Tooth Decay

By Premier Dental of Ohio

What you need to know about tooth decay

The Dangers of Tooth Decay

Tooth decay affects millions of people all over the world, causing pain, infection and tooth loss. Tooth decay is a major cause of missed work and school absences. The good news is that, in most cases, we can prevent it from occurring. Read this week’s blog to learn everything you need to know about tooth decay.

What is Tooth Decay?

Tooth decay is another term used to describe the dental disease caries. Caries is a bacterial infection of the hard structures of the teeth.  Most people commonly refer to tooth decay as cavities.  We call them cavities because the destruction of the hard tooth structure often leaves small holes, or cavities, in the teeth.  

The term decay describes the nature of the consequences of untreated caries. The tooth structure that was once hard, white and strong becomes soft, brown and mushy.  

The bad news about tooth decay is that it affects parts of the teeth that do not have the ability to heal and regenerate. Once hard tooth structure decays, it will never revert back to its healthy state. This is why the intervention of a dentist is necessary.

What Causes Tooth Decay?

Tooth decay is a multifactorial process. There must be several conditions present in order for decay to develop. The risk for decay depends on the ways in which these conditions occur. We will describe each in detail in this section, and the ways in which you can fight these causes in the last section on prevention.

Tooth Structure

It may seem silly to point this one out, but you cannot have tooth decay without a tooth. This means that patients who wear full dentures with no natural teeth cannot get tooth decay. Similarly, missing teeth replaced with dental implants (made of titanium and porcelain) cannot suffer from tooth decay.

The state of the tooth structure affects the risk for decay. When the structures making up the teeth (enamel and its underlying dentin) are healthy and strong, they are less likely to suffer from decay. If teeth are weak from prior damage or a developmental problem, they may have a greater likelihood of developing decay.


A specific bacterium, known as Streptococcus mutans, is responsible for tooth decay. This bacteria is present even in healthy mouths. It lives in dental plaque, which keeps it in contact with the teeth. Bacteria can reproduce very rapidly, quickly populating the mouth within dental plaque.

The bacteria’s method of destroying enamel and dentin is through the production of strong acids. The acid produced by the bacteria in plaque softens and weakens the enamel where the plaque remains. Over time, this weakening allows the bacteria to break through the outer layer of enamel and work its way into the tooth, destroying tooth structure as it goes.


The bacteria cannot produce acid on its own.  It must have a source of fuel, and its fuel is sugar. When we say “sugar”, we mean any simple carbohydrates. The bacteria eats carbs and produces the acid as its waste product.  

Bacteria must have carbohydrates in order to produce the acid responsible for cavities. The more sugars you have in your diet, the higher your risk for cavities.  


It takes time for bacteria to ingest sugar and create acid, and it takes time for the acid to damage enamel. This factor in the cavity process can work both to our disadvantage and to our advantage.  

It works to our disadvantage when we leave dental plaque on the teeth for any extended period of time or ingest sugar over a prolonged period. It works to our advantage by giving us a small grace period between eating or drinking sugar and suffering damage.

What is the Treatment for Tooth Decay?

The treatment for tooth decay depends on its severity, which is directly related to its size. Because cavities grow slowly over time, early or minor cavities are small, and late-stage decay is very large. The treatment for decay becomes more extensive and more expensive the larger it is. As we mentioned earlier, the tooth structure, once destroyed by decay, does not have the ability to regenerate, so we must replace it with dental restorations.


Composite dental fillings are restorations that replace small amounts of decayed tooth structure. There is not a set precedent, but in general, a filling is capable of restoring decay that destroys less than fifty percent of the visible tooth structure. Once more than fifty percent of the tooth structure has decay, a filling will not structurally support the tooth for its necessary chewing function.


Dental crowns completely cover a tooth in order to replace the outer enamel layer. This is necessary when enough decay is present to weaken the tooth, making it unsuitable for chewing. Dental Crowns rebuild a broken-down tooth back to the natural shape and function.

Root Canal Treatments

If decay grows into the tooth so far that it reaches the nerve chamber in the hollow center of the tooth, a root canal treatment is necessary. Decay contains bacteria, so when it reaches the nerve tissue, that becomes infected and must be removed from the tooth.

A tooth that needs a root canal treatment typically also requires a crown to restore the tooth once the dentist cleans the internal chamber of the tooth, removing the infected nerve and filling the chamber with a biocompatible material.


When decay destroys most or all of the visible tooth structure, leaving only the root remaining, restoring that tooth is unwise. It will not function well or last for long.  In severe cases of decay, extraction of the tooth may be necessary.  

Is Tooth Decay Preventable?


We love helping our patients prevent tooth decay. You can lower your risk for cavities and prevent them in many ways. We do so by fighting the factors in the cavity process described above. We will use the same headings to keep it simple.

Tooth Structure

You can prevent tooth decay by strengthening your tooth structure. Enamel remains strong when we protect it from strong acids, from either foods and drinks in our diet or the stomach via acid reflux. We also protect enamel by preventing damage of heavy clenching or grinding by wearing a mouthguard during sleep.

We can add strength to enamel by nourishing it with important minerals like fluoride. This is available in most toothpastes and mouthwash, as well as via prescription from your dentist.


We can prevent cavities by removing the bacteria from our teeth on a daily basis. Because the bacteria lives in dental plaque, our plaque removal via toothbrushing and flossing is essential to fighting cavities. In order to stop cavities from forming, you absolutely must brush and floss effectively and consistently.


By limiting the intake of simple carbohydrates, we can avoid tooth decay. To stop cavities, you should avoid sodas, sports drinks, and juices, which are loaded with sugar.  Avoiding sweets, like candy and desserts, is an important way to fight cavities, too. The most important time to avoid sugar is between meals. If you absolutely must have some simple carbs, try to enjoy them with a meal instead of as a snack.


We affect the factor of time as it relates to bacteria and carbohydrates. In order to stop cavities, we should limit the amount of time that we expose the teeth to both bacteria and carbohydrates. That means we must remove plaque in a timely manner, usually by brushing a minimum of twice a day and flossing every night. If you skip a day, you are allowing the bacteria twice as much time to damage your teeth!

The factor of time in regards to carbohydrates is of particular importance with beverages. Those who slowly sip on a sugary drink throughout the day will have a very high risk for cavities. Limiting the time during which you expose your teeth to the sugar lowers that risk.

More Questions about Tooth Decay?

Call your nearest Premier Dental of Ohio location today to schedule a consultation or evaluation with one of our wonderful dentists. We can answer any question you have about tooth decay and assess your specific situation. We love helping our patients prevent tooth decay and maintain a completely healthy mouth!

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