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Teeth · Perivale, Ealing

Tooth Decay. How it starts, and how to stop it.

Tooth decay often causes no symptoms at first, so it’s usually found at a check-up. Early decay can sometimes be reversed with fluoride. Once a cavity forms, it needs treatment.

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Written and clinically reviewed by Marisa Lennie, GDC 252605 · Last reviewed

What’s going on

How decay starts.

Bacteria in plaque feed on sugar and produce acid. Each time that happens, the acid softens the enamel, and over time it can break down into a cavity.

How often you have sugar matters as much as how much, because every sugary snack or drink restarts the acid attack. Fluoride helps enamel repair itself, which is why the right toothpaste and fluoride varnish make such a difference.

Source: NHS: Tooth decay (opens in a new tab), Delivering Better Oral Health (opens in a new tab).

What raises the risk

  • Frequent sugarSugary snacks and drinks between meals, and sugary medicines.
  • Plaque left on teethPlaque holds the bacteria and acid against the enamel.
  • Not enough fluorideUsing a low-strength toothpaste, or rinsing it away after brushing.
  • Smoking and alcoholThe NHS advises not smoking and keeping alcohol within 14 units a week.

At home

What helps, and what to avoid.

Do

  • Brush twice a day with a fluoride toothpaste, last thing at night and one other time
  • Spit out after brushing, but don’t rinse
  • Clean between your teeth with floss or interdental brushes
  • Keep sugary food and drinks to mealtimes, and choose sugar-free medicines

Avoid

  • Don’t snack on sugary food or drinks between meals
  • Don’t rinse the toothpaste away with water: spit it out instead
  • Don’t wait for pain: early decay often has no symptoms

Based on NHS: Tooth decay (opens in a new tab), Delivering Better Oral Health (opens in a new tab).

At your appointment

What I check for decay.

  1. A close look at every tooth

    Early decay can show as a chalky white patch before it becomes a hole.

  2. Your decay risk

    Diet, fluoride, dry mouth and past fillings all affect how often you should be seen.

  3. Prevention first

    Where decay is early, fluoride varnish and the right toothpaste can help the enamel repair.

  4. The right next step

    If a cavity needs treatment, I’ll explain what’s involved and who will carry it out.

How I can help

Treatments for tooth decay.

Tooth Decay FAQs

Questions about tooth decay.

Something else on your mind? Email me or call 020 8997 0933.

Can tooth decay be reversed?

Early decay can sometimes be reversed with fluoride, such as a fluoride varnish or mouthwash. Once a cavity has formed, it needs a filling.

What are the first signs of tooth decay?

Often there are none. Later signs include toothache, pain with hot, cold or sweet food and drink, and white, brown or black marks on a tooth.

How can I prevent tooth decay?

Brush twice a day with a fluoride toothpaste and spit rather than rinse, clean between your teeth, keep sugar to mealtimes and keep up regular check-ups.

What happens if decay isn’t treated?

It can reach the nerve, which may need root canal treatment, and can cause a painful abscess. In severe cases the tooth may need to be removed.

How often should children have their teeth checked?

The NHS advises check-ups at least once a year for under-18s. Children from age 3 can also have fluoride varnish at least twice a year.

Marisa Lennie, Dental Hygienist & Therapist

Written & clinically reviewed by

Marisa Lennie

Dental Hygienist & Therapist · Dip DHDT (RCS England) · GDC 252605

Last reviewed

Marisa qualified through the Royal College of Surgeons of England, training clinically at King’s College Hospital, London, and is an Approved Education Supervisor for trainee hygienists & therapists. She assesses and treats tooth decay at Bilton Road Dental Practice in Perivale.

About Marisa Verify on the GDC register (opens in a new tab)

Sources & guidance

  1. NHS: Tooth decay Page reviewed August 2025
  2. Delivering Better Oral Health, chapter 2: summary guidance tables for dental teams Updated September 2025
  3. General Dental Council: Direct access

This page is general information about tooth decay. It isn’t a diagnosis. See a dentist as soon as possible if you think you have decay.

Catch decay early, before it hurts.

Call the practice or send an email to book your appointment. No referral needed.

Book An Appointment 020 8997 0933

Bilton Road Dental Practice · 56 Bilton Rd, Perivale, Greenford, London, UB6 7DH

Decay checks and prevention in Perivale (UB6), close to Greenford, Alperton, Sudbury, Hanwell and Northolt.

Please note

Before you continue

This website is currently under construction. While we try to keep everything accurate and up to date, some content, treatment details or information may be incomplete or out of date. Please contact the practice directly to confirm anything important before making decisions about your care.

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