When you drink cold water or a hot cup of coffee, do your teeth feel a little sensitive? Or, when you take a bite of food, do you have a toothache shortly after? If you answered yes, you might be experiencing tooth decay.

Tooth decay, also known as cavities or caries, is caused by a bacterial imbalance on the teeth. This imbalance has many factors – diet, hygiene habits, and overall oral environment.

Emerson Martins, D.D.S., M.S.c, Ph.D., gives us the rundown on how and why dental decay occurs.

“Our mouth environment is always changing, and our saliva’s pH plays a big role in the dental caries. If the pH decreases, the tooth will lose vital minerals and the decaying process begins.”

“For example, if you drink something that lowers your pH, you should rinse your mouth with water and use a dental product that contains fluoride to raise your pH and protect your teeth,” he said.

Martins suggests drinking tap water for fluoride. The U.S. Department of Health and Human Services recommends a level of 0.7 milligrams per Liter (mg/L) of fluoride in your drinking water. This is the level that prevents tooth decay and promotes good oral health. Bottled water offers less fluoride and can actually erode your enamel if the pH level is too low.

“You can prevent tooth decay by avoiding sugary drinks, brushing your teeth twice a day with fluoride toothpaste, and flossing once a day.”

Martins said there are six stages of tooth decay to look out for:

Stage 1: White spots

Stage 2: Enamel decay

Stage 3: Tissue (dentin) decay

Stage 4: Involving innermost layer (pulp) of tooth

Stage 5: Abscess formation

Stage 6: Tooth Loss

Luckily, you can reverse small cavities if you act fast.

“If you notice signs of decay, your dentist can prescribe fluoride treatments like mouthwash to reverse early tooth decay. You'll probably need a filling if you have a hole (cavity) in your tooth. If tooth decay has reached the soft tissue (pulp) in the middle of your tooth, you may need root canal treatment,” he said.

If you take steps to reverse tooth decay but symptoms continue to advance, contact your dentist immediately.

Symptoms of advancing tooth decay include:

• Toothache
• Tooth sensitivity
• Mild to sharp pain when eating or drinking something sweet, hot, or cold
• Visible holes in your teeth
• Brown, black, or white staining on the surface of your tooth
• Pain when you bite down

You cannot fully reverse tooth decay through natural treatments. Some treatments can stop the deterioration of enamel and help lost tooth structure, as well as get rid of plaque that causes cavities. You can even reverse some early cavities with the right treatment. However, you can’t reverse a cavity once it gets deep enough.

Prevention of tooth decay is easier than you think. “Avoiding dental caries is very simple with diet control. Managing when eating/drinking carbohydrates, brushing twice a day and flossing, and especially avoiding snacking before bed,” Martins said.

“At UAB School of Dentistry, we focus on gentle and effective treatments to keep your teeth healthy. Instead of aggressive methods, we aim to prevent damage and, when necessary, make repairs rather than replacements. We use special products like MI Paste and Prevident 5000 to help strengthen your teeth and prevent decay. Our team is always exploring new, advanced materials and technologies, such as tiny particles that help rebuild tooth enamel and new types of coatings and adhesives that fight cavities and support tooth health.”

Martins also encourages patient education and prevention.

“Educating our population is the most important thing. As dentists, we should invest more time in preventing these issues. Instead of simply focusing on fixing the problems, our future dentists should also be more focused on educating our patients towards the prevention of the dental decays, which is simple and cheap, especially for the underserved communities in Alabama and worldwide.”