Image of dental caries (tooth decay) formation step by step, forming dental plaque and finally caries and cavity.

Dental Caries (Tooth Decay): Causes, Prevention, and Treatment

Tooth decay, or dental caries, is the silent menace of oral health issues. Unlike gum disease or halitosis, tooth decay has subtle symptoms that are easy to ignore as it progresses. 

Unless your dentist detects the condition and intervenes in its early stages, tooth decay can advance quickly, leading to oral health complications that can severely affect your overall health and well-being. 

So what can you do to protect your teeth from decay? This article will answer this question and provide insight into the causes of dental caries, the consequences of untreated tooth decay, and the available treatment options for this common but serious oral health issue. 

Causes of Dental Caries


Role of Plaque and Oral Bacteria in Tooth Decay

Plaque is a sticky substance that forms on the teeth and along the gumline. It’s a combination of food residue, oral bacteria, and saliva. Though dental plaque forms naturally, poor oral hygiene and certain foods can accelerate its accumulation. 

What’s concerning is that plaque provides an ideal environment for oral bacteria like Streptococcus mutans, which is associated with developing dental caries. These bacteria feed on food residue on your teeth, producing acids. 

Over time, these acids dissolve crucial minerals such as calcium and phosphate from the enamel. This process, known as demineralization, weakens the enamel making it porous and leading to early stages of cavity formation. 

If left untreated, the cavity grows larger as oral bacteria reach the dentin and pulp layers beneath the enamel. At this point, tooth damage worsens since these layers are more vulnerable to decay. 

Effect of Diet and Sugar on Tooth Decay

Your diet significantly impacts your oral health. For example, frequently consuming foods high in sugar increases your risk of developing dental caries. 

Acids produced by oral bacteria as they feed on sugar erode the enamel and weaken your teeth structure. Furthermore, foods with high sugar content increase the rate of plaque buildup leading to the increase of harmful bacteria in the mouth. 

Importance of Oral Hygiene Practices

Maintaining a proper oral hygiene routine is arguably the most effective way of preventing dental caries. 

Remember, plaque forms constantly on your teeth. Brushing and flossing using the proper routine removes plaque buildup from all teeth surfaces before it can mineralize into tartar. This hard, yellow deposit can only be removed by a dental professional.

Additionally Oral hygiene practices can help reduce the amount of harmful bacteria in your mouth. This has various benefits to your oral health, including reduced risk of gum disease, dry mouth, and halitosis. 

Risk Factors for Dental Caries


Poor Oral Hygiene Habits

Your mouth is a thriving ecosystem home to different types of bacteria. An effective oral care routine prevents harmful oral bacteria like Streptococcus mutans from multiplying and wreaking havoc on your teeth. 

Poor oral hygiene habits like infrequent teeth cleaning or tooth brushing and flossing with the wrong techniques lead to plaque buildup, which directly contributes to the increase of harmful bacteria in your mouth. What’s worse, plaque in hard-to-clean mouth areas like the back molars can mineralize into tartar which forms a breeding ground for bacteria.

Since tartar can’t be removed through brushing and flossing, cavity-causing bacteria will thrive, increasing your risk of developing dental caries and other oral health complications. 

High Sugar and Carbohydrate Consumption

Foods high in sugar and carbohydrate content substantially impact tooth decay. Oral bacteria need simple sugars to thrive and multiply. After eating foods like bread and pasta, oral bacteria metabolize carbohydrates into simple sugars. They then feed on these sugars producing acids that weaken the enamel increasing your risk of tooth decay.

On the other hand, foods and drinks with added sugars, such as energy drinks and candies, are harmful to your dental health since they provide oral bacteria with a ready food source. What’s concerning is that such foods and drinks are habit-forming and often consumed in large quantities leading to an increased risk of dental caries and other oral health problems.  

Dry Mouth Conditions

Saliva keeps your mouth hydrated, maintains a neutral oral pH, and cleanses the mouth by washing away food residue and harmful oral bacteria. Dry mouth, a condition that causes reduced saliva flow, can contribute to dental health problems, including caries. 

For instance, saliva contains minerals like calcium that help remineralize the teeth and strengthen the enamel. Insufficient saliva levels leave your teeth vulnerable to tooth decay since acids produced by oral bacteria demineralize the teeth by dissolving minerals like calcium and phosphate from the enamel.

Moreover, saliva contains antimicrobial properties that play a role in inhibiting the growth of harmful oral bacteria. Reduced saliva levels leave your mouth unprotected against harmful bacteria, making your teeth more susceptible to dental caries.

