South West Implant Centre

Tooth Decay.

Image of decaying teeth being inspected by a dentist and mirror What is decay (caries)?

Tooth decay, or dental caries, to give its correct name, is the process where the tooth becomes destroyed. In its earliest stages caries will only be visible ot a hygienist or dentist, so regular checkups are essential. Decay first appears as small dark or opaque patches on the tooth surface. If left untreated, the tooth may have to be extracted. Tooth decay is rarely painful until fairly far advanced.

What causes dental caries?

Everyone's mouth contains millions of bacteria. The bacteria build up on the surface of the teeth and multiply to form a soft sticky layer called plaque. These plaque bacteria use the sugar in food and drinks and produce acids. It is these acids which attack the tooth surfaces and gradually dissolve the hard outer coating of the tooth known as enamel. With frequent sugar consumption the enamel will eventually break down and a hole, or cavity, will appear.

Is everyone at risk from dental decay?

Image of plaque bacteria at the base of some teeth. Frequent sugar consumption is the main contributing factor leading to tooth decay. Whilst all teeth are at risk, some people are at increased risk due to other factors. Saliva is nature's way of protecting the teeth by neutralising the acids produced by plaque bacteria. Anything that reduces the amount or flow of saliva can contribute to an increased risk of decay. The regular use of a fluoride toothpaste will significantly reduce the risk from caries.

What factors increase the risk of tooth decay?

Those already with fillings or crowns are also more at risk to future tooth decay, as the edges of fillings are particularly vulnerable to acid attack. With increasing age, receding gums are also more common, and this may contribute to increasing risk as the root is not covered by enamel, but by a softer material that is more easily dissolved. Exposed dentine on the roots of teeth can also be the reason for dentine sensitivity.

The wearing of any appliance that makes it more difficult to brush, such as partial dentures, a bridge or orthodontic braces.

The elderly often suffer from a condition known as dry mouth (Xerostomia). This can result from ageing or from the use of medications or certain types of drug therapy.

Image of premolar and molar teeth repaired with silver fillings. How is decay treated?

In its earliest stages, decay may be reversed by the use of fluoride. However, once a cavity has formed, the damaged part needs to be removed and replaced with a filling. If left untreated for too long, the tooth may have to be extracted.

Can caries be prevented?

Yes. Brushing with a fluoride toothpaste and reducing the amount and frequency of sugar in your diet will help. More specifically, avoid refined sugars such as glucose, sucrose, dextrose and maltose.

Why is fluoride so important?

Fluoride is thought to work in several ways to help prevent decay. Studies have shown that regular use of a fluoride toothpaste will significantly reduce decay. The use of fluoride rinses can also contribute to an additional 40% reduction in dental decay. When using fluoride rinses or gels it is best to use at a different time from brushing so as to extend the exposure of the teeth to fluoride.

How does fluoride toothpaste and rinse work?

Illustration of how fluoride toothpaste works. Fluoride works on the tooth surface by reducing the formation of plaque acids, preventing the loss of minerals by plaque acid action and by promoting the healing of the early stages of decay through a process known as remineralisation.

Fluoride in the form of rinses and gels have also been used effectively to protect and treat sensitive teeth.

Is fluoride safe?

Fluoride is safe, and the most effective way of preventing dental decay. Fluoride occurs naturally in some areas, and in a few others it is added to the water supply. However, 90% of the UK population do not receive fluoride in their water, which is why it is so important to use a fluoride toothpaste.


A Centre of Excellence in Dentistry


South West
Implant Centre,

37 Badminton Road,
Bristol BS16 6BP


07731 579 726



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