Dental passport

Risk factors and symptoms

Tooth decay occurs through the interaction of four main factors: the state of the teeth, i.e. quality of the enamel and cement, the presence of microorganisms in dental plaque (most frequently the Streptococcus mutans), low salivary pH (less than 5.5) due to diet and elapsed time. These factors determine the rate and extent of creating a dental plaque, which is the major cause of tooth decay.

Dental caries development is a relatively slow process that occurs due to the presence of the aforementioned factors, ultimately resulting in cavitation, i.e. clinically evident collapse of the enamel, depending on the age and type of the tooth surface. The first visible sign of the dental caries development is the discoloration of the tooth in the place where caries develops. The diagnosis is confirmed by examination and probing, and if necessary with the X-rays of the tooth.

Enamel remains preserved relatively long in terms of speed of damage development or a small cavity is visible, whereas the dentin – the hard dental tissue – is actually significantly destroyed. As damage can quickly progress to the pulp, the symptoms of dental pulp inflammation may occur even before the enamel collapses.

Although on the outside caries might look like dots, below the enamel surface it can actually be very large and deep – hence it is easier to treat smaller caries than wait for it to expand to a tooth pulp, which makes treatment more complex, protracted and expensive. Dental tissue damaged by caries cannot be renewed, but must be removed and replaced with appropriate materials in the form of dental restorations (fillings) or dental crowns.

The most common symptoms that may point to a caries are teeth sensitivity to hot, cold and sweet. However, in its beginning, i.e. in the stage of enamel caries, sensory symptoms may not be present until the decay penetrates into the deeper layers. Then stimulus of nerve endings occurs in dentin, which, when stimulated by something sweet, hot or strong chewing and biting can be felt like a toothache that stops after the stimulus ends. If the cavity expands to the tooth pulp (nerve), tooth pain appears that does not stop after the stimulus or the pain occurs spontaneously, without any stimulus.

It is therefore necessary to remove tooth decay as soon as possible and thus stop it from spreading to the dental pulp and inhibit the development of pain.


Learn more about alcohol and smoking as risk factors of oral cavity cancer (in Croatian): Alkohol i duhan – rizični čimbenici karcinoma usne šupljine


Next – Check what can be done to prevent tooth decay.