There are four main criteria required for caries formation: a tooth surface (enamel or dentin); caries-causing bacteria; fermentable carbohydrates (such as sucrose); and time. The caries process does not have an inevitable outcome, and different individuals will be susceptible to different degrees depending on the shape of their teeth, oral hygiene habits, and the buffering capacity of their saliva. Dental caries can occur on any surface of a tooth which is exposed to the oral cavity, but not the structures which are retained within the bone. All caries occurs from acid demineralisation that exceeds saliva and fluoride remineralisation and almost all acid demineralisation occurs where food (containing carbohydrate like sugar) is left on teeth. Though most trapped food is left between teeth, over 80% of cavities occur inside pits and fissures on chewing surfaces where brushing, fluoride and saliva cannot reach to remineralise tooth like on easy to reach surfaces that develop few cavities.
Fissure sealants placed over chewing surfaces to block food being trapped and halt the caries process. Extracted teeth where sealants were forced inside pits and fissures under chewing pressure and then the tooth dissolved in acid, leaves the sealant as an impression of how deep food is forced under chewing pressure and indicates the potential for better toothbrush design to force fluoride toothpaste inside pits and fissures before brushing to remineralise demineralised tooth like on easy to reach surfaces where few cavities occur.
Tooth decay (another name of dental caries) is the destruction of tooth structure and can affect both the enamel (the outer coating of the tooth) and the dentin layer of the tooth.
Tooth decay occurs when foods containing carbohydrates (sugars and starches) such as breads, cereals, milk, soda, fruits, cakes, or candy are left on the teeth. Bacteria that live in the mouth digest these foods, turning them into acids. The bacteria, acid, food debris, and saliva combine to form plaque, which clings to the teeth. The acids in plaque dissolve the enamel surface of the teeth, creating holes in the teeth called cavities, or caries.
To prevent tooth decay:
Brush your teeth at least twice a day with a fluoride-containing toothpaste. Preferably, brush after each meal and especially before going to bed.
Clean between your teeth daily with floss or interdental cleaners, such as the Oral-B Interdental Brush, Reach Stim-U-Dent, or Sulcabrush.
Eat nutritious and balanced meals and limit snacks. Avoid carbohydrates such as candy, pretzels and chips, which can remain on the tooth surface. If sticky foods are eaten, brush your teeth afterwards.
Check with your dentist about use of supplemental fluoride, which strengthens your teeth.
Ask your dentist about dental equipment sealants (a plastic protective coating) applied to the chewing surfaces of your back teeth (molars) to protect them from decay.
Drink fluoridated water. At least a pint of fluoridated water each day is needed to protect children from tooth decay.
Visit your dentist regularly for professional cleanings and oral examination.