Tooth Decay

Tooth decay (dental caries or cavities) is one of the most common dental problems worldwide, affecting people of all ages. It occurs when bacteria in your mouth produce acids that gradually dissolve tooth enamel, creating holes or cavities in teeth. Without treatment, decay progresses deeper into the tooth, causing pain, infection, and eventually tooth loss.

How Tooth Decay Develops

Your mouth naturally contains bacteria. When you eat or drink sugary or starchy foods, these bacteria feed on the sugars and produce acids. These acids attack tooth enamel for about 20 minutes after eating. Over time, repeated acid attacks weaken enamel, creating cavities.

Stages of Tooth Decay

1. Initial demineralization: Enamel begins to lose minerals; white spots appear
2. Enamel decay: Enamel breaks down; cavity forms
3. Dentin decay: Decay reaches dentin (layer under enamel); tooth becomes sensitive
4. Pulp involvement: Decay reaches tooth pulp (nerves and blood vessels); severe pain occurs
5. Abscess formation: Infection spreads beyond tooth root; abscess forms

Symptoms

Early decay may not cause symptoms, emphasizing the importance of regular dental check-ups. As decay progresses, you may experience:

• Toothache or spontaneous pain
• Sensitivity to hot, cold, or sweet foods and drinks
• Visible holes or pits in teeth
• Brown, black, or white staining on tooth surface
• Pain when biting down
• Bad breath or unpleasant taste

Risk Factors

• Frequent snacking or sipping sugary drinks: Provides constant fuel for acid-producing bacteria
• Poor oral hygiene: Inadequate brushing and flossing allows plaque buildup
• Dry mouth: Reduced saliva allows acids to linger longer
• Worn fillings or dental devices: Create hiding places for bacteria
• Acidic foods and drinks: Directly weaken enamel
• Eating disorders: Frequent vomiting exposes teeth to stomach acid
• Inadequate fluoride: Fluoride strengthens enamel
• Age: Young children and older adults are at higher risk
• Location of tooth: Back teeth (molars) are harder to clean

Prevention

Daily Oral Hygiene

• Brush twice daily for 2 minutes with fluoride toothpaste
• Floss daily to remove plaque between teeth
• Use antimicrobial mouthwash
• Consider electric toothbrush for more effective cleaning

Dietary Changes

• Limit sugary and acidic foods and drinks
• Avoid frequent snacking between meals
• Drink water instead of sugary beverages
• Eat tooth-friendly foods (cheese, nuts, vegetables)
• Chew sugar-free gum after meals to stimulate saliva

Professional Care

• Visit dentist regularly (every 6 months minimum)
• Professional cleanings remove plaque and tartar
• Fluoride treatments strengthen enamel
• Dental sealants protect back teeth (especially for children)
• Early cavity detection when treatment is simpler

Treatment Options

Treatment depends on decay severity:

Early Stage (Demineralization)

Fluoride treatments can reverse early decay and remineralize enamel. Available as:

• Professional fluoride varnish or gel at dental office
• Prescription high-fluoride toothpaste
• Fluoride mouthrinse

Cavities

Fillings are the standard treatment. Decayed material is removed and the hole filled with composite resin, amalgam, gold, or porcelain. See our Fillings treatment page for details.

Extensive Decay

When decay affects most of the tooth, a crown may be needed. The damaged portion is removed, and a custom cap covers and protects the remaining structure.

Pulp Involvement

Root canal treatment removes infected pulp, cleans the interior, and seals the tooth. A crown usually follows to protect the weakened tooth.

Severe Damage

If the tooth can't be saved, extraction is necessary. Replacement options include implants, bridges, or partial dentures.

Complications of Untreated Decay

• Severe toothache and pain
• Dental abscess (pus-filled pocket)
• Swelling and infection
• Tooth loss
• Chewing difficulties
• Nutritional problems from difficulty eating
• Positioning shifts of other teeth
• Infection spreading to other body parts (rare but serious)

Special Considerations for Children

Children are particularly susceptible to tooth decay. Protect young teeth by:

• Starting oral hygiene early (as soon as first tooth appears)
• Limiting juice and sugary drinks
• Avoiding putting baby to bed with bottle
• First dental visit by age 1
• Considering dental sealants for molars
• Teaching proper brushing technique
• Supervising brushing until age 7-8

Cost of Treatment

• Fluoride treatment: £20-£50 (often free for children on NHS)
• Filling: £50-£250 private; NHS Band 2 (£73.50)
• Crown: £500-£1,500 private; NHS Band 3 (£319.10)
• Root canal: £400-£1,000 private; NHS Band 2 (£73.50)
• Extraction: £75-£400 private; NHS Band 2 (£73.50)

Prevention is far more cost-effective than treatment. Investing in good oral hygiene and regular check-ups saves money and preserves your natural teeth.

The Bottom Line

Tooth decay is largely preventable through proper oral hygiene, smart dietary choices, and regular dental care. Early detection and treatment prevent progression to more serious problems. Don't ignore dental pain or sensitivity – see your dentist promptly. Your teeth are meant to last a lifetime with proper care.