There are many factors that can be held responsible for tooth decay and how it comes about but the first and principle factor is undoubtedly diet, and of course sugar consumption. Sugar doesn’t just come in the most obvious form which is in sweets or sugar in tea or drinks. The best known fizzy drink for sugar is Coca Cola, but most fizzy drinks contain too much sugar, as sadly does any form of blackcurrant juice with Ribena top of the list, even the tooth friendly variety.

Mints appear to have a predisposition to causing decay, especially polo mints, but flavoured milk and yoghurts are not too helpful either. A good idea is to take a list of everything you eat and drink over a four day period to your dentist, and he will soon point out the sugar sources.

The second factor is plaque in which are bacteria which turns sugar into acid which takes the calcium out of tooth enamel in a process called demineralisation. Plaque of course is that creamy sticky stuff that sticks to teeth. It needs to be cleaned off every day thoroughly.

Another factor is hereditary, or inherited teeth, and this doesn’t especially mean having soft teeth, but far more the shape of teeth, but in fairness the chemistry of tooth enamel does play a part in tooth decay. To this has to be added the uptake of fluoride which makes tooth enamel less susceptible to acid attack.

Teeth are not all smooth and nicely rounded sadly, and the shape of our teeth can either help or predispose us to decay. The surfaces of the molar teeth at the back of the mouth can look like mountains and valleys. If the valleys are ‘U’ shaped it is better than if they are ‘V’ shaped which are harder to clean and thus more susceptible.

It is also important to understand that the place where teeth meet and touch which are called contact points are more liable to decay because plaque becomes lodges in there. Items like dental floss are needed to clean into these inaccessible places. This is also why front teeth are easier to keep clean than back teeth, which is why most fillings are required in back teeth.

We need to add the production of saliva, its quantity and its acidity, and also the age of the individual into the equation.

Now plaque plus saliva plus sugar makes acid, and a small understanding of degrees of acidity help you to realise why and at what point teeth decay, and how fluoride can alter the balance of this equation.

Tooth enamel has an inbuilt resistance to tooth decay, in that it takes a certain amount of acidity to kick start the process. Poor enamel means less acid is needed to decay happens more easily.

If fluoride can be taken as a supplement when the teeth are being formed, in other words in early childhood it becomes part of the enamel and makes the enamel more resistant to acid attack. Of course finding out about fluoride in your water supply before making this decision is important as fluoride in excess can damage and disfigure teeth.

Finally the age of the individual is important because decay seems to strike mostly before the age of twenty one, and from the time of going to school.