Tooth Decay

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Tooth decay, also known as dental decay or dental caries, is an extremely common problem that is thought to affect one in three adults in England. Although widespread, tooth decay is often easily preventable. Symptoms often only appear when the tooth decay becomes more serious however, so it is important to have your dentist check for it regularly. If spotted by your dentist during its early stages, there are straightforward treatments that can help prevent further problems. Treatments range from simple fluoride varnish if the decay is spotted early, through to fillings and crowns if the decay is more serious.

Your mouth is full of bacteria that form a sticky substance, known as plaque, which coats the teeth surfaces if left uncleaned. Foods that are high in simple carbohydrates and sugar feed plaque bacteria, which in turn create plaque acid. This plaque acid will gradually dissolve the protective enamel surface of your tooth and the dentine underneath, creating a cavity.

If the resulting cavity exposes the dentine, the inner structure of the tooth, it can cause your teeth to be very sensitive. If the cavity reaches the soft centre of the tooth, called the pulp, it can lead to the tooth becoming infected, extreme pain and may require a root canal treatment. In some cases, the tooth may need to be extracted completely.

tooth decay

Any part of the tooth can be at risk from decay but the biting surfaces and the surfaces between the teeth are most likely to have food trapped in it, and therefore be attacked by plaque acids.

In its early stages, you might not have any symptoms. However, a dentist may be able to spot the early signs of decay during your check-up or after having taken an X-ray of your teeth.

Should the decay be left untreated, it will advance to form cavities. At this stage, you might start to notice that a tooth has become more sensitive to hot or cold food and drink. Other signs could be grey, brown or black spots on your teeth, bad breath (halitosis) or an unpleasant taste in your mouth. As the decay gets closer to your dental pulp, you may experience greater levels of pain or toothache.

Toothache and the development of abscesses are signs that you should visit a dentist as soon as possible to properly treat the problem.

How your tooth decay is treated will depend how advanced the decay is. Your dentist may suggest the following treatment options, starting with the simplest and least expensive:

Fluoride varnish

If the decay is not yet cause for a filling, your dentist may apply a fluoride varnish to your teeth that can help stop further decay and 're-mineralise' the enamel surface of the tooth.


Under local anaesthetic, your dentist will use a small drill to remove the parts of your tooth that are decayed or weakened. If necessary, a 'liner' may be used to cover the tooth to make sure there is no exposed nerve. The material used for the filling itself may be amalgam (metal alloy) or composite (tooth-coloured material). These fillings are hard wearing and can last many years, with the right care.

Inlays and onlays

When the cavity is so large that a filling will not work, a laboratory-made inlay or onlay is used to restore your tooth shape. An impression of your tooth once prepared (under local anaesthetic), will be taken to ensure that the inlay or onlay will fit perfectly over the cavity. A laboratory will be instructed to make the onlay or inlay and after a few days your dentist will fit the onlay or inlay which is usually made of either gold or porcelain.


Dental crowns are covers that fit over natural teeth that have been extensively damaged by decay so as to protect them. As crowns are made to fit over your teeth exactly, your dentist will take a mould of your tooth that can then be used to make your own bespoke dental crown, similarly to an onlay or inlay.

Root canal treatment

If severe decay has led to your dental pulp becoming infected, leading to an abscess or the nerves dying, you may need root canal treatment. This procedure requires drilling a hole in the crown of the tooth, removing the infected pulp and cleaning the area, then filling the canal and sealing the cavity with a filling.

Tooth extraction

If there is no chance of saving the tooth, it may need to be removed. A local anaesthetic will be injected into the gum and the dentist will widen the tooth socket and rock the tooth side to side until it is loose enough to pull out. The open socket will then either be stitched up or be allowed to clot and heal. The extracted tooth could be replaced with a denture, bridge or implant.

The most straightforward way to avoid tooth decay is to maintain good oral hygiene in order to keep your teeth and gums as healthy as possible. This means brushing your teeth twice a day, flossing between the teeth and moderating your intake of sugary foods and drinks. Smoking and excessive drinking can also lead to dental problems.

Whilst your saliva contains minerals that help your enamel rebuild after being attacked by acid, chewing sugar-free gum helps further provoke the production of saliva. However, this will not be as effective as limiting sugary foods and brushing regularly.

Ensure you visit your dentist as often as advised for a dental check-up so any signs of gum disease or tooth decay can the spotted and treated early and inexpensively.

A build-up of plaque can cause decay, which can be removed by a hygienist. A 'scale and polish' involves using scaler instruments and an ultrasound device to remove plaque and deep clean all the parts of your teeth you might normally miss or be unable to reach - for example, under the gum line.

This article was provided by Toothpick, the leading provider of online dentist appointments in the UK.

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