Newsletter Issue 1 December 2020 – Cavities or Caries

Cavities/ caries are permanent damage to the tooth that occurs as a result of bacterial acid attacks. They can happen on any age groups: such as infants to elderly.  Its cause are combinations of these factors: susceptible tooth, bacteria, sugar and time. Bacteria in the mouth decompose food debris and/or sugar stuck on the teeth and produce acids, which given enough time will destroy the tooth enamel (the outer layer of the tooth), causing the formation of cavities.

Here’s how caries happens…

  • Plaque forms. Dental plaque is a clear sticky film that coats your teeth. It’s due to eating a lot of sugars and starches and not cleaning your teeth well. When sugars and starches aren’t cleaned off your teeth, bacteria quickly begin feeding on them and form plaque.
  • Plaque attacks. The acids in plaque will cause erosion on your tooth’s hard, outer enamel, that is the first stage of cavities. If not treated, the bacteria and acid will progress painlessly to the next layer of your teeth, called dentin. This layer is softer than enamel and less resistant to acid. Dentin has tiny tubes that directly communicate with the nerve of the tooth causing sensitivity.
  • Destruction continues. The dentin caries is advancing to the pulp that contains nerves and blood vessels. The pulp becomes swollen and irritated from the bacteria. Because there is no place for the swelling to expand inside of a tooth, the nerve becomes pressed, causing pain. Discomfort can even extend outside of the tooth root to the bone.


The signs and symptoms of cavities vary, depending on their extent and location. When a cavity is just beginning, you may not have any symptoms at all. If cavities are not treated, they are slowly painlessly getting bigger and progress to the pulp. Deeper cavities may cause symptoms such as:

  • Tooth sensitivity to sweet, hot or cold
  • Toothache (spontaneous sharp pain without any apparent cause)
  • Brown, black or white staining on any surface of a tooth
  • Broken teeth
  • Pain when you bite down or chewing
  • Food get stuck in between teeth
  • Inflammation of the gum in between teeth; gum swelling and facial swelling


Caries can be easily treated with fillings and/ or indirect restorations such as inlay, onlay or crown, depending on the remaining tooth structure.

Risk Factors for Cavities 

  • Inadequate flossing and brushing
  • Excessive and/ or frequent snacking or sipping of certain foods and drinks: excessive consumption of sugary foods and drinks e.g., soda, fruit juice, cake, cookies, candies and sticky food that clings to your teeth for a long time e.g., dry cereal, chips etc.
  • Dry mouth: Low salivary flow increases the risk of cavities. Things that may cause dry mouth include some medications, certain medical conditions, smoking, mouth breathing, chemotherapy drugs, and radiotherapy.
  • Broken tooth fillings: this allows the accumulation of food debris and bacteria more easily, causing dental caries.
  • Not getting enough fluoride: fluoride protects the tooth from bacterial acids and reverses the early stage of dental caries.
  • Some medical conditions such as Heartburn or gastroesophageal reflux disease (GERD), anorexia and bulimia cause teeth erosion due to acid in the mouth. This acid makes the teeth weaker and increases the risk of cavities.

Prevention (is always better than cure)!

Good oral and dental hygiene can help you avoid cavities and tooth decay. Here are some tips to help prevent cavities. Ask your dentist which tips are best for you.

  • Brush with fluoride toothpaste after eating or drinking and floss. Brush your teeth at least twice a day and ideally after every meal, using fluoride-containing toothpaste.

  • Visit your dentist regularly. Get professional teeth cleanings and regular dental check-ups, which can help prevent problems or spot them early.

  • Drink some tap water. Most public water supplies have added fluoride, which can help reduce tooth decay significantly.

  • Avoid frequent snacking and sipping. Whenever you eat or drink beverages other than water, you help your mouth bacteria create acids that can destroy tooth enamel. If you snack or drink throughout the day, your teeth are under constant attack.
  • Eat healthy foods, such as fresh fruits and vegetables increase saliva flow, and unsweetened coffee, tea and sugar-free gum help wash away food particles.

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