Tooth decay Share: Save: Print: Print this page

Introduction 

Tooth decay is a common problem that occurs when acids in your mouth dissolve the outer layers of your teeth.

It is also known as dental decay or dental caries.

Although levels of tooth decay have decreased over the last few decades, it is still one of the most widespread health problems in the UK.

It's estimated that around one in every three adults in England have tooth decay and a survey of five year old children carried out in 2012 found that more than one in four had some degree of tooth decay.

Signs and symptoms

Tooth decay may not cause any symptoms until it has reached an advanced stage. As the problem develops, symptoms of tooth decay can include:

• toothache
• tooth sensitivity – you may feel tenderness or pain when eating or drinking something hot, cold or sweet
• grey, brown or black spots appearing on your teeth
• bad breath
• an unpleasant taste in your mouth

If left untreated, tooth decay can lead to further problems such as a cavities (holes in the teeth) gum disease or dental abscesses (collections of pus at the end of the teeth or in the gums).

When to see your dentist

Toothache is a warning that something is wrong and that you should visit your dentist as soon as possible. If you ignore the problem it may get worse, and you could end up losing a tooth.

Even if you don't have any noticeable problems with your teeth, it is still important to have regular dental check-ups so your dentist can check for early signs of decay. Tooth decay is much easier to treat in its early stages.

Adults over 18 should have a check-up at least once every two years and people under the age of 18 should have a check-up at least once a year. Your dentist may suggest having more frequent check-ups if you have had a history of dental problems, or you are thought to be at a higher risk of developing tooth decay.

Dentists can usually identify tooth decay by examining your teeth, although occasionally an X-ray may be carried out to check for any cavities or abscesses.

What causes tooth decay?

Your mouth is full of bacteria that combine with small food particles and saliva to form a sticky film known as plaque.

When you consume food and drink high in carbohydrates – particularly sugary foods and drinks – the bacteria in plaque turn the carbohydrates into energy they need, producing acid at the same time.

If the plaque is allowed to build up, the acid can begin to break down the outer surface of your tooth and can eventually enter and damage the soft part at the centre of the tooth.

Read more about the causes of tooth decay.

How to prevent tooth decay

Although tooth decay is a common problem, it is often entirely preventable. The best way to avoid tooth decay is to keep your teeth and gums as healthy as possible.

To do this, you should:

• brush your teeth with a fluoride toothpaste twice a day, spending at least two minutes each time
• use floss or an interdental toothbrush at least once a day to clean between your teeth and under the gum line
• avoid rinsing your mouth with water or mouthwash after brushing because this washes the protective toothpaste away – just spit out any excess toothpaste
• cut down on sugary and starchy food and drinks, particularly between meals or within an hour of going to bed

Read more about preventing tooth decay.

How tooth decay is treated

If you see your dentist when the decay is in the early stages, your dentist may apply a fluoride varnish to the area to help stop further decay.

If the decay has worn away the outer layer of your tooth and caused a cavity, your dentist will remove the decay and refill the hole in your tooth with a filling. If the nerve in the middle of your tooth is damaged, you may need root canal treatment, which involves removing the nerve and restoring the tooth with a filling or crown.

If the tooth is so badly damaged that it cannot be restored, it may need to be removed.

Read more about treating tooth decay.

Rate your dentist

You can now comment on your NHS dentist and share your experience with others. Rate your dentist here.

Page last reviewed: 30/05/2014

Next review due: 30/05/2016

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Dental abscess Share: Save: Print: Print this page

Introduction 

A dental abscess is a collection of pus that forms in your teeth and spreads to the surrounding tissue. It forms as the result of a bacterial infection.

The main symptom of a dental abscess is a severe, throbbing pain. The pain usually comes on suddenly, gets gradually worse over a few hours or days, and causes teeth to be tender and sensitive.

Read more about the symptoms of a dental abscess.

Types and causes of dental abscesses

There are two types of dental abscess:

• periapical abscess – where the abscess forms under the tooth (this is the most common type of dental abscess)
• periodontal abscess – where the abscess forms in the supporting gum and bone

Both types are caused when bacteria build up inside your mouth and usually occurs due to a combination of:

• poor dental hygiene – not cleaning your teeth and gums properly and regularly (read our advice on how to brush and floss your teeth)
• consuming lots of sugary or starchy food and drink – the carbohydrates in these encourage bacteria to grow, causing tooth decay

Read more about the causes of a dental abscess.

Treating dental abscesses

If you think you may have a dental abscess, make a dentist appointment as soon as possible.

There isn't a lot your GP can do other than recommend painkillers, such as ibuprofen or paracetamol, to help relieve the pain. You can get these over the counter from your local pharmacist.

Treatment varies, depending on what caused the abscess. Generally, treatment involves draining the pus, either with root canal treatment, removing the affected tooth or gum treatment.

This type of treatment should not be too painful, as local anaesthetic will be used to numb the affected area of your mouth.

Unlike some other types of infection, a dental abscess will not get better on its own and must be treated by a dentist. With appropriate treatment, the bacterial infection that causes a dental abscess can usually be cured. Antibiotics are not used to treat a dental abscess, but may occasionally be used to reduce the symptoms.

Read more about how a dental abscess is treated.

Complications of dental abscesses

Complications are rare, but can be serious. For example, the infection may spread to a nearby bone (osteomyelitis).

Read more about the complications of a dental abscess.

Finding an NHS dentist

If you are not registered with an NHS dentist, there are a number of options available to you:

• use the NHS Choices health services post code search to find a dentist in your area
• call NHS 111 to request details of dental services in your area
• text the word "dentist" to 64746 or NHSGO from your mobile phone from the area you need a dentist
• get in touch with your local clinical commissioning group (CCG) to find out about the dental access helpline

Emergency treatment

If you are in severe pain, you may need emergency out-of-hours dental treatment.

