What is the cause of tooth decay?

While the government is working hard to reduce tooth decay in children, in the past year alone 45,224 children needed hospital treatment because of tooth decay, with admissions rising to over 7,000. At the Dental Centre London we want to help reduce the incidence of tooth decay and have created a compendium of everything you need to know.

This article explains the problems of tooth decay in babies and children.

Tooth decay in babies



It’s true, babies can get tooth decay! As soon as your baby’s teeth begin to come through, you need to begin an oral health care routine. At the very early stages, just gently brushing your baby’s teeth with a soft toothbrush is fine. As more teeth come through, you should start using a pea-sized amount of children’s toothpaste.

Tooth decay in toddlers

Tooth decay in children is far more prevalent than in babies. This is because the diet of a toddler begins to include far more sugar. Drinking sugary drinks, including fruit juice in a bottle can be extremely detrimental to your toddler’s dental health. A bottle and teat tend to keep the drink in contact with the toddler’s teeth for longer than a sipping cup.

You should now be brushing your toddler’s teeth twice per day with a pea-sized amount of children’s toothpaste. Toddlers should not be allowed to clean their own teeth, although they should be allowed to experiment with the toothbrush to get used to doing it themselves.

Tooth decay in children

By the time your toddler has grown into a young child, you need to be extremely aware of their dental health. Children tend to eat sweets more often, particularly as they get more independent in their food choices.

Sugary drinks should be kept to a minimum, particularly fizzy drinks, as these contain extremely high amounts of sugar.

Children should be encouraged to drink any fizzy drinks through a straw as this keeps the sugary fluid away from their teeth for as long as possible.

Common questions and answers about tooth decay

Sugar and tooth decay

What is tooth decay?

Tooth decay happens when acid from the bacteria in your mouth attacks your tooth. As that acid dissolves the hard tooth structure, the tooth begins to rot. As this progresses, more of the tooth structure is eaten away. Tooth decay becomes more serious when the outer hard protective enamel of the tooth has been completely eroded.Underneath this protective enamel layer is the softer dentine which will succumb to the acid attack much easier. If the tooth decay progresses and begins to affect the internal blood supply and nerve of the tooth, extreme pain will be felt and the tooth will probably die if left untreated.

What are the early signs of tooth decay?

In order to understand the early signs of tooth decay it’s helpful to think about the process. Each day, a thin biofilm layer of bacteria covers your teeth, if you brush your teeth twice a day, floss and use a fluoride mouth rinse in between brushing then this biofilm layer is removed.

If the biofilm layer is left to build up, the bacteria will form plaque which can harden and this is called calculus or tartar. Plaque is where the bacteria lurk and if the bacteria are kept in contact with your teeth for long periods of time, the acid they excrete as they feed will attack your teeth.

As that acid attack continues, the decay starts.

So, the earliest sign of the ‘potential’ for tooth decay is plaque. This plaque can be removed by regular visits to the hygienist (every six months ideally)and will ensure that your daily cleaning standards are high.

If the plaque isn’t removed then the earliest sign of tooth decay will probably be a very small hole in your tooth. This will almost certainly be undetectable by you and can only be seen by a dentist when they undertake their routine dental health check and take the necessary x rays.

This is why it is important to visit the dentist as they will be able to spot these very early warning signs and advise on the best treatment at an early stage. Treatment at an early stage can be relatively low-cost compared to treatment at a later stage.

How is tooth decay treated?

If your dentist spots tooth decay, they will remove the rotting section of tooth with a dental drill. They will then prepare and clean the remaining section of tooth and place a filling. Very often this filling could be amalgam but in more recent years a composite resin is preferred. This composite resin is tooth-coloured and once in place is virtually indistinguishable from your natural tooth. Additionally composite fillings do not contain mercury like silver fillings.

How to stop tooth decay

The best way to stop tooth decay is to prevent it happening in the first place by maintaining good oral health care. The only way to stop tooth decay once it has started is to have all of the decay removed, the tooth cleaned and a filling placed.

What causes tooth decay?

Scientifically, tooth decay is caused by a process known as demineralisation. The normal acidity level in your mouth is what’s known as ‘pH neutral’, ideally around pH7. Demineralisation occurs if the acidic environment reaches a pH level of pH5.5 or below.

This acid comes as streptococci mutans and lactobacilli bacteria feed on the sugar in your diet.

One of the ways to reduce the acidity in your mouth is to chew sugar-free gum after eating, this increases the amount of saliva (and alkaline) which can neutralise the acid, returning your mouth to its ideal pH neutral level.

What does tooth decay look like?

dead tooth

Image source: Medical News Today

A very early stage of tooth decay will simply look like a small black dot, not necessarily in the middle of your tooth, it could be down the side of the tooth where the teeth meet each other. As the tooth decay progresses, this black dot will get bigger and bigger.

Does tooth decay cause pain?

Tooth decay in its earliest stages is not painful at all, you probably won’t spot it at home until the decay has got bigger and can be seen. If the decay is in a difficult to see area (in between your teeth or on the inside) then the first indicator you may get of decay is pain. If this happens then the tooth decay is at quite an advanced stage and you will need to see a dentist immediately.

Can you reverse tooth decay?

No, tooth decay itself cannot be reversed, it can however be treated. Treatment involves removing any decayed tooth, cleaning and then filling in the area which was decayed.

Early decay can be reversed. For this reason regular check-up visits to dentist and hygienist is recommended so that we can work on prevention.

Image source: freedigitalphotos.net unless otherwise stated