, prescription fluoride, and sealants may provide added protection for selected patients.
Treatment
- Very early noncavitated areas may be managed with fluoride, improved plaque control, diet changes, and monitoring.
- A cavity may require a filling or crown; deeper disease may require root canal treatment or extraction if the tooth cannot be restored.
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