How tooth decay and gum disease begin

By Agbai Sharonjoyce

The mouth is constantly active, and, as a result, houses many different kinds of bacteria. Notable among them is the dental plaque, a thin, sticky film that forms on the teeth. If not removed regularly through proper oral hygiene, plaque can cause tooth decay and gum disease.

How cavities are formed

When snacks or other sugary foods enter the mouth, they feed a bacterium called Streptococcus mutans. This germ produces acids that wear away the enamel, the teeth’s outer layer.  

Over time, these acids weaken the enamel, forming tiny opening. The damage soon spreads to the dentin, the softer layer beneath the enamel, which is less resistant to acid.

If the damage progresses further into the pulp, the tooth’s inner core that contains nerves and blood vessels, it can result in inflammation and severe pain.

These openings—known as cavities—can worsen if left untreated, leading to infection and, ultimately, tooth loss.

Gum disease explained

The acids produced by bacteria do not only damage teeth; they can also infect the tissues and bones that support them. This condition is called periodontal disease, commonly known as gum disease. 

The earliest stage is gingivitis, where the gum becomes red, swollen and prone to bleeding. Gingivitis is usually reversible with proper brushing, flossing and professional dental care. 

If the plaque is not removed, it hardens into tartar (calculus). Tartar provides a rough surface where more plaque can grow and hide, worsening the condition. Unlike plaque, tartar cannot be removed by brushing; it requires professional dental cleaning. 

When gingivitis is left untreated, it advances to periodontitis, a chronic inflammatory disease that damages the gums and the bones supporting the teeth. 

Unlike gingivitis, periodontitis cannot be cured, only managed with expert care. It is the leading cause of tooth loss in adults.

Those at risk

Certain factors increase the risk of tooth decay and gum disease, including:

• Smoking: A significant number of adults who smoke develop periodontitis.
• Diabetes and hormonal changes, such as during pregnancy.
• Poor oral hygiene, including infrequent brushing and flossing. 
• Frequent consumption of sugary foods and drinks.
• Genetics.

Prevention and care

• Most dental diseases are treatable and preventable. Key preventive steps include:
• Brushing at least 2 times a day with fluoride toothpaste. Fluoride strengthens enamel and can reverse early tooth damage. 
• Scheduling regular dental checkups for cleaning and examinations, at least once a year. 
• Limiting sugary foods and drinks to reduce acid production by bacteria. 
• Asking about dental sealants, which are protective coatings applied to chewing surfaces to shield teeth from acids and plaque. 

Oral care goes beyond having strong teeth—it is closely linked to overall body health. Maintaining good oral hygiene, eating a balanced diet and seeking regular dental care can help prevent tooth decay and gum disease, protecting your smile for years to come.