Cavities & Tooth Decay | Everything You Need To Know

Cavities & Tooth Decay | Everything You Need To Know

 Whitney DiFoggio MA, RDH
Written by Whitney DiFoggio MA, RDH
Medical Reviewed on Dec 10, 2023
byDr. Matthew Hannan DDS
🔬 Evidence Based
Cavities & Tooth Decay | Everything You Need To Know

Tooth decay, aka “cavities” or "dental caries", is a bacterial infection where the hard tooth surfaces start to erode, creating holes in the tooth. Some of the most common areas for them to develop include the deep pits and grooves of back teeth (molars) and between teeth where your toothbrush doesn’t clean.

It’s also one of the most common diseases to affect children. Let that sink in for just a moment! That means trips to the dentist's office account for more sick days and missed school than practically any other childhood ailment.

Fortunately, tooth decay is preventable. And diagnosing it early can prevent it from growing or spreading. When you treat cavities as soon as they’re diagnosed, you preserve as much healthy tooth structure as possible and lower the cost of any necessary dental treatment.  

Even if you feel like you’re one of those people who has always had “bad teeth”, there are things you can do to cut back on getting new cavities in the future. 

Symptoms Of Tooth Decay   

You might be thinking that pain or a toothache is the first sign of a cavity. Unfortunately, it’s not that simple. Although some cavities can and eventually do cause pain or discomfort, some of the most common symptoms to be on the lookout for include:

  • tooth sensitivity when you eat or drink something sweet (like sugary drinks and coffee)
  • something feeling “off” about your tooth while you’re chewing on it
  • feeling a rough or sharp edge with your tongue
  • food getting caught in your tooth every time you eat
  • your floss shredding when you clean a specific area
  • a bad taste coming from a specific part of your mouth

If the cavity is on a chewing surface or the smooth area of a tooth, you might also notice brown or black discoloration. In fact, the earliest stage of tooth decay is demineralization, which looks like white spots on your permanent teeth. Demineralization is what you see on people’s teeth after they just got their braces off and didn’t brush really well during orthodontic treatment; it looks like white circles where their brackets were bonded in place. It’s the side effect of acids etching away at their enamel!

Cavities on teeth don’t improve on their own. The symptoms of soreness or tooth sensitivity might even overlap with a sinus infection or gum recession. But if they don’t go away after several days or you can feel that something is wrong with your tooth, you need to see your dentist before the cavity has a chance to get any bigger. And for goodness sake, if you notice sweet sensitivity when your sipping your favorite latte or add creamer to your coffee, listen to your body. Sweet sensitivity is a huge red flag for cavities on teeth.

Cavity Prevention And Tips 

The great news is that even if you’ve had dental caries (the technical word that dentists use for cavities) in the past, you can take steps to lower your chances of getting new ones in the future. If you’re lucky enough to catch cavities while they’re still in the first phase of demineralization, you might be able to reverse the cavity altogether.  

Here’s how:

1) Brush And Floss The Correct Way

Cavities on teeth don’t just happen overnight. They’re the result of gradual plaque and acids eroding the outside layers of your enamel. To prevent that from happening, you need to physically remove the biofilm and food debris that accumulates inside of your mouth all day long.  

Yes, you have to floss every day. Yes, you have to brush twice a day. But the few minutes of day it takes to clean your teeth can save you hundreds to thousands of dollars in dental expenses years down the road.  

Brush for at least two minutes, twice per day. Even better, invest in an electric toothbrush since it offers thousands of more strokes per minute. Take care to focus on every surface in your mouth, especially along the gums to prevent gumline cavities.  

As far as flossing goes, you really want to make sure that the floss is curved tightly around each tooth so that you can slide it up and down the entire side, even just below the gums. If flossing is difficult for you, you might want to think about getting a water flosser to add into your daily routine. Your dental hygiene routine is critical for preventing cavities and controlling the bacteria in your mouth!

Related: FREE Oral Care Guide

2) Use a Fluoride Toothpaste

Also, use fluoride toothpaste to help prevent tooth decay. Fluoride strengthens tooth enamel, making it more resistant to decay caused by acids produced by bacteria in the mouth. It's an effective way to protect your teeth and maintain good oral health. Make sure to brush your teeth with fluoride toothpaste at least twice a day as part of your regular oral hygiene routine to prevent cavities.

3) Supplement With A Fluoride Rinse 

After your teeth are clean, rinse with a mouthwash that has fluoride in it. The best time to use it is right before bed so that the minerals can set on your teeth overnight when your mouth is usually drier. Just remember mouthwash does not replace flossing! It’s only as good as where it can reach, and it can’t zap through a layer of plaque.  

For those of us who may have a cavity every time we visit the dentist, you might want to ask about getting a prescription-strength fluoride that you brush or rinse with once a day. These products have a higher concentration of the mineral, so they’re stronger than what you can buy over the counter.

4) Drink More Water 

Water is a natural cleanser and lubricant, helping you combat acids throughout the day. If you’re thirsty between meals or while you’re working out, tap water is best to hydrate with. Save the sports drinks (which, by the way are known to be loaded with more sugar and acids than soda) for super-hot days or ultra-hard workout sessions, then rinse your mouth out with a ton of water afterwards.  

PRO TIP:  Most bottled water doesn’t have regulated fluoride levels in it. Your city or municipal water sources are going to have the prescribed level of fluoride. So if you’re drinking bottled water day after day, you might actually be depriving your teeth and bones of the ADA recommended fluoride levels. To play it safe (and save a few bucks) just keep a refillable bottle handy and get your H2O from the tap. Plus, it’s better for the environment because there’s no plastic waste!

