Sweet or sour candy can introduce acid to your mouth and promote tooth decay.

Did you know that tooth decay is the most prevalent chronic health condition in children? For adults, only the common cold occurs more frequently than tooth decay. However, unlike a common cold, which quickly produces noticeable symptoms, tooth decay often begins and develops unnoticed. By the time you realize there’s a problem, your teeth are already breaking down—and worse, you’re in pain. Here’s what to know so you can protect your teeth.

What is tooth decay?

Tooth decay occurs when plaque forms on the surface of your teeth, attacks them, and begins to destroy them. Plaque, a sticky substance that can make your teeth feel fuzzy, forms when bacteria combine with starches and sugars that aren’t cleaned off your teeth. When plaque remains on your teeth for long enough, it begins to harden, and may not come off with regular brushing.

Despite plaque’s hard texture, it contains acids that wear away the teeth’s enamel. “Tooth decay is caused by bacteria and is a function of oral pH. The more acidic the oral environment, the higher the risk of decay. So many sources of acids in the mouth aren’t immediately obvious,” says Donna Greco, DMD. Under the teeth’s enamel is the softer layer of dentin, in which there are tiny openings that lead to the nerves of the teeth. Decay can expose these openings, leading to infection and pain.

What are the signs of tooth decay?

Depending on the severity of your condition, you may experience one or more symptoms, including:

  • Nothing (in the early stages)
  • Staining (brown, black, or white) on the surface of your teeth
  • Visible holes—cavities—in your tooth or teeth
  • Tooth sensitivity
  • Pain (slight or severe) when eating something sweet, hot, or cold
  • Pain when biting down
  • Pain that occurs spontaneously
  • A persistent toothache

Are certain teeth more susceptible than others?

Back teeth—molars and premolars—are the most susceptible to tooth decay. They’re harder to reach and clean than front teeth, and they have more pits and crannies. They also have more roots that can trap food particles. But front teeth can still develop decay if you don’t keep them clean.

Who’s most at risk?

Anyone who has teeth is at risk, even babies. That’s why it’s important for adults to begin brushing their young children’s teeth as soon as they appear, and to make twice daily brushing an ironclad routine.

Which habits contribute to tooth decay?

When it comes to tooth decay, it’s important to know the main culprit: acid. Acid eats away at tooth enamel and causes cavities.

Acid can enter your mouth in one of two ways: either directly, through food, or it can be produced when your natural oral bacteria consume the sugars you eat. A simple way to identify foods that cause tooth decay is to know whether they are acidic or sweet/starchy.

Acidic foods include things like citrus fruits, vinegar, kombucha, and sour candy. Sweet/starchy foods include things like candy, soda or sugar-sweetened beverages, pastries, bananas, bread, cereal, rice, pasta, and crackers.

The longer these things interact with your teeth, the greater the chance for tooth decay to occur. For example, sipping on soda throughout the day, or chewing gooey caramel candies one after the other increases the amount of sugar that coats your teeth. Bacteria love to feast on this sugar, creating an acidic environment and putting your teeth at risk for decay.

How can I avoid tooth decay?

“There are steps one can take to mitigate the risk of decay beyond proper brushing and flossing. That’s why I’m so glad we offer a risk assessment to identify factors that accelerate decay. It gives patients powerful information they can use to protect their oral health. A lot of practices don’t offer that,” says Dr. Greco. Some basic tips:

  • Swish vigorously with water for at least 20 seconds after meals and snacks
  • Reduce your consumption of sweets and refined starches
  • Enjoy acidic foods in moderation or as part of a meal
  • Decrease or eliminate your consumption of soda or sugar-sweetened beverages
  • Floss at least once a day, and brush twice a day for two minutes each time

And as always, make sure to visit your dental hygienist at least twice a year to remove tartar buildup and assess your teeth for early signs of decay.

Remember, the best time to catch a cavity is in the early stages, when there are few (if any) symptoms. Keeping your regular hygiene appointments gives you the best chance of catching problems before they become painful.