What You Should Know About Cavities and the Progression of Tooth Decay

What you should know about tooth decay

Learn about cavities to better protect your oral health.

Cavities are one of the most common and well-known oral health concerns out there, but how much do you really know about them? Since they’re so familiar, it’s easy to assume that there isn’t that much to learn or that you’ve acquired everything you need to know about them in bits and pieces over the years, but you might be surprised by how much more there’s left to learn! Understanding the basic details of why cavities form, how they progress, and how to treat them are major advantages when it comes to protecting your oral health and preventing future tooth decay. 

If you do get cavities in the future, knowing these details can also help you feel more comfortable with the treatment process because you understand what’s  involved and why you need it. To help you take better care of your oral health, we’ve put together a guide on what you should know about cavities.

Causes of Cavities

Cavities are caused by bacteria in your mouth that are constantly working to form a film called plaque that sticks to the surface of your teeth. These bacteria feed on sugars and starches, so when you eat these foods, the bacteria feed on the traces left behind and produce acid as a byproduct.

Since the bacteria are sitting right on the surface of your teeth, this acid begins eating through your enamel. If the bacteria is left unchecked, the damage this acid does to your enamel will eventually cause a cavity, which is a permanent hole caused by decay. Although bacteria are the root cause of tooth decay, several factors can cause the bacteria to thrive and lead to cavities, including diet, poor oral hygiene, and certain conditions (like dry mouth).

Types and Stages of Tooth Decay 

The type of tooth decay depends on where the cavity occurs. Pit and fissure cavities occur in the grooves on the chewing surfaces of your teeth, while smooth surface cavities and root cavities live up to their names. Smooth surface cavities form on the smooth areas of your teeth, and root cavities form underneath your gumline on the roots of your teeth.

Regardless, there are five main stages of tooth decay: demineralization, enamel decay, dentin decay, pulp damage, and abscess. Demineralization is the earliest stage of tooth decay, where acid first begins eating away at the enamel, leaching away minerals like calcium. This can cause faint white spots to appear on your tooth. It reaches the second stage of tooth decay, enamel decay, when the acid moves past demineralization and begins to eat its way through the enamel. This causes a lesion to form in the tooth. Your enamel is extremely durable, so it can take the acid quite a while to eat through it.

Dentin decay, the third stage, is when the decay breaks into the layer of softer dentin beneath your enamel. It’s at this stage that tooth decay becomes a true cavity. Since dentin is softer than enamel, this is also the point where cavities begin spreading faster. Pulp decay occurs when bacteria reach the heart of your tooth—the tooth pulp. This is where the blood vessels and nerves of your tooth are, so this is the stage patients often equate with a toothache.

When a tooth continues to go untreated, it can reach a fifth stage of tooth decay by developing a dental abscess. A dental abscess is an infection resulting in a pocket of pus that forms around the end of your tooth root. They’re often very painful and are a serious risk not just to your oral health but also to your overall health. As a result, an abscess is considered a dental emergency. If you suspect you have one, you should call our office right away to schedule an emergency dental appointment with Dr. Desai.

Treatment Options at Each Stage

Thankfully, we have plenty of ways to treat cavities at each stage! If you catch a developing cavity in either of the first two stages, you may be able to reverse the damage—no filling required! Tooth enamel doesn’t heal like bone does, but it can remineralize through the application of fluoride.

During demineralization, you can usually do this through a great oral hygiene routine that incorporates fluoridated toothpaste and mouthwash. If the demineralization is a little more advanced, your dentist may recommend a fluoride treatment, which delivers a more concentrated dose of fluoride to your teeth to help fight bacteria and rebuild your enamel.

A cavity in the dentin decay stage requires a dental filling to stop the spread of the bacteria, protect the remaining tooth against future decay, and restore its function. In some cases, big cavities may need a larger restoration such as an inlay, onlay, or dental crown. Once decay reaches the pulp, treatment becomes more involved. Your dentist will need to perform a root canal to remove decayed parts of your tooth, including the inflamed tissue within the roots.

Since removing the pulp from your tooth can leave it brittle, the tooth then needs a crown to restore its function and help protect it from future decay. Severe decay can’t always be fixed with a root canal. In these cases, the best solution is to extract the tooth and replace it with one of the many types of restorations, like a dental implant.

Similarly, a dentist can treat a dental abscess by draining the abscess, performing a root canal, and placing a dental crown over the damaged tooth, but not always. Depending on the extent of decay, sometimes the only option is to extract and replace the infected tooth. Regardless of which method your dentist recommends, they may also prescribe antibiotics to help your body fight the infection and prevent it from spreading. 

Prevention at Each Stage

The best way to prevent cavities from forming in the first place is to prevent plaque buildup with a great oral hygiene routine. Brush your teeth at least twice a day, floss at least once a day, and use mouthwash every day. It’s also a good idea to incorporate fluoride into your daily oral hygiene routine by using fluoridated toothpaste and mouthwash.

Doing so not only helps prevent cavities from forming in the first place, but it can make all the difference in resolving areas of demineralization and in helping to prevent a small cavity from getting bigger. You can also ask your dentist about sealants to protect your teeth against developing decay or fluoride treatments to help resolve areas that are beginning to show signs of decay but don’t need a filling yet.

Visiting your dentist for a regular checkup every six months is also essential when it comes to catching signs of tooth decay early. Since these appointments mean that your dentist is getting a regular look at your teeth, they can catch a small cavity and treat it before it has the chance to turn into a big cavity. If you do develop a big cavity, you can prevent it from turning into an extracted tooth by going to the dentist as soon as you notice any symptoms, such as a toothache.

It’s easy to try to ignore a toothache or brush it off, but the fact is that cavities don’t usually hurt until they have already reached the center of your tooth. As a result, it’s important to get a toothache checked out as soon as you notice it! This can make all the difference between saving and losing your tooth.

Schedule an evaluation with Dr. Desai to learn more.

Understanding cavities, including how they progress and what you can do to prevent or treat them, is key to protecting your future oral health. Thankfully, since they are so common, learning about them is very easy, and you don’t have to do it alone! If you’d like to learn more about cavities, cavity treatments, or restorative dental treatments like dental implants or a full mouth reconstruction, feel free to schedule a consultation with Dr. Desai at any time.