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Tooth Decay: Signs, Symptoms & Treatments

Medically Reviewed By: Dr. Gemma Wheeler

(GDC Number: 259369)

Tooth Decay - Header Image

You have probably heard of dental caries (tooth decay), but do you really understand, what it is, what causes it and how it is treated?

If the answer is no to this question, then this article is just for you.

A guide to dental caries, the causes, treatments and preventative steps you can take to maintain your teeth and those of your family too are included.

92% of adults aged 20 to 64 in the USA have had dental caries, with 26% of those having untreated decay according to the NIDCR .

Worldwide it is believed 2.4 billion people have untreated decay, that is 35% of the population on the planet!

So bad is the situation, that the World Health Organisation ranks tooth decay and oral diseases as the 4th most expensive health conditions to treat.

Seeing as decay is not something you inherit, are born with or contract and is a condition that is completely preventable, these figures are quite alarming.

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Short of time and want to know the key information this article contains, without all the explanation?

The following points are for you:

  • Tooth decay is a diet and lifestyle related disease that is completely preventable.
  • Dental caries is where the enamel surface of the tooth is dissolved by acids, produced by bacteria in the mouth.
  • The bacteria are fed by sugars we consume as part of our diet.
  • Saliva helps protect the teeth and can repair decay in the early stages.
  • Caries often shows no initial signs.  It develops often as white or dark spots on your tooth and eventually, into a hole that extends to the inner tooth structure.  Sensitivity and pain usually occurs at this point.
  • Decay can be treated by dentists via a number of means, most commonly a filling.
  • Regular dental visits can detect decay before fillings are required.
  • You can prevent dental caries by eating a healthy diet (avoiding sugars), drinking plenty of tap water instead of sugary drinks, brushing your teeth twice a day using a fluoride toothpaste, and flossing.

If you can spend some time, now or later, it is worth readying the full article to fully understand the cause and effect relationship of your diet and decay.

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What are dental caries (tooth decay)?

Dental caries is where naturally produced acids soften and essentially eat away at the hard outer layer of your teeth.

Also known as tooth decay, if left untreated it lead to holes, also known as cavities, in the enamel that makes up the outer surface of the tooth.

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Tooth decay is the breakdown of tooth surfaces due to high levels of bacteria. The bacteria can build up due to diet (sugary and fizzy foods), lack of oral hygiene over a period of time on the tooth surface.

Dr Chhaya ChauhanIn-house dentist – GDC Number: 83940

Plaque is a naturally forming substance within the mouth, we all get it.  It is actually made up of over 600 types of different bacteria naturally. Together this bacteria collects and forms a sticky substance called plaque.

Almost all of the food we consume contains sugars, some natural, some not.  The bacteria feeds on these sugars and produces the acid which can attack the surface of the teeth.

The more times we eat and drink food with sugars in them, the more times the plaque turns those sugars into acids that work at destroying the tooth surface.

Saliva in the mouth is produced naturally and works tirelessly to restore the balance of the acids in the mouth and to in theory stop them attacking the tooth surface.  But it requires time. The more time that is left between eating, the better.

Plaque manages to get stuck into the tightest of gaps in the mouth and teeth and if not removed can pose a bigger threat as more plaque means more attacks on the teeth.  The existence of plaque is why we brush and floss our teeth.

The more we can remove, the more we protect our teeth from decay.

Whilst the body has a natural ability to fight it off, there comes a point, where it can no longer fight it and the consequence is the decay to the tooth surface.

What causes cavities? - Mel Rosenberg

What is a cavity?

A cavity is another name for a hole, a hole that exists in the surface of the tooth.

Cavities are caused by dental caries being allowed to continue and expand within teeth and are a sign that little or no preventative steps have been taken to stop or prevent the decay.

Although the enamel that coats the outside of our teeth is the hardest substance in the human body, it can still be damaged.

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When a hole exists in the tooth surface, the inner softer layers of the tooth are exposed to all that exists within the mouth.

The more delicate tissues inside are not are resistant to decay and cannot protect themselves like enamel.

