Caries (tooth decay) is one of the most widespread problems in oral health. It affects the tooth enamel and, left untreated, can lead to serious consequences – from sensitivity and pain to infection and tooth loss.
- Decay is caused by plaque bacteria turning sugars into acids that dissolve tooth enamel.
- Early decay is often painless, so regular check-ups and fluoride toothpaste are key to catching and preventing it.
- Treatment ranges from a simple filling (from €120) to root canal treatment or a crown for advanced decay.
What is tooth decay (caries)?
Dental caries is a common chronic disease of the oral cavity that affects the tooth tissue. It forms when bacterial plaque is not removed from the teeth in time. More than 10 million different bacteria live in our mouth, among which streptococci are the most harmful. When food debris remains on the teeth, these bacteria break it down and produce harmful acids. Although the tooth is the hardest structure in the body, the acids slowly dissolve its surface, including the enamel, which over time leads to caries.
Symptoms and signs of caries
The early stages of caries often occur without obvious symptoms, which makes them hard to detect yourself. As decay progresses, characteristic signs appear: tooth sensitivity to hot, cold or sweet stimuli, small white or dark spots on the tooth surface, bad breath and occasional pain or discomfort when chewing. If you notice any of these signs, visit the dentist as soon as possible so the caries can be diagnosed and treated before complications develop.
Tooth decay can progress quickly
If early caries is not treated in time, it can quickly progress into a small hole in the enamel. You may notice this as a change in the colour of the enamel, which is no longer white but becomes dark or brownish.
The process of enamel breakdown is slow at first, but caries penetrates deeper into the tooth, where it reaches the dentine. This is softer, which lets decay spread faster. If caries reaches the tooth nerve, root canal treatment is often necessary.
What does dental caries look like?
Dental caries has a different colour from healthy tooth tissue, so the dentist can most often detect it with the naked eye. Early caries first shows on the enamel as a white stain, and as it progresses the colour changes to a darker, brownish shade. To confirm the diagnosis, the dentist may also use a special dental X-ray.
Causes of tooth decay
Tooth decay can result from several factors. The main ones are poor oral hygiene, an inadequate diet, bacteria in the mouth and genetic predisposition.
Poor oral hygiene
Inadequate brushing, insufficient flossing and not using mouthwash allow bacteria and food debris to build up on the teeth. The bacteria then form acids that attack the enamel and cause decay, so good daily oral hygiene is essential.
An inadequate diet
Food and drink high in sugar and starch feed the bacteria in the mouth. These bacteria convert sugar into acids that break down the enamel and cause caries.
Bacteria in the mouth
Some types of oral bacteria are more acidic and aggressive, which raises the risk of decay. They form a sticky biofilm, known as dental plaque, that accumulates on the teeth and drives the development of caries.
Genetic predisposition
Some people have a genetic tendency towards teeth that are more susceptible to caries. If tooth decay is common in your family, your own risk may be higher.
Which teeth are most often affected by tooth decay?
Decay most often affects the back molars and the first permanent teeth. The back molars are rougher and have more grooves where food debris and plaque are retained, which raises the risk of caries. The first permanent teeth appear early and are exposed to the risk of decay for longer. Premolars, important for chewing, are also frequently affected because they are exposed to wear. That said, decay can affect any tooth when the factors that promote it are present.
How can we reduce the risk of caries?
Good oral hygiene comes first. Brushing at least twice a day with fluoride toothpaste is the basic routine for keeping teeth healthy. Do not forget to clean between the teeth with floss or interdental brushes, as bacteria most often accumulate where the toothbrush cannot reach.
It is also important to limit sweet and starchy foods, as these drive acid formation in the mouth. Cut back on sweet snacks, fizzy drinks, sweet juices and other high-sugar foods.
Try to include more fresh fruit, vegetables and wholegrain foods, which are rich in the vitamins and minerals that support enamel and overall oral health. For an independent overview of prevention, see the NHS guide to tooth decay.
| Habit | How often | Why it matters |
|---|---|---|
| Brushing | Twice a day | Removes plaque |
| Flossing | Daily | Cleans between teeth |
| Professional cleaning | Every 6 months | Removes tartar |
Foods that harm the teeth and cause caries
Among the most harmful foods are sweets such as candy, chocolate, biscuits and sugar bars, along with fizzy drinks, sweet drinks, starchy foods, dried fruit, sour foods and energy and sports bars. These contain large amounts of sugar, which promotes acid formation in the mouth. The acids attack the enamel and the tooth roots and cause caries, which is why careful oral hygiene matters so much.
How is caries or tooth decay treated?
