Tooth decay is an infectious process whereby bacteria in the mouth damages the hard mineralised structure of teeth.

Presentation and symptoms

Initially, tooth decay (or dental caries) can start out looking like a small chalky area but as the lesion progresses, it can turn brown and eventually break down into a cavity. As the decay progresses deeper towards the centre of the tooth, it can cause pain as it approaches the nerve. The pain may worsen with exposure to heat, cold or sweet food. Sometimes tooth decay cannot be seen directly and dental x-rays are required to detect it.

About the condition

Tooth decay formation and progression is influenced by a combination of factors – tooth structure, bacteria, sugars and time. Bacteria produce acids when exposed to dietary sugars and this acid attacks the tooth, dissolving tooth structure over time. Saliva helps to repair such damage by neutralising the acid and promote remineralisation of the tooth if the acid attacks are infrequent. However, impaired salivary flow and the saliva acidity can increase the risk for dental decay.

Diagnosis and treatment options

Diagnosis involves inspection of the teeth using a good light source. Large lesions can be detected by visual inspection but smaller or incipient (early) lesions may be difficult to identify. Dental x-rays may also detect decay that cannot be seen directly, especially decay between the teeth.

For small early lesions, topical fluoride can be used to encourage remineralisation of the tooth structure. For larger lesions, the progression of decay requires treatment to stop it. The decayed portions of the tooth are removed and a dental filling material is placed to restore aesthetics and function. Restorative materials include silver amalgam, composite resin, ceramics and metal alloys. In some cases, root canal (endodontic) therapy may be required if the pulp in the tooth dies. If the tooth is too far destroyed for effective restoration, extraction will be required.

Post-Visit Care Tips

Good dental health can be achieved with proper daily brushing and flossing. The goal of brushing and flossing is to remove the bacteria containing plaque. Intake of dietary sugars should be monitored and controlled and regular examinations by the dentist are recommended.