5) Get Dental Sealants

Dental sealants are protective coatings can reduce the chances of getting a cavity in the chewing surfaces of your molars. They’re recommended on children. It only takes a few minutes to apply a dental sealant and no numbing or drilling is involved. 

6) Fluoride Treatments 

Yes, getting fluoride treatments is good for stopping cavities. Fluoride makes your teeth stronger and helps protect them from the bad stuff that causes tooth decay. Dentists usually give these treatments during check-ups, and using fluoride toothpaste every day also helps keep your teeth healthy and safe from cavities.

When To See A Dentist  

If you so much as suspect a cavity on your tooth, you need to see a dentist at your earliest opportunity (not months down the road.) Cavities on teeth are a ticking time bomb. One day they’re on a specific area of your tooth, but later they can creep into the nerve or spread to adjacent teeth. Putting a filling off today may mean a root canal the next time you have a dental checkup.   

The best way to reduce your chances of cavities is to see your dentist at least twice a year for a routine cleaning and exam. During your visit, your hygienist will clean away any buildup that’s harboring bacteria, then screen your tooth surfaces for early signs of demineralization or decay. That way you can stop it ASAP.  You can also ask your dentist about fluoride treatments

However – if you haven’t seen a dentist in a really long time, or don’t even have a regular dentist – you need to visit the dental office if you notice any of the cavity symptoms listed above. Pain or rough surfaces may mean your tooth is on the verge of bigger structural damage like cracking in half or getting an tooth abscess. 

Side Note: Yes, baby teeth eventually fall out. But if your child has a cavity, it can alter their natural tooth eruption patterns, cause orthodontic complications, and even spread to the permanent tooth underneath. In rare cases, dental infections can lead to facial swelling in kids, requiring hospitalization.

Causes Of Tooth Decay  

You might be thinking, “I don’t eat a lot of sugar, so I’m not at risk of getting cavities.”   But here’s the thing. You don’t necessarily have to eat sugar to get cavities on your teeth. 

Not only that, but natural sugars like what’s in fruit juice and milk, or artificial sweeteners in drinks like soda, can also lead to tooth decay.   Cavities happen when acids start to erode your enamel. And acids are a natural byproduct of plaque biofilm, which is what accumulates inside of your mouth every time you eat.

Yep. Dental plaque is basically “germ poop.”   Eating leads to plaque, plaque leads to acid, and acid leads to cavities. Some foods just produce more acids than others. And if you’re snacking more often during the day, that’s more acid exposure to your teeth. It’s estimated that each time you eat, you have about 30 minutes worth of acids coating your teeth, which is why it’s so important to clean your mouth frequently.  

Some types of cavities (like baby bottle tooth decay) are the result of extended exposure to liquids. So, if you’re someone who likes to sip on soda or a few cups of coffee all day long, you may be in for a big surprise.

Complications Of Cavities On Teeth

There are some risk factors with tooth cavities. Cavities start out small and only get bigger. When you don’t catch tooth decay early enough, you’ll need more extensive treatment once the infection is intercepted. Some of the biggest risks of an untreated cavity include:

1) Abscessed Teeth 

Once a cavity breaks through your enamel, the softer dentin layer underneath can decay at an even quicker pace. Under the dentin is the nerve of the tooth. When your nerve is exposed to bacteria, it becomes inflamed, abscessed, and starts to die. The only option for preserving your tooth at this point is to get a root canal.

2) Broken Or Cracked Teeth

As dental cavities expand into the surrounding tooth structure, your durable enamel becomes a hollow shell. The thinner and weaker it gets, the more likely it is to give way under everyday pressures of biting and chewing. If your tooth splits off, you might be lucky enough to fix it with a crown. Or, it could be so severe that the only option is to have the tooth pulled. Untreated tooth decay can lead to tooth loss. 

4) Failure Of Existing Dental Work

If you have a restoration like a crown or bridge but get decay around the edges where the underlying enamel is exposed, the supporting tooth can give way and cause the entire prosthesis to fail.

Dental Fillings Treatment

There’s really only one way to treat cavities in teeth: remove the decaying area and fill it in to reinforce the tooth. Today’s dental fillings are usually made out of tooth-colored material called “composite” or “resin”.  They’re white and come in a variety of different shades so that your dentist can select the best color to blend in with your tooth.

Some types of composite fillings also contain fluoride, helping to further protect your tooth against recurring cavities in that same area.  Plus, white fillings bond closely to your enamel, making them less invasive than traditional amalgam fillings. But to get a filling, you need to have enough healthy tooth structure left to hold it into place.

There are of course always exceptions. Sometimes amalgam (metal) fillings are still used, especially if the cavity is large or the tooth is difficult to keep dry during the treatment. And if the cavity is extensive (to the point where there’s not enough enamel left) then a crown will be the best treatment.

Tooth Decay In A Nutshell

Cavities in permanent teeth are caused by the acid byproducts of plaque biofilm and the foods/drinks that we consume. Thankfully, they’re preventable with good daily dental care and regular checkups. The symptoms of cavities include things like sensitivity, pain, rough edges, and discoloration.

Fillings are the best treatment for cavities, but sometimes a crown or root canal is necessary, especially if complications like abscesses develop. If you catch cavities in the earliest stages, you can prevent the bacteria from eroding totally through your enamel. See your dentist at least every six months to help reduce your risk of tooth decay and intercept it when it’s small.

 Whitney DiFoggio MA, RDH
Written by Whitney DiFoggio MA, RDH"Teeth Talk Girl," is a registered dental hygienist. She started her dental health journey on YouTube, educating the public through videos.
Dr. Matthew  Hannan DDS
Medical Reviewed byDr. Matthew Hannan DDSDr. Matthew Hannan is a board-certified dentist and graduate of UT Health San Antonio School of Dentistry.
Last updated onJanuary 18, 2024Here is our process

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