Find out how you can access an NHS dentist in an emergency or out-of-hours.

You may have to pay for your treatment, depending on your circumstances.

Find out more about NHS dental services.

Who gets dental abscesses?

Anyone with teeth can develop a dental abscess – children and adults are equally affected.

A study carried out in America found that, on average, one in eight people seek treatment for a dental abscess in any given two-year period.

In England, the figure is thought to be higher, as levels of dental hygiene tend to be poorer. About 11,000 people are treated in hospital for dental abscesses in England each year.

Page last reviewed: 14/05/2014

Next review due: 14/05/2016

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Manual vs. Electric Toothbrushes for Kids

Question: "Can I use an electric toothbrush on my toddler's teeth? Are there features to look for when choosing a toothbrush for him?"

Anything that boosts your child’s interest in brushing his teeth is a dazzling idea, and that includes an electric toothbrush, says the American Academy of Pediatric Dentistry (AAPD). But there are pros and cons: For one thing, a manual brush might actually get the job done more efficiently since you scrub back and forth and hit multiple teeth at once (a big plus when you’ve got a little wiggler on your hands). Electric brushes, especially the ones with circular heads, hit one tooth at a time but may do a more thorough job if your tot has the patience. So which brush wins in the manual vs. electric-brush battle? Both methods are fine ways to clean — just see which works better with your beginning brusher. There’s another bottom line to consider, though. When it comes to choosing a toothbrush for your tot, manual or electric, keep these must-haves in mind:

• Seek out the ADA Seal of Approval. Only brushes that meet the American Dental Association’s rigorous standards make the grade. The seal means the brush will last for a normal period of time and has no rough edges or unsafe components.
• Select soft, rounded bristles. Skip firm or even medium bristles in favor of soft (also sometimes called polished), which are gentler on your tyke’s teeth and gums.
• Choose a child-sized head and handle. Whether it’s manual or electric, the brush needs to fit comfortably in your critter’s mouth so you (and eventually he) can maneuver it into all those nooks and crannies where bits of food can hide. And choose a big handle that’s easy for little paws to grip and control.
• Go for the gimmicks. Try a brush that plays music until it’s time to stop or a model that lights up — your cutie can scrub away in the dark in his private dental disco.

It’s a good idea to let your little one weigh in on dental-care purchases since he’s more inclined to use a toothbrush he actually likes (or a toothpaste in his favorite flavor). But don’t expect him to belly up to the sink with a smile after every meal. Most kids fidget and fuss, especially when you swoop in to do a clean sweep after they’ve had a go (which you should do until they’re about seven or eight to make sure their teeth are actually getting de-gunked). Just be gently persistent and do whatever you can to help make the process seem faster. A few ideas:

• Sing your own song. Choose a ditty your child knows well and sing it to him during his two-minute toothbrushing session. That way, he’ll know exactly how much time is left till he’s done.
• Count those chompers. When all those baby teeth are present and accounted for (around age three), there will be ten on top and ten on bottom. Make a toothbrushing game out of saying each one’s number as you brush.

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Learning to Brush Teeth: Six Toddler Training Tips

For nearly two years, you've been the one holding the toothbrush. Now it's time to pass the torch and teach your toddler to brush his teeth by himself.

Ever since your little one cut his first teeth, you’ve probably been asking him to open wide while you brush his growing number of pearly whites. And by now he’s likely got the brushing routine down: He’s seen how you wet the toothbrush, he’s watched how much toothpaste you squeeze out, and he’s even improved his aim so that he spits into the sink (most of the time!). So at this point, you may be ready to pass the baton — or, rather, the toothbrush — to the next generation and give your child the responsibility of scrubbing his own teeth.

But even if you’re ready to cede control of the morning and evening tooth-brushing ritual, your toddler may not be so eager to go it alone with his toothbrush. If he resists the change of guard, try these tactics to ease him into it:

• Let your toddler pick the supplies. Take your tot to the store and let him choose his own toothbrush and toothpaste. A colorful character on the brush’s handle may not inspire you, but it might make all the difference in coaxing your toddler to brush his teeth. Let him pick the toothpaste too, so that he’s sure to like the flavor.
• Lower your expectations. Your child probably won’t be cleaning the gum lines or reaching into tiny crevices just yet. Don’t sweat it. These early lessons are as much about instilling the habit as they are about technique. The more practice he gets, the faster he’ll improve.
• Take turns. If you’re really worried that your toddler’s teeth aren’t getting properly cleaned while he’s learning to take the reins, let him do the morning brushing session, while you handle the evening one. That way, he’ll get practice brushing on his own in the a.m., but he’ll also get a reminder of your technique in the p.m. Nighttime is also a good opportunity for you to get him used to flossing once a day before brushing (unlike brushing, flossing is something you’ll want to do for him at this point).
• Brush along with him. Get in on the action, and join your toddler while he brushes his teeth. Having a little camaraderie might encourage him to take a little longer and give his teeth a more-thorough cleaning. Try stepping it up a notch by setting up a competition (Who can brush every tooth?).
• Take a spin. Consider giving your child a battery-powered spin toothbrush. The novelty might coerce your toddler to brush his teeth. Plus, there are some toothbrushes that play a song until it’s time to stop, or signal that two minutes are up by making a noise.
• Find an ally. Ask the dentist to praise your child for brushing himself. Getting the thumbs-up from an authority in a white jacket will encourage your toddler to soldier on.

Updated 3/25/14

3 Things to Read Next:

• Toddler Dental Care
• Toddler Tooth Decay and Other Dental Concerns
• Keeping Your Little One's Teeth Healthy

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