If the caries is allowed to progress to the dentin inside the tooth, it will eventually work its way to the centre of the tooth, which contains the pulp.  The pulp is filled with blood vessels and nerves.

Once the decay reaches this point things get painful.  Considerably more sensitivity is felt, there can be infection or an abscess.  In the worst cases of dental decay the tooth dies off and eventually the tooth discolours.

What are Cavities?

Sugars, acid attacks and saliva

This section is for those who want to understand things a little more.  It goes into a bit more detail as to how the sugars in our food, the bacteria in our mouth and the saliva work with and against each other.

The different foods we eat are categorised into carbohydrates, proteins and fats.

Caries is not directly linked to the presence of proteins and fats within our diet, meaning not all the food we eat can be broken down by the bacteria into acids.

What a particular strain of bacteria called streptococcus mutans, likes is the sugar rich carbohydrates.

Carbs contain natural sugars and starches, but do too include the artificial and refined sugars that are added to many foods we eat.

As the bacteria uses the sugars in food to grow and become stronger, within a matter of minutes, acid is produced, as a waste product.

It is these sugars that the bacteria loves and the acid that is produced as a result that is the treat to the all natural teeth you and I have.

The formation of the acid, begins what is known as an ‘acid attack’.

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It sounds quite brutal, but although the acid is relatively weak, this occurs almost every time you or I eat something.

Repeat this daily and you can see how the number of attacks add up, particularly if many snacks are consumed between the standard 3 meals we eat.

An attack is at its worst for about 20 minutes after eating, but can last for up to a couple of hours.

As the attack begins, this is where the saliva comes in.

You may never have really thought about what saliva does, but it is the body’s way of keeping things balanced and on track, or at least as best as possible within the mouth.

The pH scale is a unit of measure used to determine how acid or alkaline a substance or environment is.  pH7 is considered neutral, neither acidic or alkaline.

During an acid attack the acidity of the mouth changes and at a microscopic level the acid is dissolving the enamel on the outer surface of the tooth.  This process is called demineralization.

The saliva works to neutralize the acidity and bring the pH level back to 7. Glands in and around the mouth with produce and secrete more as part of this process.

It is as this point a period of healing can essentially begin.  The tooth surface then goes through what is known as remineralization.

Although the tooth surface cannot fully heal itself like other cells in the human body it can essentially reverse the decay from the majority of acid attacks.

Mayo Clinic describe best what actually happens.

“Saliva supplies high levels of calcium and phosphate particles (ions) that enhance protection of the tooth’s enamel surface. The calcium and phosphate ions act to slow loss of tooth enamel (demineralization) and promote rebuilding of tooth enamel (remineralization). Saliva protects your mouth by washing away food and the sticky film of acid-producing plaque that can cling to teeth. Saliva also neutralizes damaging acids and limits bacterial growth that can dissolve tooth enamel”

The more acid attacks the greater the threat to the tooth surface and the higher the likelihood of delay.

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Attacks are brought on by eating, so if as a nation we only ever ate our 3 meals a day and never smacked in between, the figures for decay might make for more positive reading.  This is because the teeth would have more time to heal in comparison to the length of time they are attacked.

Whilst it may be more obvious to you and I that particular foods contain sugars, there are many foods that we buy that have more sugar in that we may have thought.  In fact, you might be surprised there is any sugar at all.

Natural sugars like those found in fruit are ‘better’ than those refined sugars that are addedi n the production process of the foods.

Used to flavour or preserve food, they are ‘hidden’ in things like jars of tomato based sauces.

As the teeth pass over and past each other as we chew, the surfaces of are in fact swept and cleaned by the food and saliva that exists in the mouth.  As great as that sounds, the existence of plaque kind of hampers this.

Plaque is very good at lodging itself in places that are harder to clean, along the gumline, between the teeth, and around the edges of restorations such as filling, crowns and dentures.

Larger teeth, particularly the molars you find at the back of the mouth have natural depressions or crevices.  More technically known as fissures, these small areas on the biting surfaces of the teeth are a fantastic home for the bacteria to reside.

