Bacteria that build up in our mouths as dental plaque stick mostly to places that are hard to clean: grooves and pits on the chewing surfaces, the spaces between teeth, around the neck of the tooth or on an exposed root.
The bacteria feed on sugars from our food and produce acids. These aggressive acids attack the tooth surface. The enamel demineralises and later a surface cavity forms. Demineralisation usually shows up as a chalky white spot.
Once the enamel is damaged, decay reaches the deeper and softer layer, the dentine, where it spreads quickly. Surface cavities do not hurt, but later the tooth may become sensitive to heat, cold, sweet or sour food.
When bacteria reach the nerve, the dental pulp becomes inflamed, which usually causes sharp pain, sometimes radiating to the surroundings. A filling is then no longer enough and root canal treatment is needed. A tooth can also die without any symptoms at all.
How tooth decay develops
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