Cavities and Tooth Decay: Everything You Need to Know

Everyone gets one set of adult teeth. So exercising good oral habits is critical to make sure they last. Part of having a healthy mouth is cavity and tooth decay prevention. Here's what you need to know to keep your teeth cavity-free.

A cavity is a permanently damaged area of a tooth that resembles a hole. Cavities result from tooth decay. They form when acids found in the mouth erode a tooth’s hard, protective surface. That surface is known as tooth enamel. Tooth decay is caused by several factors, including eating and drinking sugary foods, mouth bacteria, and poor oral hygiene habits.

Anyone can get a cavity, though children, teenagers, and older adults are more susceptible. Regardless of who gets them, cavities need to be treated. Failure to treat cavities can lead to bigger oral issues, including toothaches, infections, and even tooth loss.

The signs and symptoms of a cavity will vary based on several factors. The extent of tooth decay and the location of the cavity are the most prominent. You may have a cavity in its initial stages of development, but you may not feel or see any signs. However, if your cavity is more developed, you may notice the following symptoms:

• Toothache – pain that occurs for no apparent reason
• Pain that results from biting
• Bad breath
• Bleeding gums
• Tooth sensitivity to hot, cold, or spicy foods or drinks
• Visible tooth holes or pits
• Tooth stains – the stain can be black, brown, or white
• Swollen face
• Redness outside or inside the mouth

A dentist can identify any of these symptoms if you suspect you have a cavity. That's why regular checkups and cleanings are important for maintaining a healthy mouth.

So how do you get cavities? They are caused by tooth decay – a process that occurs over time. Tooth decay consists of three phases.

Tooth decay begins with plaque formation. Plaque is a clear, sticky film that collects on a tooth’s surface. Bacteria feed on the sugars that remain on your teeth after eating. The bacteria and sugar combine to form plaque. Plaque hardens into tartar, also referred to as calculus.

Once the plaque has formed, then the acids in the plaque attack tooth enamel. The acids eat away at the enamel causing small holes. The acids can then attack a tooth’s dentin after penetrating the enamel. The dentin has tiny tubes that connect with a tooth’s nerve. This breach of enamel and dentin is what results in tooth sensitivity.

The bacteria and acid then move to a tooth’s pulp. Nerves and blood vessels are found in the pulp. The bacteria cause the pulp to become swollen and irritated. This pressing of the nerve causes tooth pain.

The result of this is a tooth cavity.

Tooth decay isn’t particular when it comes to causing cavities, as all layers of a tooth are susceptible. Cavities can take as long as three years to form through enamel – the strongest part of a tooth.

Once decay penetrates the enamel, cavities can form more quickly in the dentin and the pulp. That said, three types of cavities can form in a tooth, and they vary by layer.

Tooth enamel can be penetrated, despite its strength. Proper oral hygiene is your best weapon to prevent smooth surface cavities. Brushing, flossing, and regular dental cleanings will preserve your enamel while preventing cavities. Folks in their twenties can be susceptible to this type of cavity.

The top part of a tooth – the chewing surface – is where pits and fissures can congregate. The grooves necessary for chewing and tearing food are ideal areas for food particles and bacteria to accumulate. The result is pits and fissures on a tooth’s top surface.  This type of decay progresses faster than a smooth surface cavity. Teenagers tend to develop pits and fissures.

This type of decay is more prevalent in older folks due to gum recession. When gums recede, tooth roots are exposed to plaque and acid.

Practicing good oral hygiene begins at home and is the key to preventing cavities. Some of the following tips are easy to incorporate, while some require a bit of scheduling and coordination with your dentist.

Brush your teeth at least twice each day using fluoride-based toothpaste. Ideally, brush after each meal. Clean between your teeth with dental floss after brushing.

A mouth rinse can complement regular brushing and flossing. Your dentist might recommend a rinse that contains fluoride if you are at high risk of developing cavities.