Toothbrushing and flossing is what allows us to dislodge and remove a large amount of this plaque.  So, even though you might not be a fan of having to do this, you can perhaps see what it is necessary.

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The NIDCR have a great analogy for the battle that goes on in the mouth.  They suggest it is like a tug of war.  They are indeed correct. You have the saliva and the fluoride within toothpaste working to protect the teeth, but the bacteria and sugars work against them to try and damage the teeth.

Caries causing bacteria and acid attacks will happen daily, cutting out entirely the sugars bacteria feed on is very difficult.

The body is designed to and can resist a certain number or attacks.  But it is the repeated attacks that come as a result of frequent snacking on sugar rich foods that accelerate and encourage the dental caries.

What causes caries?

Tooth decay is caused by acids that attack the tooth surface and dissolves the hard enamel outer layer of the tooth.

However, those acids don’t get produced unless sugars are feed to the bacteria in the mouth.  Therefore, the real cause is the sugars within our diet.

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The most common causes include:

  • Consuming food with high levels of sugar (natural and added)
  • Drinking sugar rich drinks such as fizzy drinks
  • Eating high amounts of citrus fruits
  • Snacking between meals (sweet and savoury carbohydrates)
  • Not brushing and flossing regularly or correctly
  • Failing to get regular dental checkups

Caries affects anyone, be that a 2 year old, a 22 year old or someone who is 102.

Providing you have at least 1 natural tooth in your mouth, decay can in theory can damage that tooth, it is being damaged every time you eat, at a microscopic level.

But the speed at which the decay develops is linked to how often we consume foods that contain sugars and how we go about maintaining our oral health.

What is most important to learn is that with a few, often very simple changes to our diets and lifestyle, we can make significant, positive impacts to our oral health and the chance of our teeth becoming decayed.

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Signs of dental caries

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What is the most common sign of tooth decay?

The most common sign is usually pain and sensitivity or even a broken tooth.

Dr Chhaya ChauhanIn-house dentist – GDC Number: 83940

Caries is a little like the flu.

The bacteria that causes us to be ill with the flu, is often in our system a few days before we feel ill.  It takes time for the bad bacteria to take over and make us feel this way.

Tooth decay is very similar.

The decay exists and shows no signs for quite some time.

Depending on the level of decay will depend on how quickly more noticeable signs are given by the body.

At first is can be small white, yellow or brown spots on the teeth, but it can evolve into much more painful toothache or sensitivity to food and drink.

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Getting regular dental checkups is vitally important, because the dentist can spot potential decay and problems before they are too serious.

This means that you might be told there is some decay to a tooth, but you can take preventative steps before ever having to worry about spots on the teeth, any form of toothache or pain.

With regular dental checkups you can prevent and even reverse decay.

Whilst in the later stages there are more noticeable symptoms, plaque buildup is initially something to look out for.

Remembering that the acid that decays the tooth is produced by plaque, large plaque buildup will be one of the early indicators to potential decay.

It you run your tongue across your teeth and they feel a bit fury, this is a sign of plaque.

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Run your fingernail across the teeth and you may feel a sticky substance, that you might actually pull off the teeth, that is plaque too.

It is really only when the decay begins to get more severe do the signs become more noticeable.

Common signs and symptoms of decay are:

  • Small white, yellow, brown or even orange spots on the teeth
  • Bad breath
  • A bad taste in the mouth
  • Toothache/pain
  • Sensitivity to food and drink, be that hot or cold
  • Pain and discomfort when eating
  • Visible holes or pits in your teeth

Commonly associated with decay, sometimes they can be the sign of other dental health issues, but your dentist will make an assessment and confirm the problem.

Part of the reason that the early stages of decay are not felt or realize is because of how the tooth is structured.

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Nerves in the tooth exist only in the very centre of the tooth, in what is called the pulp.

The dentin that makes up the majority of the tooth is softer, but still contains no nerves.

And the enamel on the outside of the tooth contains no nerves either.

When the decay gets to the stage that it has eroded the enamel and the dentin and found its way to the pulp, this is when the pain is felt.

