Tooth Decay: Symptoms, Causes & Treatment | Everything You Need To Know About Cavities

Dental caries is an infectious disease. The enamel of the tooth is the first affected.

To learn more about this dental problem, see our complete fact sheet on this subject below.

Tooth decay, what is it?

Dental caries is an infectious disease. The enamel of the tooth is the first affected. A cavity forms in the tooth and then the cavity spreads in depth. If the caries are not treated, the hole gets bigger and caries can reach the dentin (layer under the enamel).

Pain begins to be felt, especially hot, cold, or sweet. Decay can reach the pulp of the tooth. We then speak of a toothache. Finally, a dental abscess can appear when bacteria attack the ligament, bone, or gum.

Sugars would be one of the main ones responsible for the attack of the enamel. Indeed, the bacteria present in the mouth, mainly the bacterium Streptococcus mutants and lactobacilli, break down sugars into acids. They bind to acids, food particles, and saliva to form what is called dental plaque, which causes tooth decay. Brushing your teeth removes this plaque.

Dental caries, which is very common, affects milk teeth (a carious milk tooth must be cared for even if it falls out) and permanent teeth. They tend to reach the molars and premolars, which are more difficult to clean when brushing. Cavities never heal on their own and can lead to tooth loss.

Tooth decay: Symptoms

The symptoms of dental caries are very variable and depend in particular on the stage of evolution of caries and its location. At the very beginning, when the enamel is the only one affected, the cavity can be painless.

The most common symptoms are:

  • dental pain, which gets worse over time;
  • sensitive teeth;
  • sharp pains when eating or drinking something cold, hot, or sweet;
  • pain when biting;
  • brown spot on the tooth;
  • pus around the tooth.

Tooth decay: what are the causes?

The causes of dental caries are multiple but sugars, especially when consumed between meals, remain the main culprits. For example, there is a link between sugary drinks and cavities or between honey and cavities.

But other factors such as snacking or poor toothbrushing are also implicated.

Tooth decay: possible complications

Cavities can have serious consequences on teeth and health in general. It can, for example, cause severe pain, abscesses sometimes accompanied by fever or swelling of the face, chewing and nutrition problems, teeth that break or fall out, and infections… Cavities must therefore be treated as soon as possible.

Tooth decay: people at risk

Heredity plays a role in the appearance of cavities. Children, adolescents, and the elderly are more likely to develop cavities.

Tooth decay: risk factors

Oral hygiene is a very important parameter in the appearance of dental caries. A diet high in sugar also greatly increases the risk of developing cavities.

A lack of fluoride would also be responsible for the appearance of cavities. Finally, eating disorders such as anorexia and bulimia or gastroesophageal reflux are pathologies that weaken the teeth and facilitate the installation of cavities.

Tooth decay: how to diagnose it?

The diagnosis is easily made by the dentist since the cavity is often visible to the naked eye. He asks about tooth pain and sensitivity. An X-ray can confirm the presence of a cavity.

Dental caries: who is affected?

Cavities are very common. More than nine out of ten people would have had at least one cavity. In France, more than a third of six-year-old children and more than half of 12-year-old children1 have been affected by this infection. In Canada, 57% of children between the ages of 6 and 12 have had at least one cavity.

The prevalence of cavities that affect the crown of the tooth (the visible part that is not covered by the gums) increases until the age of forty and then stabilizes. The prevalence of cavities that affect the root of the tooth, often by loosening or erosion of the gum, continues to increase with age and is frequent in the elderly.

Some preventive measures can be put in place to prevent the appearance of cavities, as well as a treatment if the infection occurs despite everything.

Discover them in this Article.

Tooth decay: preventive measures

An essential point to prevent cavities is to brush your teeth as soon as possible after each meal, without forgetting to change your toothbrush regularly, with fluoride toothpaste. The use of interdental floss is strongly recommended.

Chewing sugar-free gum increases the amount of saliva in the mouth and helps neutralize the acids present in the mouth. Chewing gum can therefore reduce the risk of cavities. But sugar-free chewing gum should not replace brushing!

Beyond good oral hygiene, it is necessary to avoid snacking and watch your diet. Eating sugary foods between meals that get stuck in the teeth greatly increases the risk of developing cavities.

Certain foods such as milk, ice cream, honey, table sugar, soft drinks, grapes, cakes, cookies, candies, cereals, or crisps tend to stick to the teeth. Finally, babies who fall asleep with a bottle of milk or fruit juice in their bed are at risk of developing cavities.

The dentist can also prevent the appearance of cavities in the teeth by applying resin to the surface of the teeth. This technique, mainly intended for children, is called furrow sealing. He can also offer a varnish application. The healthcare professional can also advise a fluoride intake if necessary (tap water is often fluoridated). Fluoride has been shown to have a carioprotective effect.

Finally, it is essential to consult a dentist every year in order to detect a cavity before it is even painful.

Tooth decay: how to treat it?

Cavities that have not had time to reach the pulp of the tooth are easily treated and only require a simple filling. Once cleaned, the cavity is filled with an amalgam or a composite. Thus, the pulp of the tooth is preserved and the tooth is alive.

For more advanced decay, the canal of the tooth will need to be treated and cleaned. If the decayed tooth is very damaged, devitalization and extraction of the tooth may be necessary. A dental prosthesis will be placed.

These treatments are generally performed under local anesthesia.

Pain caused by tooth decay can be relieved with paracetamol (acetaminophen such as Tylenol) or ibuprofen (Advil or Motrin). In case of an abscess, antibiotic treatment will be necessary.

In the event of dental caries, certain complementary approaches make it possible to treat it in a more natural way.

Check out the list here.

Tooth decay: effective complementary approaches


Studies have suggested the effectiveness of xylitol in preventing cavities. This natural sweetener would inhibit the bacteria Streptococcus mutans. Chewing gums containing xylitol could therefore be beneficial for the teeth.


A few animal trials have shown promising results from propolis, but in humans, the results obtained remain mixed. According to the author of the synthesis on the anti-caries properties of propolis, the results diverge because the composition of the propolis used during the tests varies.


The consumption of cheese could, according to numerous studies, prevent the appearance of cavities8,9,10. The responsible for this cariogenic effect would be the minerals of the cheese and in particular calcium and phosphorus. They would prevent the demineralization of teeth and even contribute to their mineralization11.

The study has for their part suggested the effect on cavities of yogurt consumption, without however showing the same results for other dairy products such as cheese, butter, or milk.


Tea, whether green or black, would also help prevent tooth decay. It would reduce the action of an enzyme present in the saliva which has the role of degrading the starch of food into simple sugars.

Green tea would have a beneficial action on caries thanks to its polyphenols which would limit the growth of bacteria associated with caries.


Cranberry consumption would reduce the formation of dental plaque and dental caries. Caution, however, because the juices that contain it are often high in sugar and therefore bad for oral hygiene.


Polyphenols, substances present in hops, would slow down the formation of dental plaque according to certain studies and would therefore contribute to the prevention of cavities.

Image Credit: Photo by engin akyurt on Unsplash

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