Tooth Decay (dental caries)
Decay happens when sugars in food and drinks react with the bacteria in plaque, forming acids.
Every time you eat or drink anything containing sugars, these acids attack the teeth and start to
soften and dissolve the enamel.
The attacks can last for an hour after eating or drinking, before the natural salts in your saliva cause
the enamel to ‘remineralise' and harden again.
Snacking between meals on sugary or acidic foods and drinks can increase the risk of decay, as the
teeth come under constant attack and do not have time to recover. It is therefore important not to
keep snacking on sugary foods or sipping sugary drinks throughout the day.
What is dental decay?
Dental decay is caused by plaque acids that gradually dissolve away the enamel and dentine of the
tooth. This happens when you have eaten or drunk anything containing sugars, the tooth becomes
softened by this acid attack and over time the acid forms a cavity
What is enamel? Enamel is the hard, protective outer coating of the tooth and is the hardest part of
the body. It does not contain any nerves or blood vessels and is not sensitive to pain.
What is dentine? Dentine lies under the enamel, forming most of the tooth, and it can be very
sensitive to pain. Dentine covers the central ‘pulp' of the tooth.
What is the pulp? The pulp is a soft tissue which contains blood vessels and nerves and is in the
middle of the tooth.
What is plaque? Plaque is a thin, sticky film that keeps forming on your teeth. It contains many
types of bacteria.
What are the signs of dental decay?
In the early stages of dental decay there are no symptoms, but your dentist may be able to spot a
cavity in its early stages when they examine or x-ray your teeth. This is why you should visit your
dentist regularly, as small cavities are much easier to treat than advanced decay.
What happens if I have a cavity?
Once the cavity has reached the dentine your tooth may become sensitive, particularly with sweet
foods and drinks, and acidic or hot foods. As the decay gets near the dental pulp you may suffer
from toothache. If the toothache is brought on by hot or sweet foods this may last for only a few
seconds.
As the decay gets closer to the dental pulp the pain may last longer and you may need to take
painkillers to control the pain.
What happens if I don't get it treated early?
Toothache is a sign that you should visit a dentist straight away, as it is a warning that something is
wrong. If you don't do anything, this will usually make matters worse and you may lose a tooth that
could otherwise have been saved.
What areas of my teeth are more likely to decay?
The biting surfaces of the teeth and the surfaces between the teeth are most likely to decay, as food
and plaque can become stuck in these areas. But any part of the tooth can be at risk.
What treatment will I need?
If the decay hasn’t progressed too far, the dentist will remove all the decay and restore the tooth
with a filling. Sometimes the nerve in the middle of the tooth can be damaged. If so, the dentist will
need to carry out root canal treatment by removing the nerve and then restoring the tooth with a
filling or a crown. If the tooth is so badly decayed that it cannot be restored, the dentist may have to
take the tooth out.
Will I always need a filling?
No. In the very early stages of decay, your dentist may apply a fluoride varnish onto the area. This
can help stop further decay and help ‘remineralise' the tooth. However, it is important to follow the
cleaning routine your dentist or hygienist suggests, using fluoride toothpaste to prevent decay
starting again.
What can I do to prevent decay?
The best way to prevent dental decay is by brushing your teeth thoroughly twice a day with fluoride
toothpaste, making sure that you brush all surfaces of your teeth.
Children up to three years old should use a toothpaste with a fluoride level of at least 1000ppm
(parts per million).
Threeyear-olds to adults should use a toothpaste that contains 1350ppm to 1500ppm of fluoride.
Using ‘interdental' brushes, or dental floss helps remove plaque and food from between your teeth
and where they meet the gums. These are areas an ordinary toothbrush can't reach.
Is there anything else I can do?
-Visit your dentist regularly.
-Avoid snacking between meals to limit the times your teeth are under attack from acids.
-Chewing sugar-free gum for up to twenty minutes after a meal can help your mouth produce more
saliva, which helps to neutralise any acids which have been formed.
