How a cavity forms
Tooth decay is the gradual breakdown of the hard tissues of a tooth. It results from three things coming together: the bacteria in dental plaque, sugars in your diet, and time.
When you eat or drink sugars (table sugar, sweet drinks, pastries, but also starchy foods that stick to the teeth), the bacteria in plaque turn them into acids. These acids dissolve minerals from the enamel: this is demineralisation.
Saliva plays a protective role. Between meals and snacks, it neutralises acids and supplies minerals that partly repair the enamel, especially when fluoride is present: this is remineralisation. A cavity develops when acid attacks happen too often for saliva to keep up with repairs. That is why how often you have sugary foods matters as much as how much.
Factors that increase the risk
Anyone can get tooth decay, but some factors raise the risk:
- frequent snacking and sweet drinks sipped throughout the day, including fruit juice and sweetened tea or coffee;
- irregular brushing or brushing without fluoride toothpaste;
- a dry mouth, caused by some medicines, certain conditions or mouth breathing;
- areas that are hard to clean: deep grooves on the molars, crowded teeth, the edges of old fillings, braces;
- receding gums, which expose the root, a surface softer than enamel;
- in young children, prolonged night-time bottle feeding with sweet drinks.
Knowing your own risk factors helps your dentist tailor prevention and decide how often you should be seen.
Early signs to look out for
At the very beginning, decay does not hurt. The first visible sign is often a chalky white spot on the enamel, sometimes brown. At this stage the lesion can still remineralise.
As decay progresses through the enamel and into the dentine (the layer beneath the enamel), other signs may appear:
- brief sensitivity to sweet, cold or hot things;
- a small hole, pit or rough edge that your tongue can feel;
- food that always gets stuck in the same place;
- a dark stain that is spreading.
Sharp, lingering pain, especially at night, or a swollen gum often signal advanced decay that has reached the nerve. Many cavities, however, particularly between the teeth, stay invisible and painless for a long time: only an examination and, where needed, an X-ray will find them.
Prevention: fluoride, diet and oral hygiene
Preventing tooth decay comes down to a few simple habits that work when they are regular:
- Brush twice a day with fluoride toothpaste, and spit without rinsing heavily so the fluoride can work.
- Clean between your teeth every day with floss or suitable interdental brushes.
- Cut down how often you have sugar: a dessert at the end of a meal is better than sweet snacks spread across the day. Choose water between meals.
- After a meal, chewing sugar-free gum can help stimulate saliva.
- If your mouth feels dry, talk to your doctor or dentist rather than compensating with sweets.
Depending on your level of risk, your dentist may suggest fluoride varnish applications at the practice or a higher-strength toothpaste. These measures add to your daily routine; they do not replace it.
Children: fissure sealants and follow-up
Baby teeth and newly erupted permanent molars are particularly vulnerable. The grooves (fissures) on the molars, sometimes very deep, trap plaque and are hard to clean even with good brushing.
Fissure sealing means covering these grooves with a thin protective resin coating, with no drilling and no anaesthetic. It is often offered on the first permanent molars (around age 6) and the second ones (around age 12), depending on the child's decay risk. Sealants then need to be checked regularly.
Decay in baby teeth also needs treating: it can be painful, become infected and affect the permanent tooth developing underneath. Regular visits to a children's dentist, from the very first teeth, allow early detection and support for parents. At German Dental Clinic in Agdal, paediatric dentistry is part of the care offered.
What the dentist does at each stage
Treatment depends on how deep the decay goes, assessed by clinical examination and, if necessary, an X-ray:
- Early enamel lesion (white spot): in many cases no drilling is needed. The dentist reinforces your hygiene routine, applies fluoride and monitors the area.
- Decay in the enamel and dentine: the dentist removes the affected tissue, under local anaesthetic if needed, then rebuilds the tooth with a filling (usually a tooth-coloured composite). This is the most common form of cavity treatment.
- Extensive decay: when a large part of the tooth is destroyed, a bigger restoration such as an inlay, onlay or crown may be needed to protect it.
- Decay that has reached the pulp (the nerve): irreversible inflammation or infection usually requires root canal treatment, meaning the root canals are cleaned and sealed before the tooth is rebuilt.
- A badly broken-down tooth: when it cannot be saved, extraction is considered, followed by a discussion of how to replace the tooth.
The earlier decay is treated, the simpler the treatment and the more of the tooth is preserved.
Regular check-ups: your best protection
Because decay can progress without pain for months, regular check-ups are the best way to catch it before it reaches the nerve. How often you need them depends on your personal risk: your dentist will suggest a suitable interval, shorter if you often have cavities.
At a check-up, the dentist examines each tooth, checks existing fillings, assesses the gums and takes X-rays when they are justified. It is also the right time to ask questions about brushing, diet or which products to use.
If you live in or are visiting Rabat and have not had a check-up for a while, or notice unusual sensitivity, you can book an appointment for an examination.
Sources
Frequently asked questions
Can a cavity go away on its own?
A very early lesion, at the white spot stage on the enamel, can stabilise or remineralise with fluoride and good oral hygiene. Once an actual hole has formed, the tooth cannot repair itself and treatment is needed.
Why do I get cavities even though I brush?
Brushing does not reach everywhere, especially between the teeth, and how often you have sugar plays a major role. A dry mouth or deep grooves also increase the risk. Your dentist can identify your risk factors and adapt the advice.
Does having a filling hurt?
When decay has reached the dentine, the treatment is usually done under local anaesthetic, which keeps it comfortable. Some mild sensitivity may occur for a few days after a filling. The earlier decay is treated, the shorter and simpler the procedure.
Do cavities in baby teeth need treating?
Yes. Untreated decay in a baby tooth can cause pain and infection, disturb the child's eating and sleep, and affect the permanent tooth forming beneath it. The dentist chooses a treatment suited to the child's age and the stage of decay.
The information on this page is general. Only a consultation allows a diagnosis and a suitable treatment plan.
