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Bacteria turn sugar into acid that dissolves the tooth — not the amount but the frequency counts.
Also known as: tooth decay · dental caries · cavity
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Plaque bacteria turn sugar into acid that demineralises enamel — a cavity forms. Early lesions can partly reverse with good hygiene and little sugar; deeper ones need a filling. Key levers: cut sugar frequency, brush thoroughly, regular check-ups.
From the day after the procedure rinse gently with lukewarm salt water, do not gargle, several times a day.
After every contact with sugar the pH in the mouth drops for about half an hour. Six snacks are worse than one dessert in one go — even at the same amount.
That is where the majority of holes start, and the brush does not reach there. Floss or interdental brushes once a day are the biggest single lever after brushing itself.
After citrus, wine, soft drinks or vomiting the enamel is soft. Brushing at once wears it away. Rinsing with water and waiting is the better route.
Saliva is the natural protection. Many medicines, mouth breathing and some illnesses dry it out — then the risk rises independently of the care. Knowing this allows counter-measures.
If the gums recede, the neck of the tooth lies bare — and it is much softer than the enamel of the crown. Root caries in later life almost always starts there.
Fluoride kills no bacteria — it is built into the enamel, makes it more resistant to acid, and draws mineral back into the attacked spot. So it only works if it is present often and in small amounts: twice a day beats one large dose. Spitting without rinsing after brushing leaves a residue in the mouth. Early demineralisation can reverse over months; a hole in the tooth cannot.
From the first demineralisation to a cavity often takes one to three years in adults, faster in children. The pH in the mouth falls below 5.5 within minutes after sugar and needs thirty to sixty minutes to recover — which is why the number of sugar contacts counts for more than the amount. Fluoride works better twice daily than as one high dose. Spitting without rinsing after brushing leaves about twice as much fluoride in the mouth.
A short, stabbing pain with sweet, cold or sour things that stops again at once. That is the earliest noticeable sign — and the moment when a small filling is enough.
Chalky white patches at the neck of the tooth near the gum are the early stage and still reversible. Brown or black discolouration with a rough spot is already a hole.
If food regularly gets caught between two teeth and the floss tears there, a hole usually sits there — even if nothing hurts.
A throbbing pain without a cause that wakes at night, increases with warmth and lasts minutes to hours means the nerve is involved. A swollen cheek with it belongs treated the same day.
At first only with sweet, cold or warm things and briefly; if the pain persists or wakes you at night, more than the enamel is involved.
If many new cavities appear in a short time and the mouth is dry, the long-term sugar belongs in the workup.
With a persistently dry mouth plus dry eyes, Sjögren’s syndrome is looked for; ANA is the first value.
In studies in children an adequate supply was linked with about a quarter less decay. That is prevention over years — an existing cavity does not close from it.
Enamel is made of calcium phosphate, but after eruption it is no longer supplied from inside. What works from outside is fluoride — and the spacing between sugar contacts.
Particular lactobacillus strains have been studied in children, with less decay in individual trials. The catch: many lozenges themselves contain sugar or sugar alcohols — xylitol is the one that was tested.
Enamel is laid down before the tooth erupts — what is missing in that time cannot be made up later. This is why vitamin D works over years in children and not at all on a finished tooth.
Saliva neutralises the acid and returns minerals. Everything that dries the mouth — many medicines, mouth breathing, drinking too little — markedly raises the decay rate. A dry mouth is the most underestimated risk for decay.
It is not the amount of sugar that decides but how often. Every sugar contact lowers the pH for about 30 minutes — six small nibbles do more harm than one dessert.
Frequency of acid attacks matters more than amount — snacking less often protects most.
It is not the amount of sugar that counts but how often. After every sugary bite the pH falls for about 30 minutes — five small snacks attack the enamel longer than the same amount at once.
Offered as a tooth cleaner. Mineral clays can be abrasive and wear the enamel over time — and without fluoride the protection best supported by studies is missing.
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