What’s the Difference Between Dental Plaque and Tooth Decay?

Fight plaque and tooth decay by taking good care of your teeth.

Dental plaque and tooth decay are two of the most common issues affecting dental patients, and everyone with teeth—adults, babies, and children—is at risk. Is there a difference between the two conditions? Does one cause the other? Here’s what you’ll want to know.

Which comes first, plaque or tooth decay?

The bacterial film you might feel on the surface of your teeth and along your gumline is plaque. It’s colorless and sticky, and it can make your teeth feel coated or fuzzy if it has the chance to accumulate. Plaque can result from regular eating and drinking; moreso if you consume lots of sugary and starchy foods or drinks. 

How does plaque form?

When you eat foods that contain carbohydrates, traces of these can remain on your teeth afterwards. The natural bacteria in your mouth feasts on the sugar in these foods, and this results in plaque formation. Brushing your teeth thoroughly can help eliminate the feeling of fuzzy teeth, but it’s not a guarantee against tooth decay.

What’s so bad about plaque? 

If plaque forms because there are food particles on or between your teeth, it can give you bad breath. However, this isn’t the worst of it. Over time, plaque buildup on teeth can also harden into tartar. This is a calcified substance that can only be removed during a professional teeth cleaning. Over time, plaque buildup can lead to tooth decay.

How does tooth decay begin?

It’s important to know that plaque produces the acids that wear away tooth enamel—this is the process of tooth decay. Even worse, plaque may not remain only on the surface of your teeth. It can also affect their roots under the gums. When this happens, the bone that supports the teeth can break down, resulting in gum disease

Dentin (or dentine in British English) is the main supporting structure of your teeth. According to recent research, acid dissolves the minerals in different structures of dentin at different rates.  Within the dentin are tiny openings leading to the tooth nerves. If teeth begin to decay, these openings may be exposed, leading to infection and pain. However, exactly how this happens at a microstructural level is still a topic of dental research. This is why prevention of tooth decay is so important.

Who is at risk, and which teeth are most at risk?

Tooth decay can affect anyone who has teeth, even babies. Front teeth can develop decay if you don’t clean them properly, though molars and premolars—the back teeth—are most susceptible. They have more roots that can trap tiny particles of food, as well as more pitting. It’s also more difficult to reach and clean them than it is to reach front teeth. 

What symptoms indicate tooth decay?

Any or all of these signs could occur:

  • Nothing (in the beginning)
  • Tooth surface staining (brown, black, or white)
  • Cavities (visible holes)
  • Sensitivity in your teeth
  • Pain (minor or major) when eating something sweet, hot, or cold
  • Pain upon biting
  • Pain occurring spontaneously
  • Persisting toothache

Isn’t toothbrushing enough to help me avoid tooth decay?

There are many steps you can take to help minimize your risk of tooth decay, including:

  • Brushing your teeth twice a day for two minutes each time, and flossing once a day
  • Eating acidic foods as part of a meal and in moderation
  • Eliminating or decreasing your intake of soda and sugary drinks
  • Eliminating or decreasing your intake of refined starches and sweets
  • Rinsing and swishing vigorously with water for at least 20 seconds after meals and snacks

And of course, you should also see your dentist and hygienist regularly—at least twice a year—to have your teeth professionally cleaned. 

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