Dra. Cléo Salustiano In this article
SummaryHow does tooth decay start and progress?How do you treat and prevent tooth decay?FAQRead nextTooth Decay: What It Is, How It Starts and How to Treat It Early
Quick summary of this article+
Tooth decay is mineral loss caused by the acids plaque bacteria produce from sugar. It starts as a chalky, painless white spot that can be controlled with hygiene, fluoride and less sugar; it then forms a cavity that needs a filling; if it reaches the nerve, a root canal may be required. Prevention: brush at least twice a day with fluoride toothpaste, floss, reduce how often you have sugar and keep regular check-ups. There is no home remedy that closes a cavity. In Mooca, Dr. Cléo Salustiano (CRO-SP 170844) sees patients every day, from 8 a.m. to 10 p.m.
Tooth decay (dental caries) is a disease in which the tooth loses mineral because of the acids produced by plaque bacteria when they ferment sugars from the diet. At first it appears as a chalky white spot on the enamel, with no pain; if the process continues, a cavity forms, which can progress into the dentin and reach the tooth's nerve.
The most important point is that decay starts silently. In clinical practice, early lesions are often found in people who feel nothing, especially between teeth and in the grooves of back teeth. At this stage, with proper hygiene, fluoride and monitoring, many lesions can be controlled without drilling; once there is a cavity, the tooth needs a filling.
Dr. Cléo Salustiano (CRO-SP 170844), a dentist in Mooca, explains how decay forms, which signs to watch for, how treatment works at each stage and what really helps prevent it.
This article comes from Dr. Cléo Salustiano's dental office in Mooca, São Paulo (care in English, Portuguese and Spanish). See the general dentistry page to learn how the treatment is done here and book your assessment.
How does tooth decay start and progress?
Decay starts when plaque stays on the tooth for long periods and frequently receives sugar: bacteria produce acids that remove minerals from the enamel. Saliva and fluoride help return those minerals, and decay appears when loss outweighs recovery, over and over.
Early stage: a chalky, dull white spot, usually near the gumline, between teeth or in the grooves. It does not hurt. This is when control without a filling is most feasible, with brushing, flossing, fluoride and fewer sugar exposures.
Cavity in enamel and dentin: a hole forms, which may darken and trap food. There may be sensitivity to sweets, cold or chewing. At this stage, treatment usually means removing the damaged part and placing a filling, generally with tooth-colored composite.
Deep decay: when it gets close to the nerve, it can cause spontaneous pain, lingering pain or swelling. A root canal treatment may then be needed before the filling. A dark spot is not always active decay, and active decay is not always dark: only an exam, sometimes with an X-ray, can tell.
| Stage | What appears | What is usually done |
|---|---|---|
| Early | Chalky white spot, no pain | Hygiene, fluoride, less sugar and monitoring |
| Cavity in enamel | Small hole or dark spot | Filling, usually composite |
| In the dentin | Sensitivity to sweets or cold, food trapping | Decay removal and filling |
| Near the nerve | Spontaneous or lingering pain | May require root canal treatment |
How do you treat and prevent tooth decay?
Treatment depends on the stage: early lesions can be controlled with hygiene, fluoride and monitoring; cavities need a filling; decay that reaches the nerve may require a root canal. The earlier decay is found, the simpler treatment tends to be.
Prevention that works: brush at least twice a day with fluoride toothpaste, floss daily, cut down how often you have sugar between meals (frequency matters more than amount), avoid grazing on sweets throughout the day and keep regular check-ups and cleanings. The article how to brush your teeth properly shows the technique.
Who is at higher risk: people with dry mouth (from medications, for example), braces, old fillings with open margins, receding gums with exposed roots and diets with many sugary snacks. In these cases, the dentist may recommend extra fluoride or more frequent visits.
There is no home remedy that "closes" a cavity: if you see a hole, feel pain when chewing or notice new sensitivity, consult a dentist. In Mooca, Dr. Cléo Salustiano sees patients every day, from 8 a.m. to 10 p.m., including Sundays and holidays; for severe pain or swelling, the emergency dentist in Mooca page explains how to be seen quickly.
What is tooth decay?
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It is a disease in which the tooth loses mineral because of the acids plaque bacteria produce when fermenting sugars. It starts as a white spot on the enamel and, if not controlled, forms a cavity that can progress to the tooth's nerve.
How can I tell if it is early decay?
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Early decay usually appears as a chalky, dull white spot near the gumline, between teeth or in the grooves. It does not hurt. Because many lesions are between teeth, only a dental exam, sometimes with an X-ray, confirms it. Consult a dentist if you notice new spots.
Can early decay be reversed without a filling?
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Early lesions without a cavity can often be controlled without a filling, through proper brushing, flossing, fluoride and fewer sugar exposures, with the dentist monitoring. Once there is a hole, the tooth needs to be restored.
Does tooth decay hurt?
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Not at first. Pain usually appears when decay reaches the dentin, with sensitivity to sweets or cold, or when it gets close to the nerve, with spontaneous pain. Waiting for pain before seeing a dentist usually means more extensive treatment.
Is a black spot on a tooth always decay?
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Not always. It may be staining from coffee, tea or smoking, an old inactive lesion or active decay. Color alone does not decide it. The dentist assesses texture, location and, if needed, an X-ray to decide whether to treat or just monitor.
How can I prevent tooth decay?
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Brush at least twice a day with fluoride toothpaste, floss every day, reduce how often you have sugar between meals and keep regular check-ups and cleanings. People with dry mouth or braces may need extra care.
Where can I have tooth decay treated in Mooca?
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In Mooca, Dr. Cléo Salustiano (CRO-SP 170844) provides exams, fillings and decay monitoring at Rua Hipódromo, 1141, near Bresser-Mooca station. The office is open Monday to Sunday, from 8 a.m. to 10 p.m., including holidays, via WhatsApp (11) 97409-7834. She sees patients in Portuguese, English and Spanish.