Treatment is carried out according to the degree of tooth damage, and usually follows these steps:
- Examination by the dentist: a thorough check of the mouth so the dentist can gauge the extent of the caries and choose the best treatment.
- Removal of damaged enamel: if the caries is limited to the surface and has not reached the dentine, the dentist removes the damaged enamel and prepares the tooth for a filling.
- Filling: after removing the decay, the dentist restores the tooth with a filling.
- Inlay or onlay: for more extensive damage, the dentist can place an inlay or onlay – restorations made from ceramic or composite – when the damage is too large for an ordinary filling but has not yet reached the nerve.
- Root canal treatment: if decay reaches the deeper layers and affects the tooth nerve, root canal treatment is needed, in which the endodontist removes the infected nerve and fills the canal with a special material.
- Dental crown: when a tooth is badly damaged with significant loss of structure, a crown can be placed to surround and protect the remaining tooth.
- Tooth extraction: if a tooth can no longer be preserved, it may need to be extracted and replaced with a dental implant, a bridge or a denture.
It is important to see the dentist at OrthoDental at the first signs of caries, as timely treatment prevents further progression.
Risks and consequences of decayed teeth
Decayed teeth, the result of advanced caries, can cause numerous risks and serious consequences for oral health and general wellbeing. Decay opens a path for bacteria to reach the interior of the tooth, the roots and the surrounding tissues, which can lead to serious infections and abscesses that need urgent care. When decay forms on a wisdom tooth, it sometimes has to be removed – read more about wisdom tooth extraction.
Caries can lead to tooth loss, affecting the look of your smile, your ability to chew and your speech. Gum inflammation is another common consequence, causing sensitivity, bleeding and bad breath.
Decay can also affect general health, as some studies have linked it with an increased risk of cardiovascular disease, diabetes and other problems.
Do fluoride toothpastes prevent decay?
Fluoride toothpastes are an effective tool for preventing caries. Fluoride is a mineral that helps strengthen the enamel and protect it from the acids produced by bacteria. Regular use of fluoride toothpaste helps reduce the risk of decay.
Treating very advanced tooth decay
Very advanced decay can require complex, specialised procedures. When the caries has reached the tooth nerve, root canal treatment is needed: the dentist removes the infected or damaged nerve, then cleans and fills the canal with a special material.
In some cases, when decay has advanced greatly and caused severe damage to the bone or tissue around the tooth, surgical treatment may be necessary. This can include removing the infected tissue and placing a bone graft to preserve or restore the stability of the affected tooth.
Treating very advanced decay is demanding and calls for an experienced dentist, such as those at OrthoDental.
When should you visit the dentist?
A dental visit is recommended for regular preventive care, with an examination and cleaning at least once every six months. You should also see the dentist in the case of pain or tooth sensitivity, bleeding gums, tooth injuries, difficulty chewing or opening the mouth, or aesthetic concerns.
Why are regular check-ups important?
Detecting caries early is crucial for preventing it from progressing. During regular visits, the dentist can spot the first signs of caries in time, such as initial colour changes in the enamel or small holes, and prevent more serious problems like pain, gum inflammation, root canal treatment or tooth loss.
Do dark spots on the teeth always mean caries?
Dark spots are not always a sign of caries. While they can indicate decay, other factors also change tooth colour, such as natural pigmentation of the enamel, surface deposits and the consumption of tea, coffee and red wine. Our dentist will carry out a thorough examination and advise on suitable treatment or on improving the look of your smile where needed.
How much does treating dental caries cost?
The price depends on the extent of the caries and the number of affected teeth. Prices usually range from €120 for smaller restorations (fillings) to several hundred euros for more extensive procedures, such as root canal treatment or a crown. Visit OrthoDental and our dentist will assess the extent of the caries and give you an accurate estimate. A dental granuloma can also form as a result of tooth decay.
Frequently asked questions
How do I know if I have a cavity?
Early cavities are often painless. Watch for tooth sensitivity to hot, cold or sweet, white or dark spots on the tooth, bad breath or discomfort when chewing. Only a dentist can confirm a cavity, sometimes with an X-ray, which is why regular check-ups matter.
Can early tooth decay be reversed?
Very early decay, while it is still limited to the enamel as a white spot, can sometimes be halted or remineralised with fluoride and good hygiene. Once a cavity has formed a hole, it cannot heal on its own and needs a filling.
How much does treating a cavity cost at OrthoDental?
Treatment starts from €120 for smaller fillings and rises for more extensive work such as root canal treatment or a crown. Your dentist will give an exact estimate after examining the tooth.
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