Tooth decay

Your mouth is full of bacteria that form a sticky film over your teeth, called dental plaque. When you eat or drink something high in sugar, the bacteria in this plaque use the sugar for energy and release acid as they do.

If plaque is left to build up, this acid slowly dissolves the surface of your tooth, creating small holes called cavities.

Once a cavity has formed in the enamel, plaque and bacteria can reach the dentine underneath, the softer, bone-like layer. Because dentine is softer than enamel, decay then spreads faster.

Left untreated, bacteria eventually reach the pulp, the soft core of the tooth holding its nerves and blood vessels. At this point, the nerves are exposed to bacteria and the tooth usually becomes painful.

The bacteria can go on to cause a dental abscess in the pulp, and the infection may spread into the surrounding bone.

Treatment for tooth decay depends on how far it has progressed.

If the decay is still at an early stage, your dentist will talk to you about how much sugar is in your diet and when you eat it. They may put a fluoride gel, varnish or paste on the affected area. Fluoride protects teeth by strengthening the enamel, so teeth can better resist the acids from plaque that cause decay.

For more advanced decay, your dentist may talk to you about a filling or crown. This means removing the decayed part of the tooth, giving a local anaesthetic to numb it, and then filling the hole.

If the decay has reached the pulp (the centre of the tooth, which holds blood vessels and nerves), it may need to be removed through root canal treatment.

If the tooth is too badly damaged to be saved, it may need to be taken out. Your dentist may then be able to replace it with a partial denture or bridge.

Some people do not have to pay for dental treatment, including everyone under 26, and those who are pregnant or have given birth in the last 12 months. Financial help may also be available for people with a low income or who receive certain benefits.

The cost of private dental treatment varies from practice to practice, since there is no fixed charge. If you choose private dental care, agree on the cost before treatment begins.

Preventing tooth decay

Although tooth decay is a common problem, it’s often entirely preventable. The best way to avoid tooth decay is to keep your teeth and gums as healthy as possible.

Do

• visit your dentist regularly – your dentist will decide how often they need to see you based on the condition of your mouth, teeth and gums
• cut down on sugary food and drinks, particularly between meals or within an hour of going to bed – some medications can also contain sugar, so it’s best to look for sugar-free alternatives where possible
• look after your teeth and gums – brushing your teeth properly with a fluoride toothpaste twice a day, using interdental brushes or floss daily
• avoid smoking or drinking alcohol excessively – tobacco can interfere with saliva production, which helps to keep your teeth clean, and alcohol can contribute to the erosion of tooth enamel
• see your dentist or GP if you have a persistently dry mouth – this may be caused by certain medicines, treatment or medical conditions

Protecting your child’s teeth

Good eating habits by limiting sugary snacks and drinks can help your child avoid tooth decay. Regular visits to the dentist at an early age should also be encouraged.

Toothbrushing

You should start brushing your child’s teeth and gums daily as soon as their first tooth grows in.

Find out more about toothbrushing for babies, toddlers and pre-schoolers

Childsmile has advice for keeping children’s teeth healthy:

• under 3s
• 3 to 5 year olds
• 5 to 12 year olds

Children should still brush their teeth twice a day, especially before bedtime.