The nerves in the tooth are not normally exposed and the hole in the layers above means that food, drink, temperatures and even the air in the mouth can cause the nerves to send electronic pain signal to the brain.

Should you find or experience any of these symptoms, you should get them checked out by a dentist to have the problem confirmed and begin taking steps to correct the issue.

When to see a dentist

If you have concerns about your dental health at any point, you should see a dentist.

Even if they confirm there is nothing to worry about, the peace of mind can be worth the few dollars it costs to get their professional opinion.

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If you do not have a dentist,  use the American Dental Associations find a dentist tool, available here, to find a registered professional close you where you live.

Ideally you should have regular dental checkups with your dentist, every 6-12 months.

Professionals are trained to spot signs of decay and other oral health problems that you and I might not be able too.  This means they can offer preventative treatment most of the time, rather than restorative treatment.

Too many people avoid the dentist through fear, cost or lazyness.  Arguably valid reasons, the problem is that failing to take steps to check for and prevent problems can mean that when problems do occur, the pain is worse, the fear becomes greater and the cost is much higher.

Just because there is no pain or obvious signs, does not mean everything is fine.

Should you get the the stages of experiencing pain, and have any of the symptoms listed in section above, you need to arrange to see a dentist as soon as possible as even if the pain stops the decay is too advanced to reverse itself.

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I think I have tooth decay. When should I see a dentist?

You should see your dentist asap. Tooth decay can be vert damaging for the tooth so it is important to have get it sorted asap.

Dr Chhaya ChauhanIn-house dentist – GDC Number: 83940

How to prevent dental caries?

7 cubes of sugar is the recommended amount of sugar we should have each day, according to the World Health Organisation


  • A can of energy drink contains on average 13 cubes of sugar (based on a 500ml can)
  • A can of cola contains on average 9 cubes of sugar (based on a 330ml can)
  • A juice drink with added sugar contains on average 5 cubes of sugar (based on 200ml juice drink pouch)

Sugars are what feed the acids that cause decay.

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The key messages to preventing decay involve reducing sugar, improving cleaning, and the use of fluoride on your teeth. Dentists will tailor the advice they give you, but it is based on the principle of delivering better oral health

General advice is as follows:

Key tips for looking after your teeth

When it comes to looking after your teeth, the most important thing is to create a regular cleaning habit following these steps:

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Given that just 1 can of cola can take us over our recommended daily allowance, it is quite a challenge to do the right thing and limit that sugar intake.

Preventing caries does not mean you have to give up on sugars entirely and never drink an energy drink again, but it does mean thinking about what you eat and drink a bit more carefully for the sake of your teeth.

To help you understand what changes you can make, here are a list of some good and bad foods.

Good snacks:

  • Unflavoured chips
  • Unsweetened yoghurt
  • Low-fat cheese
  • Raw fibrous vegetables such as carrots and celery
  • Non-citrus fruit, such as apples, pears and peaches
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Bad snacks:

  • Sweet and chocolate bars
  • Biscuits
  • Cakes
  • Fizzy drinks
  • Pure citrus fruit juices
  • Tea and coffee with sugar

When you are hungry and looking to snack on something, here are a number of questions you could ask yourself.

  • Is there a sugar free or reduced sugar option you could chose?
  • Do you need the chocolate bar or bag of sweets?
  • Could you eat a piece of fruit rather than drink a bottle of juice?
  • Do you need to snack between mealtimes?
  • Would a piece of sugar-free gum satisfy my craving to eat?

Chewing gum can actually be really beneficial, particularly if you chew straight after eating.

The UK’s Oral Health Foundation has shown that chewing sugar free gum for up to 20 minutes after a meal can help the mouth produce more saliva and help cancel out any acids that form.

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You can drink as much water as you like without fear of doing damage to the teeth.

Coffee isn’t all that bad either in the scheme of things.  However, if you add sugar, creamer or like the new super sweet offering from Starbucks, be warned, these are not good for the teeth (sweetener is a harmless alternative).

