How Tooth Decay Works
In 2026 a phase III trial of 830 young children, published in JAMA Pediatrics and widely reported in October, found that silver diamine fluoride, a liquid brushed onto cavities without drilling, arrested 54% of treated lesions against 22.5% for a placebo. This film explains the fundamentals behind that result: how a tooth is built from enamel, dentin and pulp; why enamel is almost pure mineral and cannot grow back; how plaque bacteria such as Streptococcus mutans turn sugar into acid; why a pH of about 5.5 is the line where enamel dissolves; how saliva repairs it and why sugar frequency matters; how a white spot becomes a cavity and reaches the nerve; how fluoride makes tougher crystals, from Grand Rapids in 1945 to toothpaste today; and how fillings and silver diamine fluoride stop decay.
The slow war in your mouth
How a hole gets into the hardest thing you own.
A tooth up close
Three layers, one of them alive.
The sticky film
A city of bacteria, built on sugar.
The acid attack
Every sugary bite starts a dip.
From spot to hole
The first stage can still be undone.
Fluoride
A small swap inside the crystal.
A world of cavities
Preventable, and still everywhere.
Stopping decay
Remove it, or kill it where it sits.
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