Schedule regular appointments with your dentist for cleanings and oral exams. Your dentist can diagnose potential oral issues in their early stages.

Eating healthy, nutritious foods is good for your overall health. But try to incorporate foods that are teeth-healthy too. This means avoid snacks that can get stuck in the nooks and crannies of your teeth. Opt for fresh fruits and veggies instead. 

Many public water supplies contain fluoride. Fluoride helps repair tooth enamel and can potentially reverse a cavity that has started if caught early enough.

Besides public tap water, there are other ways to get fluoride. Discuss them with your dentist at one of your regular checkups.

Anyone who has teeth is at risk of getting cavities. But there are specific factors that can increase your risk.

• Poor oral habits – failing to brush after eating leads to plaque accumulation.
• Food choices – foods high and sugar and that will cling to your teeth can cause decay.
• Tooth type and location – molars and premolars are more likely to develop decay because of their grooves and uneven surfaces that collect food particles.
• Lack of fluoride – tooth enamel can weaken without fluoride treatments.
• Dry mouth – saliva naturally rids your teeth of food particles and plaque.
• Eating disorders – stomach acid from chronic vomiting can dissolve tooth enamel.
• Acid reflux – like an eating disorder, stomach acid forced into your mouth will wear down tooth enamel.
• Frequent snacking – snacking on sugary foods or sipping sugary drinks produces more acid to attack your teeth.
• Infant feeding at bedtime – giving an infant a liquid that contains sugar, such as juice or formula, before bed allows the liquids to rest on their teeth for hours.

Cavity treatment options depend on the severity of the cavity.

Fluoride Treatment is used when a cavity is caught in the early stages. Remineralization is the process of using fluoride treatments to repair tooth enamel. Fluoride treatments can sometimes reverse a cavity when it is in its infant stage. Your dentist can apply fluoride during office visits. The treatments can take various forms, including liquid, gel, foam, or a varnish brushed onto your teeth by the dentist. Fluoride can also be placed in small trays that fit over your teeth. You might also need a prescription toothpaste and mouthwash.

A cavity tooth filling is the standard treatment once your dentist detects a hole in the tooth. That means the cavity has advanced beyond the stage of being treated with fluoride. The dentist drills out the decayed part of the tooth and repairs it with a filling.  Dental fillings tend to consist of tooth-colored composite resin, porcelain, silver amalgam, or gold.

Crowns are a treatment option for excessive decay or when the tooth has weakened. A crown is a custom-fitted covering that is placed over the tooth. Your dentist first drills away the decayed tooth portion along with some additional tooth surface so that the crown will securely fit the remaining tooth. Crowns can be made from several materials, including porcelain, resin, porcelain fused to resin, or gold.

A root canal becomes necessary once the cavity has advanced to root decay. Endodontists are specialists at performing root canals. A root canal procedure removes the tooth pulp that consists of the pained nerve endings and replaces it with a filling. Root canals repair and save a tooth from being removed.

Tooth extraction becomes necessary for severe tooth decay that leads to rotten teeth. If the tooth can’t be restored, removing it is the only option. Replacing the extracted tooth with a dental implant or a dental bridge will prevent your teeth from shifting while maintaining your appearance.

Once you know that you have a cavity, your dentist needs to fill it. So there will be some cost. How much cavity fillings cost depends on the filling type.

A silver amalgam filling on a couple of surfaces will cost between $50-$150. Tooth-colored composite resins can run from $90-$250. Porcelain or gold fillings can cost $250-$4,500. Dental insurance typically covers between 50%-80%, so there will be some savings there.

Consult your dentist to discuss the best methods to treat a cavity and tips to prevent tooth decay. If you don't have a dentist and are asking where to find a dentist near you,  The Smile Generation can help find a dentist near you for your cavity treatment needs. You can read patient reviews, peruse staff bios, and schedule an appointment online with a click of your mouse.