Presence of Dental Appliances or Restorations

Even though dental appliances and restorations are meant to correct oral health issues, they can lead to tooth decay. For example, orthodontic appliances like braces can make it harder to properly clean the teeth and gums, leading to plaque buildup. 

Additionally, certain dental restorations, such as implants, can interfere with the oral environment leading to conditions like dry mouth. As mentioned, saliva maintains a neutral oral pH and helps remineralize the teeth. Therefore, reduced saliva flow can increase the risk of tooth decay.

Age and Genetic Factors

As you age, your teeth may undergo various changes making them susceptible to tooth decay. For example, it’s natural for your teeth to wear and tear after a lifetime of chewing and biting. Unfortunately, there is a high chance that dental caries will develop in the worn areas. 

Moreover, aging can contribute to gum recession, exposing the root surfaces of the teeth. These areas are more vulnerable to tooth decay since they don’t have an enamel covering as hard and thick as the one on the tooth’s crown. 

Genetic factors can also increase your risk of tooth decay. For example, genetic variations may cause your enamel to be thinner, making your teeth prone to decay.

Prevention of Dental Caries


Effective Oral Hygiene Practices

Effective oral hygiene practices can help prevent tooth decay, reduce your risk of developing serious oral health issues, and improve your overall health. 

Here’s a breakdown of oral hygiene practices for tooth decay prevention:

Proper Brushing Technique and Frequency

Proper brushing techniques help prevent plaque buildup, especially in hard-to-clean mouth areas and along the gumline. For example, Stillman’s brushing method effectively cleans the gumline and the tooth surface. It involves positioning the bristles at a 45-degree angle towards the gum line and using short and light horizontal brushing strokes. 

On the other hand, Charter’s brushing method is ideal if you have orthodontic braces installed. It involves positioning the toothbrush at a 45-degree angle with the bristles pointing towards the tooth’s crown and using short circular motions to remove plaque below the brackets and arch wire. 

Flossing and Interdental Cleaning

Interdental cleaning plays a crucial role in tooth decay prevention. For example, flossing helps remove plaque buildup from areas your toothbrush can’t reach. However, using the right flossing technique is important to ensure the best results and reduce the risk of gum injury. 

For example, the finger-wrap method easily cleans interdental spaces and areas below the gumline. It involves wrapping a piece of floss about 20 inches long around each middle finger and carefully wrapping it between the teeth in an up-and-down motion. 

Moreover, if you find flossing challenging, you can use interdental cleaners such as dental picks, water flossers, and interdental brushes. 

Use of Fluoride Toothpaste and Mouthwash

Fluoride toothpaste strengthens the enamel through remineralization, making it less vulnerable to acid corrosion. Moreover, fluoride toothpaste also inhibits bacterial metabolism in the mouth, reducing the ability of oral bacteria to produce harmful acids. 

On the other hand, mouthwash prevents plaque buildup in hard-to-clean mouth areas by killing harmful oral bacteria. Mouthwash also keeps the mouth hydrated by stimulating saliva production. Furthermore, using mouthwash once a day prevents halitosis and reduces the risk of gum disease and other oral infections. 

Fluoride mouthrinses have also been proven to help strengthen the enamel and reduce the risk of dental caries.  

Healthy Dietary Habits

A healthy diet plays a significant role in the prevention of dental caries. For example, limiting your intake of foods high in sugar and acidic content reduces the risk of tooth decay. Sugar provides oral bacteria with a ready food source allowing them to multiply and produce acids at a higher rate. 

On the other hand, acidic foods offset your mouth’s pH balance creating an ideal environment for harmful oral bacteria to thrive. Moreover, acidic foods and beverages weaken the enamel over time, making it susceptible to dental caries and tooth decay. 

Including tooth-friendly foods in your diet profoundly benefits your oral health and overall well-being. Examples of tooth-friendly foods include the following: 

  • Nuts and seeds: Chewing on almonds, cashew nuts, and pumpkin seeds helps scrub plaque from the teeth and stimulate saliva flow. They are also rich in minerals like calcium and magnesium, which help strengthen the enamel
  • Vegetables: Spinach, kale, and cucumbers are rich in vitamins and minerals that help remineralize the enamel. They also prevent dry mouth by stimulating saliva flow
  • Green tea: Green tea contains compounds called catechins that inhibit the growth of oral bacteria. Consuming green tea without sugar further reduces the risk of dental caries
  • Dairy products: Dairy products can reduce the risk of tooth decay by buffering the acids in your mouth. The high calcium and phosphate content in milk, yogurt, and cheese remineralizes the enamel making it stronger and less vulnerable to acid corrosion

Regular Dental Checkups and Cleanings

Enamel erosion and small cavities can occur naturally despite practicing proper oral hygiene habits. Your dentist can detect cavity formation early, allowing for effective treatment before the situation worsens. 

