Caries: What You Need to Know About the Most Common Cause of Tooth Damage and How to Fight It

19 June 2025

Caries is one of the most widespread non-infectious diseases in today’s world, statistically affecting approximately 95% of the global population. This pathological process develops as a result of the activity of microorganisms residing in the oral cavity. It essentially involves the progressive demineralization and subsequent destruction of the dental tissues following the breakdown of enamel. Caries is mostly the consequence of poor oral hygiene and dietary habits. In this article, we will explore in detail what caries is, how it manifests, the stages it goes through, and the ways modern dentistry combats it.

Learn how to protect yourself from this prevalent problem and maintain a healthy, attractive smile.

How Caries Manifests and What Contributes to Its Development: An In-depth Analysis

The human oral cavity represents a unique ecosystem, home to myriad microorganisms including streptococci, lactobacilli, and actinomyces. These bacteria, typically transmitted from mother to child at birth, multiply rapidly; within a few hours of the initial erosion of the teeth, their numbers can increase manifold. These microorganisms—especially streptococci—metabolize sugars obtained from food, including sucrose commonly found in refined sugar and any sugar-containing product. As a result, acids are produced that adversely affect the teeth. Caries begins when these acids cause the dental tissues to lose minerals. If this demineralization process is not halted in time, it gradually damages the dentin, then the deeper layers of the tooth—its dentin and eventually, the nerve. The formation of dental plaque creates an ideal habitat for bacteria on the tooth surface.

Diet plays a major role in the development of caries. Numerous clinical and experimental studies have confirmed that a high intake of sweets—especially those that remain in the oral cavity for a prolonged period (such as toffees, candies, and dried fruits)—significantly increases the risk of carious damage. Sugary drinks, including sodas, fruit juices, and energy drinks, directly harm the dentin and set the stage for caries development. Additionally, systemic diseases that alter the quality and quantity of saliva (for example, Sjögren’s syndrome, diabetic conditions with high sugar levels, or radiation therapy) may adversely affect the demineralization process and contribute to the onset of caries. A decreased amount or altered composition of saliva undermines its protective function.

Without the interplay between the dental tissues, bacteria, and food sugars, caries could not develop; hence, bacterial colonization is a direct causative factor. External factors—for instance, radiation therapy in the head and neck region—often lead to dental damage in the form of white spots, which later evolve into carious lesions. This is due to the damage inflicted on the salivary glands, which reduces saliva’s protective function and increases the viscosity of the oral environment. The thickened oral environment, or “xerostomia”, further raises the risk of caries because the saliva is unable to properly cleanse the tooth surfaces.

Dental plaque—a biofilm consisting predominantly of bacteria that adheres tightly to the tooth surface—provides an optimal environment for dentin demineralization. Within the plaque, bacteria multiply actively and secrete acids that lead to increased acidity and gradual softening of the enamel. Over time, plaque can harden into calculus, further compromising oral hygiene and fostering the development of caries and periodontal diseases.

The protective role of saliva is, however, of utmost importance: it not only mechanically cleanses the oral cavity but also contains minerals such as calcium and phosphate that aid in the remineralization of the dentin—helping to repair damaged areas. Saliva also includes buffering systems that neutralize the acids secreted by bacteria, thereby reducing the risk of demineralization. Any alteration in the normal composition of saliva—whether due to certain diseases or medications—can predispose an individual to the development of caries.

In clinical practice, caries is typically classified into four main stages:

• Early (White Spot) Stage:
  
  At this initial stage, the tooth is not deeply damaged; only a spot of altered color—more white or off-white compared to the natural enamel—is visible. The superficial layer of enamel is demineralized, although the overall structure is still intact. The damage is reversible, and remineralization therapy (using fluoride-containing preparations or special therapeutic procedures) can often restore the enamel without discomfort.
  
  
• Enamel Caries:
  
  At this stage, the outer enamel is compromised and dark spots—frequently brown or black in color—begin to appear. Although the enamel’s structure is disrupted and a small defect may form, the dentin remains largely unaffected. The patient may experience slight, transient discomfort when consuming cold, hot, or sugary foods.
  
