Tooth decay also refer to as dental caries or tooth rottening is a bacteria infection which lead to loss of minerals ( demineralization) of the hard surfaces ( enamel, dentine, cementum) and layers of the teeth causing eventual breakdown of the enamel thereby creating a hole or cavity on the tooth/teeth. Dental caries affects every age group though more prevalent among children and young adults. It first manifest as chalky white color on the enamel then brown, dark and eventually cavity or hole. Lifestyle, eating habits, snacking and poor oral hygiene do predispose to dental caries. Tooth decay can lead to tooth stain, cavity, dentinal hypersensitivity, toothache, bad breath, swelling, tooth loss etc. Tooth decay can both be treated and prevented.


The following indicates the presence of tooth decay;

  • Dull appearance of the tooth
  • Choky white spot on the tooth
  • Brown and dark coloration
  • Cavity or hole
  • Dentine hypersensitivity
  • Toothache
  • Pain triggered by taking of sweet food, hot or cold beverages
  • Bad breath
  • Swelling
  • Increased saliva production
  • Tooth loss

When to see a dentist

See a dentist when you notice the following

  • Food lodging in the cavity
  • Inability to chew properly
  • Toothache that prevent routine activities
  • Swelling

Causes of tooth decay

Tooth decay occurs when bacteria in the oral environment convert sugar in food eaten to acid which in turn soften the enamel. The causes of tooth decay are;

  • Poor oral hygiene
  • Frequent consumption of sweet food especially snacks
  • Lack of fluoride
  • Disease like diabetes mellitus and Sjogren’s disease
  • Medication like antihistamines and antidepressants
  • Chronological enamel hyperplasia
  • Amelogenesis imperfecta
  • Dry mouth

How saliva works

Saliva has antibacterial property that reduces the amount of bacteria in the oral environment. Saliva also contain minerals that help to remineralize the enamel that is, repair damaged enamel at onset of tooth decay.

However, the preventive ability of saliva is dependent on the amount produced and the rate of flow, therefore tooth decay is more eminent during period when saliva production and flow is at is lest which is at night. For this reason Frequent late night snacking is not safe.

Risk factors

  • Feeding from bottle and bedtime infant feeding
  • Frequent snacking
  • Shape, size and location of tooth
  • Sugary food and drinks
  • Poor oral habits
  • Reduced fluoride intake
  • Reduced saliva production and flow
  • Age
  • Baby teeth
  • Dental restoration and prostheses
  • Gastrointestinal problems
  • Crooked teeth
  • Severe fluorosis
  • Eating Abnormalities


When tooth decay is ignored it can degenerate into more serious and painful infection and conditions like ;

  • Toothache
  • Gingival polyp
  • Pulp polyp
  • Acute apical periodontitis
  • Dentoalveolar abscess
  • Dental cyst
  • Pulp necrosis
  • Swelling
  • Tooth loss
  • Tooth collapse
  • Accumulation of tartar
  • Bad breath
  • Ludwig Angina


The incidence of tooth decay can be reduced by observing the following;

  • Brushing your teeth twice , last thing before going to bed and after your meal in the morning
  • Brush with fluoride containing toothpaste
  • Drinking adequate water after meal and rinsing of your mouth
  • Visiting dental clinic every 6 months for professional cleaning of the mouth
  • Avoid kissing babies in the mouth
  • Reduce intake of refined food
  • Avoid eating in between sleep
  • Reduce intake of sugary food and drink
  • Eat tooth friendly food

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