Decay is caused by the build-up of a sticky film called plaque on the teeth. Plaque contains bacteria that feeds off of carbohydrates (starches and sugars) in the mouth. As the bacteria is feeding it produces acids that attack the tooth surface (enamel). If the plaque is not removed it continues to build up creating more acid that attacks the tooth enamel. As the enamel continues to be weakened, decay is able to set in and destroy the enamel. There is typically no pain when a cavity is just in the enamel but as it progresses to the underlying soft pulp layers where the nerves are located, you begin to feel pain. At this point a large amount of the tooth has been destroyed and will need to be removed to treat the cavity. This is why it is extremely important to receive routine cleanings and exams every six months. Our hygienist can remove the plaque build-up that brushing and flossing alone can’t. Many times we can also detect cavities while they are small, before they have had a chance to cause significant damage to the tooth.