We are not saying you have to stick to just 3 meals a day, we all like and want to snack at times.  But, even when you come to eat a normal meal, your job can be made harder, because many foods we buy have extra sugar in them.

To make things worse, they are often hidden in foods and it is far from obvious that they are there at all.

If you are concerned about decay and the amount of sugar you consume, here are some types of products you might not have expected to contain large amounts of sugar.

  • Cooking sauces, particularly those with a tomato base
  • Table sauces, including tomato ketchup
  • Flavoured crisps
  • Fruits canned in syrup
  • Some tinned vegetables including baked beans and sweetcorn
  • Some breakfast cereals
  • James, marmalades and chutneys
  • Some low fat products, as sugars is used often added to improve their taste.
  • Tinned fish and  meat in tomato sauce
  • Soups
  • Savory crackers and biscuits
  • Some processed ready meals
  • Energy drinks
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A change in your diet (food and drink) is the most effective modification to reduce the likelihood of dental caries.

Even with proper brushing routines, if your diet consists of snack between the 3 regular meals (Breakfast, Lunch and Dinner) decay can still take place.

As you have learned, it is the acid attacks and the frequency at which they occur that can be a big influence on the decay of the teeth.

Thinking twice about the foods you consume and how often can go a long way to helping prevent or delay decay.

You know that cleaning is important too.  It is most important to brush before bedtime, and at least one other time during the day. Brush for two minutes using a fluoride-containing toothpaste. After brushing, spit, don’t rinse out with water, to ensure that the toothpaste is left on the teeth to be able to work. Likewise, do not use mouthwash directly after brushing as this washes off the toothpaste, which actually has more fluoride in it. If you would like to use mouthwash, consider using it at a separate time of day, for example after eating lunch.

As part of this brushing routine, make sure you use a fluoride based toothpaste and replace the brush head on your toothbrush every 3 months.

Electric toothbrushes are easier to use than manual toothbrushes and so remove more plaque. Oh and of course regular dental checkups is a must.

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Top tip for preventing tooth decay

Tooth decay is caused by too much sugar and not enough good cleaning. My best advice is to keep anything with sugar to mealtimes only and to brush thoroughly, with an electric toothbrush, twice daily.

Dr Gemma WheelerIn-house dentist – GDC Number: 259369

Can tooth decay be stopped or reversed?

Yes, it is possible to stop and reverse caries.

With any natural teeth there is always a chance of decay.  But, with the right approach it can be prevented entirely.

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But, there is a catch.

If you already have extensive decay and perhaps have toothache and pain, you will likely need to get some form of treatment to cure the current decay you have.

Decay can be stopped and reversed if it has not gotten too serious.

In many cases, a dentist may detect the early signs of decay, but as it has been picked up early, no treatment is needed and you can reverse the decay, but taking action.  That action is reducing sugars and brushing better.

The teeth do not repair themselves like the bones in the body do, but they can repair themselves a little bit.

This repair process is called remineralization and relies on the enamel being rebuilt with calcium and phosphate particles.

In some instances, the dentist can help you and your teeth out a bit.  Particularly those who are prone to decay or struggling to prevent it.

Sealants, can be used to essentially cost the teeth in a thin layer of plastic.  This coating fills the crevices and depressions (technically known as fissures) to create a flat surface that is easier to clean and more resistant to decay.

Treatments for tooth decay

Although the most minor stages of decay generally require no treatment, if the decay has advanced to the point you are showing symptoms, then it will likely be necessary for a dental treatment to resolve the issue.

Most common is a filling.

A filling is a form of dental restoration, that uses metals or composite materials to fill restore the shape and function of a tooth damaged by decay.

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Quite often the dentist will need to take an x-ray to assess the extent of the decay and the cavity in the tooth.  Larger fillings like this will normally require an anaesthetic injection to numb the tooth area whilst the dentist removes the decay and restores the tooth surface.

With the most minor of decay, it might well be possible to place a small filling without any numbing agent, because the area to be treated, the enamel, has no nerves in it.

