Dental caries or commonly known as dental decay is the process in which bacterial action results in localised loss of minerals from a tooth's surface. These bacterial loads reside in dense masses known as dental plaque.

Dental caries is a chronic disease and is known as one of the most prevalent diseases worldwide.

How much damage can plaque cause?

Plaque has the ability to produce acids after exposure to fermentable carbohydrates and in turn cause dissolution of a tooths’ organic matrices, both enamel and dentine. In some instances the matrix is overwhelmed with enamel/dentine breakdown and collapses, forming a dental cavity.

Is dental caries contagious?

There is strong evidence which supports that bacteria involved in dental caries development is capable of transmission from adults to children, particularly during the first three years of an infant's life. Transmission is avoidable by practicing good oral hygiene.

Can dental caries be painful?

Yes, dental decay can in fact be very painful. The caries process initiates from the outer layer of a tooth's surface (enamel), however it has the potential to continue penetrating into dentine (second layer) and eventually the pulp (nerve tissue). Pain levels are unique to each individual, generally the deeper the caries the worse the pain, in some instances you may experience neither pain or sensitivity.

What causes dental caries?

The process of dental decay has a multifactorial etiology. Risks involved with developing dental decay include; physical, biological, environmental, behavioural, and lifestyle-related factors. Common examples include: a high/frequent intake of fermentable carbohydrates (sugars), inadequate salivary flow, insufficient fluoride exposure, and poor oral hygiene.

When to treat dental caries

Depending on the extent of caries and status of your oral hygiene a dentist may not opt to fill your tooth. Incipient decay may be manageable by thorough dental advice and fluoride treatment while other lesions will require fillings. In large carious lesions the tooth may require nerve treatment (root canal treatment) or extraction.

More Frequently Asked Questions about Dental Caries

What bacteria causes dental caries?
Streptococcus mutans
What are the symptoms of dental caries?
Generally dental caries can cause sensitivity to sweet, cold and hot foods. When cavities form, food and debris may fill the cavities and cause further pain and/or gingival irritation. If the tooth becomes infected, an abscess or pocket of pus may form and result in facial swelling and/or fever.
How to prevent dental caries
There are many ways in which you can prevent tooth decay. Firstly it is crucial to have a good oral hygiene routine that includes both tooth brushing (twice daily) and flossing. Furthermore making smart food choices (decreasing intake of sugars/starches) and increasing fluoride exposure can assist with avoiding dental caries. Professional advice and regular cleans play an important role in avoiding tooth decay.
How does fluoride prevent dental caries
A tooth’s surface has the ability to absorb fluoride, in doing so the tooth forms a harder, more resistant matrix, thus strengthening the tooth's surface.
Can you reverse dental caries?
In the very early stages of tooth decay, there is potential for a tooth’s surface to restore it’s lost minerals, this process is known as tooth remineralisation. Multiple factors aid remineralisation, they include; good hydration, fluoride exposure, plaque control, diet control, xylitol, CPP-ACP/recaldent products.
Can diet cause dental caries?
Yes, complex carbohydrates (e.g. starches) and simple sugars such as sucrose have high cariogenic potential. A diet high in fermentable carbohydrates as such will significantly increase your risk of dental decay.
Further Reading and References
1. Selwitz, R. H., Ismail, A. I., & Pitts, N. B. (2007). Dental caries. The Lancet, 369(9555), 51-59.
2. Gibbons, R. J., & Houte, J. V. (1975). Dental caries. Annual review of medicine, 26(1), 121-136.
3. Büttner, M. (1994). Is dental caries contagious?. Revue belge de medecine dentaire, 49(3), 9-13.
4. National Research Council. (1989). Diet and health: implications for reducing chronic disease risk. National Academies Press.

Dental caries/decay is removed by a dental professional via both high and slow speed drills. The tooth cavity is cleaned of bacteria and filled with dental materials which is contoured to restore the tooth’s original function.

How to remove dental caries

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