Dental caries is an infectious disease that can occur when cariogenic bacteria colonize a
tooth surface in the presence of dietary carbohydrates, especially refined sugars. The bacteria
metabolize the carbohydrates, producing lactic acid, which over time demineralizes the tooth
structure. 3 The earliest visible manifestation of dental caries is the appearance of a
demineralized area on the tooth surface, which presents either as a small white spot on a smooth
surface or a pit or fissure. At this stage, a caries lesion is usually reversible. If oral conditions
do not change, demineralization will continue with the eventual result that the tooth surface loses
its natural contour and a “cavity” develops. At this stage, restorative treatment is necessary to
prevent the continuation of the caries process, which if left untreated will eventually result in
pulpitis and ultimately tooth loss.