Tooth decay begins when the hard enamel layer on the tooth surface is dissolved by acids. The acid is formed when the bacterial plaque attached to the teeth meets sugar. When you eat cola, fruit juice, biscuits or bread during the day, the bacteria in the plaque turn sugar into acid; this acid pulls calcium out of the enamel crystals. This is how the chalk-colored, dull areas we call “white spots” form. This point is still in the early stages, meaning that the tooth surface is smooth and there are no real pits.
This is where the teeth have a chance to heal themselves. Saliva is the natural buffer; it carries calcium, phosphate and fluoride. If plaque is removed at least twice a day by brushing and flossing, the minerals in the saliva settle back into this prematurely damaged area and re-harden the enamel. Fluoride paste, mouthwashes or fluoride varnishes applied by the dentist accelerate this process. Limiting sugar to main meals, drinking water and increasing saliva flow by chewing sugar-free gum during the day also shorten the acid attacks. This can make the white spot disappear within a few months, or at least halt its progression.
However, the situation changes if the enamel layer is pierced and a real, albeit small, cavity forms. Bacteria now enter the soft dentin, which dissolves much faster than enamel. Here the body’s repair power is not enough, the decay is irreversible, and unless the dentist cleans and fills the cavity, it will progress and cause pain and inflammation. In summary, the tooth can only be recovered when the “shell is scratched”; if the “shell” is broken, the repair must be done by human hands.
So how do we know if the decay is early or late? Most of the time it is not obvious to the naked eye, which is why regular visits to the dentist before the onset of pain are important. With a simple X-ray or special light systems, the white spot is detected, fluoride treatment and home care are planned. In this way, the tooth can be used for a lifetime without the need for fillings.
