Concerned about tooth decay? Book an assessment today.
Tooth Decay (Dental Caries)
South Kensington, London
Tooth decay — also known as dental caries — is one of the most common dental conditions worldwide. It occurs when bacteria in the mouth produce acids that gradually break down the tooth's protective enamel, creating areas of damage that can progress into the softer dentine beneath and, if left untreated, eventually reach the nerve (pulp) inside the tooth. Early detection of tooth decay is important because it allows for more conservative treatment and helps preserve as much natural tooth structure as possible. At our South Kensington dental practice, our dentists carry out thorough clinical and radiographic assessments to identify decay at the earliest possible stage and discuss the most appropriate preventive or restorative approach for each patient.
Explore the full range of dental conditions we treat or read on to understand tooth decay, its causes, and how cavities can be treated and prevented.
Concerned About a Cavity?
We can assess the tooth and discuss your options
- Thorough clinical examination
- Digital X-rays where indicated
- Early decay detection
- White filling and restoration options
- Personalised prevention advice
What Is Tooth Decay?
Tooth decay begins when bacteria in dental plaque produce acids as they feed on sugars from the food and drink we consume. These acids attack the mineral structure of the tooth’s enamel — the hard outer layer — in a process called demineralisation. In its earliest stage, this appears as white or chalky spots on the enamel surface.
If the demineralisation continues without intervention, the enamel surface eventually breaks down, forming a cavity. Once a cavity has formed, the decay can progress into the softer dentine layer beneath the enamel, where it tends to spread more rapidly. At this stage, the tooth may become sensitive or painful.
In advanced cases, the decay can reach the pulp — the soft tissue containing the tooth’s nerve and blood supply — leading to infection, abscess, and significant pain. Early detection and treatment help prevent this progression, allowing for simpler, more conservative restorations and better long-term outcomes for the tooth.
Early Signs of Tooth Decay
Tooth decay does not always cause pain in its early stages, which is why regular dental examinations are important for detection. The following may indicate early or developing decay:
Early decay can sometimes be managed with preventive measures before a filling is needed. A clinical examination is the most reliable way to assess whether decay is present and determine the appropriate approach.
Causes of Dental Caries
Understanding the factors that contribute to tooth decay helps guide both treatment and prevention strategies.
Poor Oral Hygiene
Inadequate brushing and flossing allows plaque — a sticky film of bacteria — to accumulate on the tooth surfaces. The bacteria in plaque feed on sugars and produce acids that attack the enamel, initiating the decay process.
High Sugar Intake
A diet rich in sugary foods and drinks provides a frequent supply of fuel for plaque bacteria. Each sugar exposure triggers an acid attack on the enamel that can last for up to 30 minutes, so the frequency of sugar consumption is as significant as the quantity.
Frequent Snacking
Eating or drinking frequently throughout the day — particularly sugary or acidic items — means the teeth are subjected to repeated acid attacks with less time for saliva to neutralise the acid and support remineralisation between exposures.
Dry Mouth
Saliva plays a vital role in washing away food particles, neutralising acids, and providing minerals that help strengthen the enamel. Reduced saliva flow — whether due to medications, medical conditions, or dehydration — increases the risk of decay.
Deep Grooves in Teeth
The chewing surfaces of the back teeth (molars and premolars) often have deep pits and fissures where plaque and food debris can accumulate and become difficult to clean with a toothbrush alone, making these areas particularly susceptible to decay.
When Should You See a Dentist?
While regular dental examinations are the best way to detect decay early, the following signs suggest it may be time to arrange an assessment:
A visible hole or cavity in a tooth
If you can see or feel a hole in a tooth — even a small one — it indicates that the enamel has already broken down and the decay requires professional treatment.
Persistent sensitivity
Ongoing sensitivity to sweet, hot, or cold foods and drinks — particularly when it affects a specific tooth — may indicate that decay has progressed beyond the earliest stage.
Pain when chewing
Discomfort when biting or chewing on a particular tooth can indicate decay, a crack, or an issue with an existing restoration that warrants assessment.
Darkening or discolouration of a tooth
A tooth that appears grey, brown, or black may have underlying decay. Not all discolouration indicates decay, but a clinical examination can clarify the cause.
Persistent bad breath or an unpleasant taste
Ongoing bad breath that does not improve with good oral hygiene may be associated with decay, particularly if food debris is accumulating in a cavity.
Concerned About a Cavity?
If you have noticed sensitivity or visible changes in a tooth, our South Kensington dentists can provide a thorough examination and discuss appropriate treatment options.
How We Assess Tooth Decay
Our assessment combines clinical examination with imaging and risk evaluation to build a complete picture of your dental health:
Clinical examination using visual and tactile assessment of all tooth surfaces
Digital X-rays where appropriate to detect decay between the teeth and beneath existing restorations
Assessment of individual risk factors including diet, oral hygiene, saliva flow, and medical history
Evaluation of existing fillings and restorations for signs of marginal breakdown or secondary decay
Discussion of findings, treatment options, and a personalised prevention plan
The extent and location of decay can only be confirmed through clinical assessment — often supplemented by X-rays. Your dentist will explain the findings and discuss all suitable options before any treatment is carried out.
