Dentistry focuses on diagnosing, preventing, and treating conditions of the teeth, gums, and oral structures, supporting oral health and overall well-being.
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Tooth decay, or dental caries, is a long-lasting infection that damages teeth. It is more than just a hole; it happens when certain bacteria in the mouth interact with sugars from food and the surrounding environment. Tooth decay is one of the most common chronic diseases around the world.
Tooth decay starts at a microscopic level, long before you can see a cavity. It happens when the loss of minerals from the tooth is greater than the amount being replaced. Over time, this weakens the tooth’s structure.
Tooth decay mainly happens because acids dissolve the tooth surface. The mouth contains many types of bacteria, called the oral microbiome. Some bacteria, especially Streptococcus mutans and Lactobacilli, feed on sugars and starches from food.
When these bacteria break down sugars and starches, they produce acids like lactic acid. These acids lower the pH on the tooth surface. If the pH drops too low, the minerals in the enamel, such as calcium and phosphate, start to dissolve.
Dental plaque, also called biofilm, is the main cause of tooth decay. It is a sticky, clear layer of bacteria that always forms on teeth. This film lets bacteria stick to the enamel and grow in a protected space.
Inside this biofilm, bacteria are arranged in a way that makes them hard to remove with just saliva. Thick plaque keeps acids on the tooth surface longer, stopping saliva from balancing the pH and fixing early damage.
Enamel is the hardest material in the body and can handle the strong forces of chewing. It is made of tightly packed mineral rods called hydroxyapatite. Even though it is very hard, enamel can be damaged by acids.
Enamel is not completely solid. It has tiny pores and channels that let fluids and ions move through. Acid can get into these small spaces and dissolve the minerals from the inside, which can cause a white spot to appear on the tooth.
The body naturally fights tooth decay through a process called remineralization. Saliva contains calcium, phosphate, and fluoride. When the mouth’s pH goes back to normal, these minerals can rebuild weakened enamel.
If acid attacks do not happen often, saliva can repair the tiny damage to teeth. Fluoride helps this process by forming a stronger crystal called fluorapatite, which resists acid better than normal enamel.
The chewing surfaces of back teeth have rough, deep grooves called pits and fissures. These grooves are often so narrow that even a toothbrush bristle cannot reach them, making them hard to clean.
Most cavities in children and teens start in these grooves. Plaque gets stuck at the bottom, letting decay spread quickly into the softer layer under the enamel, often without being seen on the surface.
Interproximal decay happens between two teeth where they touch. A toothbrush cannot clean these tight spaces, so this type of cavity usually develops when people do not floss or use special cleaning tools.
These cavities are hard to see until they become large. Dentists use bitewing X-rays to spot the triangle-shaped shadow that shows decay between the teeth.
As people get older, their gums may recede and expose the roots of their teeth. Unlike the top part of the tooth, which has hard enamel, the root is covered by a softer layer called cementum. Cementum is more easily damaged by acids, so the roots are more likely to get cavities.
Root cavities can get worse quickly and are a big problem for older adults and people with dry mouth. The nerve is closer to the root, so pain or sensitivity can start sooner.
How often you eat sugar matters more than how much you eat. Each time you eat foods with sugar or starch, bacteria make acid for about 20 to 40 minutes. This is called an acid attack.
Snacking often keeps the mouth acidic and does not give saliva enough time to fix the teeth. This ongoing acid exposure leads to more tooth decay.
This type of tooth decay is very aggressive and affects the baby teeth of infants and young children. It often happens when a child goes to bed with a bottle of milk, formula, or juice.
When a child sleeps with a bottle, the liquid collects around the upper front teeth. This quickly damages the teeth, which can cause early tooth loss, pain, infection, and problems with adult teeth later on.
People who have radiation treatment for head and neck cancer are at high risk for a fast-spreading type of tooth decay. Radiation harms the salivary glands, causing a long-lasting and severe dry mouth (xerostomia).
Without saliva to protect them, teeth are left unprotected against acid. This type of decay often forms around the gumline and can quickly separate the top of the tooth from the root.
Saliva is the main way the mouth protects itself. Anything that greatly reduces saliva, like certain medicines or health conditions, raises the risk of tooth decay. Common causes include blood pressure drugs, antidepressants, and autoimmune diseases.
A dry mouth does not have enough fluid to wash away food or provide the minerals needed to fix early tooth damage. This makes the mouth more acidic and helps cavity-causing bacteria grow.
Send us all your questions or requests, and our expert team will assist you.
A cavity is a permanently damaged area in the hard surface of your teeth that develops into a tiny opening or hole. It is the physical result of tooth decay, in which minerals have been stripped away by bacterial acids.
Yes, the bacteria that cause tooth decay, specifically Streptococcus mutans, can be transmitted from person to person through saliva. This often happens from mother to child by sharing spoons or tasting food, or between partners.
In the very early stages, before a physical hole forms, decay can be reversed through remineralization with fluoride and saliva minerals. However, once the enamel surface breaks and a hole forms, the tooth cannot heal on its own and requires professional treatment.
Sugars are found in many foods, including carbohydrates like bread, chips, pasta, and fruit. Bacteria metabolize these fermentable carbohydrates into acid. Frequent snacking on starchy foods can be just as damaging as eating sweets.
Yes, sugar free sodas can still cause erosion and decay. While they lack sugar for bacteria to eat, the beverages themselves are highly acidic. This acid directly dissolves the enamel surface, weakening the tooth and making it more susceptible to bacterial attacks.
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