Fillings are a straightforward process, completed in the dentists chair and take about 10-15 minutes to complete (for a small one).

Where the decay is severe and infection inside the tooth exists, it might well be necessary to undergo root canal treatment, which is a more complex procedure to save the natural tooth.  This removes the infection from the nerve containing part of the tooth (the pulp) and places a filling there to prevent bacteria getting back in later on.  A relatively routine treatment, the effects of this are greater and to ensure success and long term reliability, a new, artificial crown may well be required.

Where the diagnosis is too late to save the tooth, extraction is the other option available.  Dentists will resort to this as a last choice and will do all they can to save the tooth.

Removing a tooth can have a knock on effect to the mouth and will often require a denture or implant.  If you wish to know more, you should read our article on tooth extraction.

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The cost of treating tooth decay

We would love nothing more to give you a very accurate idea as to just what it will cost to get your dental decay treated, but it is not that simple.

The location, expertise and reputation of the dentist have an influence in addition to the extent of the decay and the treatment required.

More wealthy parts of the country tend to be more expensive than the more deprived areas.

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Assuming the decay is very minimal and it is only picked up by a dentist upon a routine checkup, there will be no cost to treat the decay, as more than likely the dentist will just provide the advice on how to stop it getting worse.

Therefore the only cost will be any fee for the examination, which is often covered by dental insurance, if you have it.

If the dentist feels the tooth could require a sealant to protect against future decay or to stop the early stages of decay you may already have, the cost will be around $30-60 per tooth.  Whether this is covered on your dental insurance will depend on the specifics of your plan.

Where the decay is more severe and a filling is needed, the cost can be anything between $150-600 per tooth.

Affecting the overall price is the location of the filling, how many surfaces of the teeth are affected and the material used for the filling.

The more filling required, the higher the cost will be.

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A small filling in a rear molar, where a metal alloy is used is going to be nearer the $150 price point than a large filling required to 2 surfaces of the rear molar to be completed using a white colored composite filling compound.

If the decay is so bad that root canal treatment is required things quickly get considerably more expensive.

Treatment for a root canal in the USA averages at around $1000, for the therapy alone.

This does not include the cost of any crown you may need.  The crowns can range from $500-3000. It is therefore possible to be paying up to $5000 to have a root canal treatment completed fully and successfully.

The figures quoted give you an idea as to what you can expect to pay if you do not have dental insurance.  Do be aware though, there may be extra costs such as those for an examination and x-rays. Most dental offices will be able to give you a fairly accurate estimation of cost prior to a visit.

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If you have dental insurance, this can be massively helpful in paying for dental treatment.

Most policies cover routine or emergency care and treatment.  Fillings typically fall inside those treatments allowed and paid for by the insurer.

However, not all policies are the same and some will not cover them at all, whilst others will offer a percentage/fixed amount contribution to the cost.

Some may cover a metal alloy filling, but not a white filling.

You need to consult your dental insurance plan to find out what they cover and the conditions associated with the cover.

Where more advanced treatment, such as root canal therapy is required, expect the contribution by the insurer to drop significantly.  It is more common for this to be supported up to only 50% of the cost.

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Children and dental caries

The latest data available actually dates back to a research conducted between 1999 and 2004, so it is a little over 10 years old, but it revealed that 42% of children aged 2-11 have had caries in their first set of teeth.

23% of those had caries which has not been treated.

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Society and our own personal values tend to make us feel quite disappointed by these figures.  But it is society at large and us as parents to the next generation that are allowing such levels of tooth decay to exist in the young.

Without doubt it is hard, given the vast amount of hidden sugars, but the good news is that it is easy to resolve if your child has caries.

The preventative steps and treatments are just the same as they are for adults.

Therefore the recommended steps are to:

  • Make sure a child brushes their teeth twice a day
  • Encourage them to floss and clean interdental spaces once a day
  • Use a fluoride toothpaste
  • Supervise their brushing until they are about 7 years old
  • Have them use an electric toothbrush designed for kids with educational aids to encourage better brushing
  • Be aware of and if possible reducing the amount of sugar they consume both in foods and drinks.
  • Limit snacking between meals – If they do, encourage raw vegetables and fruit
  • Take them for regular dental checkups

In our busy lives this can be hard to do.  But to help you further, the American Academy of Paediatrics has put together some helpful resources around healthy eating.