  
• Intermediate Stage Caries:
  
  In this stage, the size and color intensity of the spots become considerably more prominent. The damage extends into the dentin, which is softer and demineralizes more quickly than enamel. This results in heightened tooth sensitivity to cold, hot, or sweet foods, characterized by a longer-lasting and more intense reaction. In some cases, the supporting soft tissues around the tooth may also be affected if the infection spreads, leading to inflammation of the pulp.
  
  
• Advanced (Deep) Caries:
  
  This is the final and most severe stage of caries, where the damage reaches the nerve (pulp). At this point, pain becomes intense and persistent. Pulpitis—a severe inflammation of the nerve—may develop, necessitating urgent medical intervention. In some cases, despite treatment attempts, it may be impossible to save the nerve, requiring endodontic therapy (root canal treatment). When the damage is very deep and a significant portion of the dental tissue is lost, tooth extraction is sometimes recommended to prevent the spread of infection and avoid further complications, such as abscesses or bone destruction.
  
  

Treatment of Dental Caries and the Importance of Prevention: Modern Approaches

The successful treatment of caries depends on early diagnosis and appropriate intervention. The method of treatment varies depending on the stage and severity of the damage. In the early white spot stage, remineralization therapy is often sufficient to restore the lost minerals to the tooth. This may involve the use of fluoride-containing preparations, specially designed toothpastes and mouthwashes, or professional fluoride treatments in a dental office. In cases of enamel caries, where dark spots have formed and the enamel’s structure is compromised, the damaged area must be removed and the tooth restored using modern, aesthetic restorative materials. Today, composite materials that closely mimic the natural color of the teeth are used to achieve both functional and aesthetic results.

For intermediate and advanced caries, treatment becomes more complex. After the removal of the damaged tissues, the cavity is filled with restorative material. It is crucial that the restoration accurately reproduces the anatomical form and function of the tooth to ensure proper occlusion. In advanced cases, where the infection is close to or has already affected the nerve, endodontic treatment (root canal therapy) may be necessary. This procedure involves the removal of the infected or damaged nerve, disinfecting the canals with special solutions, and then sealing them to prevent re-infection. After endodontic treatment, the tooth often requires a crown because its structure has been weakened. Occasionally, in cases of severe damage, saving the tooth may not be possible, leading to the need for implant placement or the use of a dental bridge to restore both function and aesthetics.

Prevention is the most important aspect of fighting caries. Regular and proper oral hygiene—such as brushing teeth twice daily with fluoride toothpaste, the regular use of dental floss to remove plaque and food debris, and the use of mouth rinses—can significantly reduce the risk of caries. It is also essential to limit the consumption of sugary products and to follow a balanced diet rich in fiber, fruits, and vegetables, which promote saliva production and help naturally cleanse the teeth. Establishing good oral habits from an early age, particularly in children, and having preventive dental check-ups at least twice a year, can help detect caries in its early stages and allow for timely intervention that prevents complications and maintains a healthy smile. Dentists will also assess the overall condition of the oral cavity and provide individualized hygiene recommendations or professional cleaning if necessary, to eliminate plaque and tartar.

Dental Caries Treatment at “Blits Dental – Kakhaber Kharebava Clinic”

“Blits Dental – Kakhaber Kharebava Dental Clinic” (located at Vera, Kuchishvili Street 11) offers a complete range of diagnostic and treatment services for caries, employing the latest technologies and methods. Our professionals, with many years of practical experience, provide expert consultations, accurately assess each medical case, and design a comprehensive treatment plan tailored to your needs. Our goal is not only to resolve the existing problem but also to maintain your oral health in the long run.

Our clinic uses only high-quality, certified materials and equipment, ensuring both effective and safe treatment.

We are ready to bring back your smile!

For more detailed information regarding consultation scheduling and dental treatment options, please contact us at: (+995) 322 22 15 16