Furthermore, regular professional dental cleanings effectively remove plaque and tartar buildup from hard-to-clean mouth areas. Not only does this reduce the risk of tooth decay, but it also improves your oral health. 

Also, dental checkups and cleanings can help your dentist recommend tooth decay prevention treatments unique to your oral health needs. These may include the following:

  • Dental sealants: These are thin protective coatings applied to the molars and premolars. Sealants provide an extra layer of protection against tooth decay by making it harder for food and plaque to accumulate in the chewing surfaces of back teeth. 
  • Fluoride Treatments: Fluoride treatments involve directly applying fluoride to the enamel using special foam, gel, or varnish. This boosts the absorption of essential minerals like calcium, fluoride, and phosphate into weakened enamel areas, reversing tooth decay damage and halting the formation of dental caries

Treatment of Dental Caries

Treatments for dental caries include the following:

Dental Fillings for Tooth Decay

Dental fillings are a common but effective treatment for dental caries. Different filling types can be used depending on your preferences and unique dental needs. These include porcelain, amalgam, and composite resin fillings. 

The filling process involves removing the decayed part of the tooth using a dental drill. Your dentist then prepares the cavity by carefully cleaning and shaping it. Afterward, a filling material of your choice is placed into the cavity, shaped, and polished to preserve the tooth’s structure and prevent the cavity from growing further.

Dental Crowns for Tooth Decay

Your dentist may recommend a dental crown if tooth decay has affected a substantial portion of the tooth. The treatment involves removing the decayed portion of the tooth and shaping the remaining healthy structure to create a foundation for the dental crown. 

Your dentist then makes an impression to fabricate a custom crown that matches the shape and color of your natural teeth. Afterward, your dentist places a temporary crown for protection while you wait for the permanent crown. 

Once the permanent crown is ready, your dentist will cement it on the healthy tooth structure, protecting it from further decay. 

Root Canal Treatment for Tooth Decay

Tooth decay can reach the pulp, which contains nerves and blood vessels nourishing the tooth, if it’s not detected and treated in its early stages. In this case, your dentist will recommend root canal treatment to save the tooth. This treatment involves drilling an access hole in the tooth and removing the infected pulp from the root canals. 

After cleaning and shaping the root canals, your dentist fills them with a biocompatible material. The access hole is then sealed using a dental filling or dental crown.  

Tooth Extraction as a Last Resort

Your dentist may recommend tooth extraction as a last resort if the decay has advanced so that the tooth can’t be saved using dental restorative procedures. Your dentist will numb the surrounding gums using local anesthesia before loosening the tooth from its socket using dental forceps. 

Once the tooth is extracted, you’ll receive aftercare instructions to ensure a smooth recovery. Your dentist may also recommend tooth replacement options such as dentures, implants, and bridges. 

Complications and Consequences of Untreated Dental Caries

If left untreated, tooth decay can lead to various complications that can have devastating consequences on your oral health and overall well-being. Here are some detrimental effects of untreated dental caries: 

  • Tooth pain and sensitivity: Dental caries can cause toothache and sensitivity. You may experience excruciating pain when chewing and tooth sensitivity when eating hot or cold meals. Tooth pain can also make it challenging to speak and limit your productivity
  • Tooth abscess and infection: Dental caries can cause a painful infection called an abscess if it reaches the tooth’s pulp chamber. Abscesses can cause intense facial pain and significant swelling of the jaw which can lead to temporary facial deformity. In severe cases, abscess infection can spread to other parts of the body leading to serious health issues, hospitalization and even death.
  • Impact on overall health and well-being: Dental caries are among oral infections linked to systemic health issues such as respiratory infections, pregnancy complications, and cardiovascular diseases. Additionally, bad breath, persistent pain, and the unappealing appearance of decayed teeth can negatively affect your self-esteem and overall well-being

To summarize, tooth decay is a serious oral health issue that shouldn’t be taken lightly. If left untreated, dental caries can wreak havoc on your teeth, causing severe tooth pain, gum disease, halitosis, and tooth loss. 

Furthermore, tooth decay can contribute to debilitating systemic conditions such as cardiovascular diseases and respiratory infections. 

So why risk it? Early detection and intervention will save you a lot of grief. Schedule a dental checkup appointment today and take charge of your oral health.