Patient education: Tooth decay in adults (The Basics)

What is tooth decay? — 

This is when the enamel that covers a tooth is damaged (figure 1). Then, a soft spot, hole, or "cavity" forms.

Tooth decay can happen on the tooth surface, on the tooth root where there is gum recession, or deeper in the tooth. The tooth decay will worsen if it is not repaired. Repair involves putting in a "filling."

What causes tooth decay? — 

After eating or drinking, bits of food and sugar are left on the teeth. Germs in the mouth combine with food and sugar to make plaque, which is a soft, sticky, film-like coating. If you don't brush your teeth, the plaque builds up. The bacteria in plaque combine with food and sugar to make acid. The acid can weaken the protective enamel on the tooth and cause decay. People with dry mouth can have more tooth decay because saliva is a very important for protecting the teeth against decay.

If the soft plaque stays on the teeth, it can also harden and form something called "tartar." Dental plaque can also cause inflammation of the gums ("gingivitis") and bone loss around the tooth ("periodontitis").

What are the symptoms of tooth decay? — 

Since it takes time for acid to break down enamel, there are often no symptoms of early tooth decay. It might only be seen with X-rays.

When there is more breakdown in the enamel or the tooth root, people can have symptoms. These might include:

●Tooth sensitivity to hot or cold

●Bad breath, or a bad taste in the mouth

●Gray, black, or brown spots on a tooth

●Bleeding, red, or swollen gums

●Swelling of the jaw, face, or neck

Will I need tests? — 

Most problems with teeth are treated by a dentist. They will check your teeth, gums, and mouth. They gently touch and tap on your teeth to check them. The dentist might ask about pain or problems with heat or cold.

Sometimes, they might do other tests, like an X-ray, to check your teeth.

How is tooth decay treated? — 

Treatment is based on how serious the tooth decay is. Possible treatments include:

●Putting a coating of fluoride on the tooth to treat early tooth decay and prevent it from getting worse

●Removing decay, and placing a filling or crown on the tooth

●Doing a root canal if the nerve of the tooth is infected or inflamed

●Pulling a tooth if it cannot be fixed

How can I help prevent tooth decay? — 

Here are some tips:

●Brush your teeth at least 2 times a day. Use toothpaste with fluoride.

●Use dental floss to clean between your teeth every day.

●If you cannot brush your teeth after a meal, chew sugar-free gum.

●See your dentist for regular cleanings and check-ups. This is important even if you don't have any symptoms or problems with your teeth. The dentist might put fluoride or a sealant on your teeth.

●Eat a healthy diet. Try to avoid or limit foods and drinks that are high in acid, sugar, and starch. These include things like chocolate, sweets, and fizzy or sugary drinks. Multiple snacks during the day can increase tooth decay formation.

●If you smoke, try to stop. Your doctor, nurse, or dentist can help you. Smoking can make some dental problems worse.

When should I call the doctor or dentist? — 

Call for advice if you have:

●Signs of infection, such as:

•A fever of 100.4°F (38°C) or higher

•Swelling of the gums, neck, or face

•Discharge or pus around a tooth

●A toothache that doesn't go away in a few days, or pain that is getting worse or keeps you from sleeping

●Trouble swallowing, breathing, chewing, or opening your mouth all of the way

●A lot of bleeding from your gums

More on this topic

Patient education: Fluoride (The Basics)
Patient education: Toothache (The Basics)
Patient education: Dental abscess (The Basics)
Patient education: Tooth decay in children (The Basics)