Fact Sheet: About Tooth Decay

Tooth Decay


Tooth decay is a chronic disease in which there is localised destruction of susceptible dental hard tissue by acidic by-products from bacterial fermentation of dietary carbohydrates. This damages hard tooth structure causing tooth decay. It is the most common chronic disease on the planet, affecting 80 percent of the population, in which some regions have higher rates of caries than others.

Early forms of tooth decay – known as early or initial caries – can be stopped and reversed if the multiple causative factors are reduced. On average, people in the North Africa and Middle East (NAME) region have 1.9 instances of DMFT – Decayed, Missing, or Filled Teeth – each, with some countries’ populations averaging up to 4.6 DMFT per person. In several countries, the instances of 6 year olds with untreated tooth decay is higher than 80 percent, up to as much as 100 percent.


The formation of cavities occurs along a continuum which spans a series of stages from small initial caries lesions that might evolve in time to gross cavities. Each time we eat, sugars from food are converted to harmful acids by bacteria in our mouths. As acid levels rise, pH levels decrease which cause a loss of mineral structure on the tooth’s surface. Teeth are in a constant state of demineralisation and remineralisation, impacted by our dietary patterns and oral hygiene practices. When the rate of demineralization occurs more quickly than remineralisation, early white-spot lesions (caries) can form. Importantly, early caries is both preventable and reversible with proper management. However, without proper care, teeth continue losing strength and structural integrity, eventually forming a cavity. Relentless progression through all the stages of disease severity is however, not inevitable.


An unhealthy diet rich in sugars, inadequate fluoride and poor personal oral hygiene are the most important factors to be countered by interventions in caries prevention and management. However, there is variable use of these tools around the world. As dietary patterns around the globe shift, some countries struggle to manage the growing prevalence of caries in their population.   Some of the reported problems associated with caries include the following:

  • Health Impact: Poor dental health can lead to serious oral health conditions such as cavities and tooth loss and can result in pain, suffering and reduced oral function.
  • Social Impact: Caries can impact an individual’s sense of well-being, self-esteem, employability and social mobility. Globally, it causes children to miss 51 million hours of school each year.
  • Economic Impact: The impact of poor dental and oral health is not just seen at an individual level, but also on the country level where as much as five to 10 percent of health costs can go towards treatment.


Source: Alliance for a cavity free future ©

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