Caries Prevention: How Caries Develops and What Influences It

"Nothing hurts, so everything is fine, right?" But caries in its early stage may indeed cause no symptoms at all. Let us go through it step by step: where it comes from and what doctors call prevention.

How caries develops

Bacteria live in the mouth. Some of them are beneficial, while others are involved in destroying the tooth. They combine with food and form a soft, sticky plaque on the tooth surface. The bacteria in plaque use sugar and starch from what we eat and drink and turn them into acids.

Acids leach minerals out of enamel. Enamel is the hardest tissue in the body, and 96% of it consists of minerals. But hydroxyapatites are sensitive to acid, and destruction begins at a pH of 4.5.

Then it goes like this: first a white spot appears — an area where minerals have been lost. This is an early sign, and at this stage the process can be stopped or reversed. If nothing changes, the enamel breaks down further and a cavity forms, that is, a hole. This is already irreversible damage: the tooth will not restore itself, and a filling is needed. Over time, plaque hardens and turns into tartar, which irritates the gums and leads to gum disease.

Which factors increase the risk of caries

The two main factors are insufficient oral care and too much sugary and starchy food and drink. There are also risk groups: people with insufficient saliva (due to medications, certain diseases, cancer treatment), those who get little fluoride, and very young children — especially if they are given juice from a bottle or a bottle at night, because their teeth remain in sugar for hours. In older people, the gums recede, tooth roots become exposed, and they decay more easily.

Caries is the most common human disease, affecting more than 93% of people. In 80–90% of children with primary teeth, there are carious cavities; about 80% of adolescents finish school with cavities, and 95–98% of adults have filled teeth.

What dentistry means by caries prevention

Dentists call prevention a set of everyday habits and regular check-ups.

• brush your teeth at least twice a day with fluoride toothpaste, and after brushing spit rather than rinse with water;
• clean the spaces between teeth every day with floss or interdental brushes;
• limit sweets and starchy foods, especially between main meals;
• do not smoke and do not regularly drink more than 14 units of alcohol per week;
• for children, place sealants on the chewing surfaces of the back teeth as soon as they erupt.

The role of fluoride and saliva in protecting enamel

Teeth lose and regain minerals all day long. Saliva and fluoride help return them. Fluoride enters the body from toothpaste, water, and other sources and, together with saliva, helps enamel recover. Fluorapatites, which form when hydroxyl groups are replaced, are more resistant to acids. According to World Health Organization recommendations, fluoridation of drinking water to a concentration of one milligram per liter reduces the incidence of caries by 30–50%.

Saliva, together with fluoride, helps enamel recover. If there is little saliva or it is viscous, it is easier for bacteria to attach to the tooth and build up plaque.

Why preventive check-ups are needed

Caries does not hurt at the start, so check-ups are scheduled rather than prompted by pain. The doctor examines the teeth, probes them with instruments, asks about symptoms, and sometimes an X-ray is needed. If you have not seen a dentist for two years, that is already a reason to come, and before age 18 — one year.

When signs of caries require a visit to the dentist

You should see a dentist if a tooth hurts, if sharp pain occurs with hot, cold, or sweet foods, if white, brown, or black spots are visible on a tooth, if the gums hurt, swell, or bleed when brushing.

Toothache alone is not a reason to call an ambulance. 103 or 112 — if facial swelling appears along with it and the temperature rises: this may be a sign of pus accumulation (abscess).

This material is for reference and does not replace a doctor's consultation: an examination will show what is happening specifically with your teeth.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer