Why Tooth Decay And Toothache Happen

July 8, 2026
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Many of us will have experienced decay and toothache, but what is the process that causes this?

Almost everyone knows that eating too much sugar is bad for their teeth. Most of us have probably also experienced toothache at some point, whether it was a dull ache that came and went or a sharp pain that was impossible to ignore. While we recognise these as issues, many of us probably don’t really understand how this happens.

Tooth decay doesn’t appear overnight, and a painful toothache is usually the result of a problem that has been developing for quite some time. Understanding what happens inside the mouth can make it easier to prevent these problems in the first place.

Plaque build up

Our mouths naturally contain hundreds of different types of bacteria. Most of them are harmless or even beneficial, but some feed on the sugars that are left behind after we eat and drink. When they do this they create a sticky substance known as plaque. This develops continuously, which is why brushing your teeth is essential on a daily basis as opposed to every now and then in order to remove it and prevent it from accumulating.

When plaque is not removed properly, the bacteria within it begin to produce acids.

Acid damage to the teeth

Although tooth enamel is the hardest substance in the human body, it is not completely indestructible. The acids that are produced by plaque gradually demineralise the enamel surface, causing it to weaken. You won’t necessarily notice this happening but it will.

As long as you brush your teeth regularly and with a fluoride toothpaste, the enamel can sometimes repair itself, using minerals that are contained in our saliva; a process known as remineralisation. Where too many sugary foods and drinks are consumed though, or where we snack so frequently that the remineralisation process doesn’t have time to work, this exposes the tooth enamel to repeated acid attacks throughout the day and small cavities start to form.

Cavities

Cavities start off very small and are unlikely to be noticed. You are unlikely to experience discomfort at this early stage. If you don’t visit our Bromley dental clinic for regular check ups, the cavity will only grow larger and become more problematic, where a small filling could have prevented this from happening.

The problems really start when the acids meet the dentine layer, just beneath the tooth enamel. Unlike enamel, dentine is softer and contains thousands of microscopic channels that reach the centre of the tooth where the nerves are stored within the root canal system.

As the damage passes through this part of the tooth, you may notice more tooth sensitivity and possibly toothache too.

Pulp infections

Deep within every healthy tooth is a soft tissue called the pulp. This contains nerves and blood vessels that keep the tooth alive. If bacteria eventually reach the pulp, inflammation develops.

Unlike other parts of the body, there is very little room inside a tooth for swelling to occur and as pressure builds within the tooth, it puts pressure on the nerves and discomfort is likely to be a lot more noticeable when this happens. Some people describe a constant throbbing pain, while others experience sharp episodes that seem to come and go.

Root canal pulp death

If the decay continues untreated, the pulp in the root canals may eventually die. Although the pain sometimes settles temporarily, this does not mean the problem has gone away. Instead, bacteria may spread beyond the root of the tooth into the surrounding bone. If this happens, an abscess can form. This can potentially be very dangerous and you should contact the Smile Dental Practice straight away if you notice symptoms such as severe pain, facial swelling or swelling of the gums or an unpleasant taste as the abscess bursts. If the bacteria in the abscess enters the bloodstream, it can be very serious and this problem should never be ignored.

Stopping tooth decay

There are many things that patients of the Smile Dental Practice in Bromley can do to prevent tooth decay. The most obvious one is to brush your teeth with a fluoride toothpaste both morning and night. Using dental floss or an interdental brush to reach between the teeth is important too as bacteria collect easily in these areas.

Reducing the number of sugary drinks and snacks will help a lot too as this will help to deny the bacteria an important food source for them and help to keep their numbers under control.

Finally, it should go without saying that you should have your teeth checked every six months, or possibly more frequently if you are at a higher risk such as may be the case with smokers and diabetics. Seeing the dentist means that any damage that does occur can be treated promptly, preventing it from worsening.

Don’t wait until you are in pain with a toothache or other dental problem. Make sure you have an appointment for a check up booked with us already. If you are not sure if you have one booked, or would like to make an appointment at our Bromley dental practice, you can book one by calling us today on 020 8462 2473.

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