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Tooth Decay

Patients & Caregivers

Tooth decay is damage to a tooth’s surface, or enamel. It happens when bacteria in your mouth make acids that attack the tooth’s surface. Tooth decay can lead to cavities (dental caries), which are holes in your teeth. If tooth decay is not treated, it can cause pain, infection and even tooth loss.



When decay-causing germs come into contact with sugars and starches from foods and drinks, they form an acid. This acid can attack the tooth’s surface causing it to lose minerals.

This can happen if you eat or drink often, especially foods and drinks containing sugar and starches. The repeated cycles of these “acid attacks” will cause the tooth’s surface to continue to lose minerals. Over time, the tooth’s surface is weakened and then destroyed, forming a cavity.

People of all ages can get tooth decay once they have teeth—from childhood through the senior years.
Because many older adults experience gums that go back , which allows germs in the mouth to come into contact with the tooth’s root, they can get decay on the shown root surfaces of their teeth.


In early tooth decay, there are not usually any symptoms. As tooth decay continues, it can cause a toothache (tooth pain) or tooth sensitivity to hot and cold as well as foods with high amounts of sugar. If the tooth becomes infected, a pocket of pus can form, that can cause pain, facial swelling, and fever.


Ways to prevent/slow the process of cavities

Brushing teeth

  • Brush teeth and gums with a soft-bristle brush 2 to 3 times a day for 2 to 3 minutes. Be sure to brush the area where the teeth meet the gums and to rinse often.

  • Rinse the toothbrush in hot water every 15 to 30 seconds to soften the bristles, if needed.
    Use a foam brush only if a soft-bristle brush cannot be used. Brush 2 to 3 times a day and use an antibacterial rinse. Rinse often.

  • Let the toothbrush air-dry between brushings.

  • Use a fluoride toothpaste with a mild taste. Flavoring may irritate the mouth, especially mint flavoring.
    If toothpaste irritates your mouth, brush with a mixture of 1/4 teaspoon of salt added to 1 cup of water.


  • Use a rinse every 2 hours to decrease soreness in the mouth. Dissolve 1/4 teaspoon of salt and 1/4 teaspoon of baking soda in 1 quart of water.

  • An antibacterial rinse may be used 2 to 4 times a day for gum disease. Rinse for 1 to 2 minutes.

  • If dry mouth occurs, rinsing may not be enough to clean the teeth after a meal. Brushing and flossing may be needed



  • Floss gently once a day



Fluoride can be delivered purposefully and orderly. Applied fluorides strengthen teeth already present in the mouth, making them less likely to decay.  Applied fluorides encourage the natural repair of the tooth’s surface, and also prevent bacterial metabolism, reducing the growth of plaque bacteria.

Teeth with fluoride included in their tooth’s surface are less affected by the acidic removal of calcium and can easily add calcium when pH increases. If drinking water does not have correct amounts of fluoride, fluoride supplements taken by mouth are recommended for children from 6 months through 16 years.

For more information about tooth decay, see these resources:


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More information regarding the following topics will be coming soon:

  • Importance of Good Oral Health Before, During, and After Cancer Care

  • Dental Care and Home Care Before, During, and After Treatment


The information on the Rhode Island Cancer and Oral Health Resource Guide, including but not limited to, text, graphics, images, and other external materials are for informational purposes only. The Partnership to Reduce Cancer in Rhode Island does not provide medical advice. The information on this website is not intended as a substitute for professional medical advice, diagnosis, or treatment. 

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