Pathophysiology

Teeth are washed in saliva and have a coating of bacteria on them (biofilm) that is constantly forming. Minerals in the hard tissues of the teeth (enamel, dentin and cementum) are constantly undergoing processes of purification and remineralisation. Dental caries results when the rate of demineralization is faster than remineralization and there is a net mineral loss. This occurs when there is an ecological transition within the dental biofilm, from a balanced community of microorganisms to one that produces acids and can survive in an acidic environment.[73]