Dental caries

Tooth decay is a common problem that occurs when acids in your mouth dissolve the outer layers of your teeth.

It is also known as dental decay or dental caries.

Although levels of tooth decay have decreased over the last few decades, it is still one of the most widespread health problems in the UK.

It's estimated that around one in every three adults in England have tooth decay and a survey of five year old children carried out in 2012 found that more than one in four had some degree of tooth decay.

Signs and symptoms

Tooth decay may not cause any symptoms until it has reached an advanced stage. As the problem develops, symptoms of tooth decay can include:

toothache
tooth sensitivity – you may feel tenderness or pain when eating or drinking something hot, cold or sweet
grey, brown or black spots appearing on your teeth
bad breath
an unpleasant taste in your mouth

If left untreated, tooth decay can lead to further problems such as a cavities (holes in the teeth) gum disease or dental abscesses (collections of pus at the end of the teeth or in the gums).

When to see your dentist

Toothache is a warning that something is wrong and that you should visit your dentist as soon as possible. If you ignore the problem it may get worse, and you could end up losing a tooth.

Even if you don't have any noticeable problems with your teeth, it is still important to have regular dental check-ups so your dentist can check for early signs of decay. Tooth decay is much easier to treat in its early stages.

Adults over 18 should have a check-up at least once every two years and people under the age of 18 should have a check-up at least once a year. Your dentist may suggest having more frequent check-ups if you have had a history of dental problems, or you are thought to be at a higher risk of developing tooth decay.

Dentists can usually identify tooth decay by examining your teeth, although occasionally an X-ray may be carried out to check for any cavities or abscesses.

What causes tooth decay?

Your mouth is full of bacteria that combine with small food particles and saliva to form a sticky film known as plaque.

When you consume food and drink high in carbohydrates – particularly sugary foods and drinks – the bacteria in plaque turn the carbohydrates into energy they need, producing acid at the same time.

If the plaque is allowed to build up, the acid can begin to break down the outer surface of your tooth and can eventually enter and damage the soft part at the centre of the tooth.

Read more about the causes of tooth decay.

How to prevent tooth decay

Although tooth decay is a common problem, it is often entirely preventable. The best way to avoid tooth decay is to keep your teeth and gums as healthy as possible.

To do this, you should:

brush your teeth with a fluoride toothpaste twice a day, spending at least two minutes each time
use floss or an interdental toothbrush at least once a day to clean between your teeth and under the gum line
avoid rinsing your mouth with water or mouthwash after brushing because this washes the protective toothpaste away – just spit out any excess toothpaste
cut down on sugary and starchy food and drinks, particularly between meals or within an hour of going to bed

How tooth decay is treated

If you see your dentist when the decay is in the early stages, your dentist may apply a fluoride varnish to the area to help stop further decay.

If the decay has worn away the outer layer of your tooth and caused a cavity, your dentist will remove the decay and refill the hole in your tooth with a filling. If the nerve in the middle of your tooth is damaged, you may need root canal treatment, which involves removing the nerve and restoring the tooth with a filling or crown.

If the tooth is so badly damaged that it cannot be restored, it may need to be removed.