Dental Cavities: What You Should Know

Cavities, also called tooth decay or dental caries (the scientific name) are holes that develop on the hard surface of your teeth. This is how the process of decay occurs over time:

1. Bacteria feed off sugar and carbohydrates (starches) in the foods we eat, producing acids.

2. If the acids stay on your tooth and are not brushed off, they dissolve minerals in the hard enamel.

3. Over time, the enamel erodes or develops pits. They are too small to see at first. But they get larger over time.

4. If the decayed enamel is left uncontrolled, then the decay process continues, forming a cavity.

According to the Mayo Clinic, the cavity symptoms you experience depend on how many you have, where the cavity is located, and the severity of the decay. When a cavity is small for example, you might not even have symptoms. As the decay gets larger, it may cause symptoms such as:

• Toothache and other pain.

• Tooth sensitivity that may include mild to sharp pain when eating or drinking something sweet, hot, or cold.

• Visible holes or pits in your teeth.

• Tooth discoloration: brown, black or white stains on the tooth’s surface.

• Pain when you bite down.

You may be able to turn back time when it comes to certain stages of cavity formation. White spots on the surface of your teeth are one of the first early warning signs that decay is there, but it hasn’t broken through the enamel. Fluorides and other prevention methods can help a tooth in early stages of decay to repair itself (remineralize).

Once cavities get worse and there is a break in the enamel, only a dentist can repair the tooth. Then, the standard treatment for a cavity is to remove the decay and restore the tooth with a filling or recommended treatment.

Before a dental professional gets to work on your cavity, they will usually apply a numbing agent to the gums. This is so you are more comfortable when a local anesthetic such as lidocaine is administered to freeze the treatment area. Once that is numb, the dentist will remove the diseased part of the tooth. If the decay is contained, then the dentist will remove the decay and replace it with a filling. These can be made of different materials. If the decay is not contained, then the dentist will remove the decay and recommend the type of treatment that is needed to restore the tooth. 

Wherever a cavity forms, whether at the root of the tooth or on an exposed part of the enamel, the development of the cavity is the same. However, the placement of the cavity can determine how fast it forms and other factors can impact your risk.

1. Coronal cavities: These are the most common type of cavities and occur in both children and adults. They are located on the chewing or biting surfaces of the teeth.

2. Root cavities: As the name suggests, this type of cavity forms at the root of the teeth as the acids eat away at the cementum (the material that covers tooth roots and is softer, making it more at risk for decay). As we age, our gums can recede, exposing the enamel on the root surface and may become vulnerable to decay.

3. Recurrent decay: Decay that reoccurs on a tooth that can form around existing fillings and crowns if plaque is left uncontrolled.

4. Interproximal cavities: These cavities occur between the teeth, especially the back teeth which are harder to clean.

The good news: cavities are preventable! Set your mouth and teeth up for success with these simple oral hygiene habits and tips:

• Brush at least twice a day and floss daily to remove plaque from between teeth and below the gumline.

• Use antibacterial mouth rinses to reduce the levels of bacteria that cause cavities.

• Have regular dental checkups. Preventive care can help stop problems from occurring and keep minor problems from becoming major ones.

• Eat a well-balanced diet that limits starchy or sugary foods. When you do eat these foods, try to eat them with your meal instead of as a snack to minimize the number of times that your teeth are exposed to the acids in these foods.

• Chew gum that contains xylitol to help decrease bacterial growth. Unlike sugar, xylitol is not a food source for bacteria.

• Use dental products that contain fluoride, including toothpaste and mouth rinses.

• Make sure that your children's drinking water is fluoridated. If your water supply does not contain fluoride, your dentist or pediatrician may prescribe fluoride supplements.

• Ask your dentist about sealants for yourself, and for children to protect teeth from decay. Dentist hygienists can place dental sealants on teeth that have no cavities.

It makes sense that the hard-to-clean surfaces of your teeth are the parts most likely to develop cavities. These include:

• Cracks, pits or grooves in the back teeth

• Between teeth

• Around dental fillings or bridgework

• Near the gumline

Take extra care when cleaning these areas to prevent plaque build-up.

Remember, the formation of cavities is a process that occurs over time, which also means you have opportunity to reverse the process of tooth decay if it’s caught early. Here are some ways your dentist will look for cavities during an exam:

• Probing your tooth with a tool called an explorer to look for pits or areas of weakened enamel.

• Checking X-rays of your teeth for newly forming decay, particularly between teeth.

• Applying non-toxic liquid dye or stain that can detect tooth decay.

• Using a special type of laser can also detect very early tooth decay.

The early stages of decay are usually painless. Only regular dental examinations and X-rays (or other cavity-detecting devices) can show early signs of decay. If your teeth become sensitive to drinking hot or cold drinks, or sweet foods, this could be a sign of a cavity and you should contact your dentist.

Always seek out a professional recommendation from your dentist. If left untreated, the tooth decay will continue and can destroy the tooth. Additionally, having one cavity, could lead to more for several reasons:

• The same uncontrolled oral care and dietary habits that led to the decay of your teeth will cause more decay.

• Bacteria tend to stick to fillings and other restorations that are rough and broken down more than to smooth teeth, so those areas will be more likely to have new caries.

• Cracks or gaps in the fillings may allow bacteria and food to enter the tooth, leading to decay progressing beneath the filling.

Preventing cavities begins with good oral hygiene habits. Remember to brush your teeth with fluoride toothpaste at least twice a day. Floss every day to prevent food and dental plaque from building up and visit your dentist every six months.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.