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Tooth decay: what is it?

Tooth decay is an "infectious disease" caused by acids from bacteria. Once the "caries bacteria" are in the oral cavity, they persist there. In Austria, practically every adult and every third child suffers from this widespread disease of civilization. Thanks to improved provision, there has been a decline in the past few decades. Nevertheless, tooth decay is still the most common tooth disease…


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  • ">Transmission routes


  • How does tooth decay develop?
  • Forms & signs of tooth decay
  • Prevent tooth decay
  • Whom can I ask?
  • How are the costs going to be covered?


Transmission routes

Caries is the destruction of the tooth substance by acids from bacteria from the plaque / biofilm (dental plaque). There is a multitude of bacteria in our oral cavity - this is completely natural. Most of the bacteria are actually useful because digestion begins in the mouth. Caries-causing bacteria (e.g. Streptococcus mutans, lactobacilli) are not yet present at birth. However, they are usually transmitted to the child in the first few years of life by parents, siblings or other people (e.g. by licking a spoon or pacifier).

Once the "caries bacteria" are in the oral cavity, they persist there. Only regularly removing plaque by brushing your teeth and using dental floss will help prevent tooth decay. In the case of inadequate dental care, plaque remains on, on and between the teeth. The bacteria immediately start breaking down the carbohydrates (e.g. sugar) in the food. This creates acid (e.g. lactic acid) which dissolves the tooth enamel. As the tooth decay progresses, the dentin and nerve are also affected. In the worst case, tooth decay can lead to tooth loss.

How does tooth decay develop?

Caries bacteria prefer sweets and foods with a particularly high level of carbohydrates, such as chips and pizza, on their menu. A diet rich in sugar therefore forms the ideal basis for the survival and multiplication of the bacteria that cause caries, as these mainly convert the sugar components of the food into acid. This acid attacks tooth enamel and the tooth is gradually destroyed if not cleaned or treated.

Note Children are particularly prone to tooth decay, as the enamel of milk teeth is less robust.

Saliva plays an important role. The saliva neutralizes acids in the oral cavity and can remineralize the tooth enamel - it brings back minerals such as calcium that have been removed from the tooth enamel by acids. If there is not enough “spit” in the mouth, the bacteria multiply particularly well. This is the case, for example, at night when we are sleeping. At this time the salivary glands have little to do. For this reason, it is important to brush your teeth thoroughly before going to bed so that the caries bacteria cannot multiply.

Forms & signs of tooth decay

Dentistry differentiates between the following three types of tooth decay:

  • Enamel caries / dentine caries : Enamel or dentine caries is the most common form of caries.
  • Root caries: With age, the gums retract and expose parts of the tooth root. Since the roots are not protected by tooth enamel, they get caries much faster.

Everyone should check their teeth regularly. The first visible signs are white spots - so-called "white spots" - in the tooth enamel. First, a rough surface is created on the tooth enamel. This promotes the adhesion of plaque. If tooth decay is discovered in this initial stage (initial caries), the incipient destruction of the tooth enamel can often be stopped by intensive oral hygiene and increased use of fluorides.

As the disease progresses, the affected areas usually turn yellowish-brown. The tooth decay gradually penetrates the tooth enamel and attacks the dentin. Often the first pain is noticeable now. Caries causes great pain at the latest when it has reached the nerve of the tooth and it becomes infected.

Note Incipient dental caries is not always visible from the outside. Bitewing X-rays should therefore be taken every year in order to be able to detect caries in the clinically poorly visible posterior region early enough. For some time now there have also been alternative laser-based devices that can be used to "shine through" the interdental spaces to detect caries. However, these are not yet entirely reliable. Therefore this examination is not yet paid for by the social security agencies. In any case, only your dentist can say for sure whether tooth decay has formed. Regular visits to the dentist can help detect and treat tooth decay in good time. If tooth decay is left untreated, a hole will form in the tooth enamel. In the worst case, it can lead to tooth loss.

Prevent tooth decay

Children and adults can reduce their risk of tooth decay if they regularly brush their teeth with toothpaste that contains fluoride. Cleaning your teeth removes bacteria and plaque from your teeth.

The most effective measures to prevent tooth decay are:

  • Regular brushing of your teeth also in the interdental spaces: It is recommended to brush your teeth at least twice a day after eating.
  • Regular twice-yearly check-ups at the dentist's with professional oral hygiene twice a year
  • reduce sugary foods - especially as snacks

Note Be careful with fluoride tablets! Since fluoride can have side effects, children should not ingest too much of it.

Whom can I ask?

Even if you have no symptoms, you should make regular check-ups as recommended by your dentist.

  • You can find dentists in your area under Dentist search.
  • You can find dental clinics in your area under Search for dental clinics.

How are the costs going to be covered?

In addition to dental treatment and dentures, dental services also include orthodontic services (jaw regulation).

Dental services can be used at the following doctors or institutions:

  • for contract dentists
  • for elective dentists and
  • in outpatient dental clinics (in the health insurance institutions' own facilities and in contract facilities)

Note Please note that elective doctors can freely determine their fees and are not bound to any tariffs. It is therefore advisable to clarify the cost issue with your health insurance provider before treatment.

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