How Much Juice Should Children Drink? The American Academy of Pediatrics Guidelines

If the caries already exists and requires treatment, dentists have a number of options.

A filling is not out of the question, nor is extraction.

However, more common is the use of a sealant to give the child’s teeth an extra layer of protection.

Your child’s teeth are really important and although they get a 2nd set, the health of their 1st set can influence that of their 2nd.  Be sure to get the regular checkups and allow any issues to be spotted early.


Dental caries needs 4 things to exist:

  • Certain types of bacteria
  • Carbohydrate based foods
  • The production of acids
  • Adequate time or frequency

Caries can and will continue to be a threat to anyone with natural teeth.

However, for the vast majority, it is simple diet and lifestyle changes that are necessary to reduce the chances of decay.

You can help prevent tooth decay and keep your teeth healthy by:

  • Brushing twice a day with a fluoride toothpaste.
  • Cleaning between your teeth daily with floss or an interdental cleaner.
  • Eating nutritious and balanced meals and limit snacking.
  • Visiting your dentist regularly for professional cleanings and oral examination.

Take note of the preventative steps and you should be able to protect your teeth and that of your family for many years and avoid having to treat what is an entirely preventable condition.


Is tooth decay genetic?

Some small studies (summarised here by the American Dental Association) have suggested that your genes/DNA can have some influence on the susceptibility and speed of decay. Genes can affect things like your saliva and the hardness of the enamel layer. However the majority of evidence points to the biggest factors being environmental – diet and brushing related. One of the most recent studies was on twins, and is best summarised by the author here, who said:

“”We found that identical twins, with identical genomes, have varying degrees of decay. “This means that environmental factors, like a lack of fluoride in water, seem to be the prime cause of cavities not genetic makeup.”

Diet and teeth brushing remains of utmost importance in reducing the presence of decay.

Is tooth decay a disease?

Yes, tooth decay is classed as a disease, but is classified as a lifestyle disease because it is for the most part within the control of individuals and would not really exist if the lifestyle was not the way that it is.

Can tooth decay heal?

Yes and no.

Where the human body can repair a large wound to the skin, the body cannot heal a large hole in the enamel of the tooth caused by decay.

At a microscopic level teeth do undergo a remineralisation process that can stop and even reverse early decay, but with repeated attacks on the tooth surface the body is unable to fight and heal the tooth.  Read this section of the article on sugar attacks to learn more.

Can tooth decay spread?

Any decay to a tooth can get worse and spread, creating more damage to the that individual tooth if the diet and conditions are right.

The presence of sugars and bacteria in the mouth will mean that all teeth are susceptible and the increased bacteria count can mean that multiple teeth can experience decay at the same time.

The underlying bacteria that causes decay can be spread from one person to another by sharing utensils like knives, forks, spoons and even kissing, but for most adults this risk is low due to the immunity of our body.  Children are more at risk

Bacteria requires other conditions for the decay to begin and with regular tooth brushing and oral hygiene and limiting the number of acid attacks reduces the chances of decay.

What does tooth decay smell like?

Left untreated, a decaying tooth will smell rotten and the breath from your mouth will have an unpleasant taste.  It is hard to describe the smell but in most healthy mouths there will be no distinguishable smell, other than perhaps a scent left behind by a toothpaste or mouthwash.  Those with decay will smell different, quite pungent and unpleasant.


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About Jon Love

Jon is a leading voice on electric toothbrushes and has been quoted by mainstream media publications for his opinions and expertise.

Having handled & tested hundreds of products there really is very little he does not know about them.

Passionate about business and helping others, Jon has been involved in various online enterprises since the early 2000s.

After spending 12 years in consumer technology, it was in 2014 that he focused his attention on dental health, having experienced first-hand the challenge of choosing a new toothbrush.

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