Caries of permanent teeth

• 1972Sodium fluoride approved (FDA)
• 1986Sodium monofluorophosphate approved (FDA)

Trials started per year, stacked by phase (darker = later phase). Source: ClinicalTrials.gov via Clin2, which tracks studies recruiting in recent years — early years undercount.

Caries of permanent teeth is curable or preventable in most people. Fluoride, dental sealants, and oral hygiene stop most cavities before they start, and early lesions can be reversed. Advanced cavities can be restored, so modern dentistry effectively controls the disease in most cases, though access gaps remain. Over recent decades, caries burden has fallen in many countries, thanks largely to community water fluoridation and widespread use of fluoride toothpaste. A key milestone was the U.S. Food and Drug Administration's approval of sodium fluoride in 1972, followed by sodium monofluorophosphate in 1986, which expanded preventive options. Research continues, with over 170 trials active in the last five years, mostly aimed at improving prevention and treatment.

Can early tooth decay heal without a filling?

Yes. When decay is limited to the enamel, fluoride from toothpaste, mouthwash, or professional treatments can help remineralize the area and stop the cavity from progressing.

Are dental sealants effective for preventing caries?

Sealants are highly effective. They cover the chewing surfaces of back teeth, where food and bacteria collect, and can reduce cavities in those areas by a large margin for years.

Why do cavities still occur if fluoride is available?

Fluoride greatly reduces risk, but cavities still happen due to frequent sugar intake, poor oral hygiene, and limited access to dental care. Genetics and saliva flow also play a role.

What is the current direction of caries research?

Research focuses on better prevention, such as new fluoride-releasing materials, vaccines, and ways to modify oral bacteria. Many trials are testing simpler and more affordable treatments for underserved populations.

Has tooth decay become less common over time?

In many high-income countries, caries rates in children and adults have fallen substantially since the 1970s, largely due to fluoridated water and toothpaste. However, the disease remains common globally, especially where preventive care is limited.