Treatment Options for Tooth Decay
The recommended treatment depends on the extent and location of the decay. Our dentists will discuss all suitable options with you before proceeding.
White Fillings
For most cavities, white fillings (tooth-coloured composite) are the standard restorative option. The decayed tissue is carefully removed, and the cavity is filled with a composite material that is closely matched to the natural shade of your tooth. This restores both the shape and function of the tooth while blending discreetly with the surrounding enamel.
Dental Crown (For Larger Cavities)
When decay has resulted in significant loss of tooth structure — to the point where a filling alone would not provide adequate strength — a dental crown may be recommended. A crown encases the entire visible portion of the tooth, providing structural reinforcement and protecting it from further fracture under normal biting forces.
Root Canal Treatment (If Decay Reaches the Nerve)
If decay has progressed to the point where the tooth’s pulp has become infected or irreversibly inflamed, root canal treatment may be necessary to preserve the tooth. This involves removing the infected tissue from within the tooth, cleaning and shaping the root canals, and sealing them to prevent reinfection. A crown is typically placed afterwards to protect and strengthen the treated tooth. While not every tooth can be saved, root canal treatment offers the possibility of retaining a natural tooth that might otherwise require extraction.
Can Tooth Decay Be Reversed?
In its very earliest stage — when the enamel has been softened by acid but the surface has not yet broken down — the demineralisation process may be stabilised or partially reversed through fluoride use, improved oral hygiene, and dietary modifications. This is sometimes referred to as remineralisation, and it represents the only window in which decay can be addressed without a filling.
However, once a cavity has formed — meaning the enamel surface has structurally broken down — the damage cannot be reversed by brushing or fluoride alone. At this point, the decayed tissue needs to be removed and the tooth restored with a filling or other appropriate restoration.
This is why early detection through regular dental examinations is so valuable: identifying demineralisation at the white-spot stage can sometimes allow for preventive management rather than restorative treatment.
Preventing Tooth Decay
While no prevention strategy can eliminate the risk of decay entirely, the following measures significantly reduce your susceptibility:
Brush twice daily with fluoride toothpaste
Thorough brushing removes plaque before the bacteria can produce damaging levels of acid. Use a fluoride toothpaste at the concentration recommended by your dentist, and spit without rinsing afterwards to maximise the fluoride's protective effect.
Clean between the teeth daily
Floss, interdental brushes, or other interdental cleaning aids help remove plaque and food debris from between the teeth — areas that a toothbrush alone cannot effectively reach.
Reduce the frequency of sugary foods and drinks
Each sugar exposure triggers an acid attack on the enamel. Limiting sugary items to mealtimes — rather than snacking throughout the day — reduces the number of acid attacks your teeth are subjected to.
Attend regular dental check-ups
Routine dental check-ups allow your dentist to detect early signs of decay, monitor areas of concern, and provide professional cleaning to remove hardened plaque (calculus) that cannot be removed by brushing alone.
Tooth Decay in Children vs Adults
Children
Baby (primary) teeth are susceptible to decay just as permanent teeth are. Because the enamel on baby teeth is thinner, cavities can progress more quickly. Establishing good brushing habits early, limiting sugary snacks and drinks, and attending regular dental check-ups from a young age all help protect children’s teeth.
Treating decay in baby teeth is important — not only to prevent pain and infection, but also to maintain the space needed for the permanent teeth to develop and emerge in the correct position.
Adults
Adults face additional risk factors for tooth decay, including dry mouth (often a side effect of medications), receding gums that expose the softer root surfaces, and the gradual breakdown of older fillings that can allow decay to develop at the margins.
Regular dental examinations are important throughout adulthood to monitor for new decay, check existing restorations, and address any changes in your oral health or risk profile.
Frequently Asked Questions
About tooth decay, cavities, and dental fillings
Book a Tooth Decay Assessment in South Kensington
If you are concerned about cavities or tooth sensitivity, our experienced dental team can provide careful assessment and discuss appropriate restorative and preventive options.
Open Monday–Saturday • 2 mins from South Kensington tube
Meet Our Dental Team
Our experienced dental team is fully qualified and registered with the GDC, delivering safe, high-quality care in line with the highest professional standards.
Because our patients deserve nothing less.
Registered. Regulated. Trusted.
At South Kensington Medical & Dental, we are fully registered with the Care Quality Commission (CQC) and our clinicians are registered with the relevant UK regulatory bodies, including the GDC and GMC. Our dentists, dental nurses and medical professionals deliver care that meets the highest clinical, safety and ethical standards, because our patients deserve nothing less.
