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. The process of decay occurs over time:

1. Germs 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. These are too small to see at first, but they get larger over time.
4. If the decayed enamel is left uncontrolled, the process will continue, forming a cavity.

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 the early stages of decay to repair itself (remineralise).

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

If the decay is contained, the dentist will remove the decay and replace it with a filling. If the decay is not contained, 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 that maybe vulnerable to decay.
3. Recurrent cavities: 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 wash to reduce the levels of germs that cause cavities.
• Have regular dental check-ups. 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 minimise the number of times that your teeth are exposed to the acids in these foods.
• Chewing gum that contains xylitol helps to decrease the growth of germs. Unlike sugar, xylitol is not a food source for germs.
• Use dental products that contain fluoride, including toothpaste and mouth wash.
• Make sure that your children's drinking water is fluoridated. If your water supply does not contain fluoride, your dentist or paediatrician may prescribe fluoride supplements.
• Ask your dentist about sealants for yourself and your children to protect teeth from decay. Dental 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
• Areas 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 the 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 to identify newly forming decay, particularly between teeth.
• Applying a non-toxic liquid dye or stain to detect tooth decay.
• Using a special type of laser to 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 chewing very 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 possibly 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.
• Germs 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 germs 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.