What is a dental cavity?
A dental cavity is where bacteria have started to eat through the tooth. As that bacteria begins to erode and decay the tooth, a common misconception is that sugar causes cavities. It's not sugar directly. What happens is the sugar feeds the bacteria. Imagine you have this bad thing in your mouth, and the sugar is making it stronger, fueling the bacteria to decay your tooth. Whenever that decay grows, it creates a hole, and the word cavity means hole.
What causes cavities?
There's a variety of things that can cause cavities. The number one cause is not brushing or flossing, neglecting normal routine dental hygiene. We often see stuff build up on the teeth, like sticky white plaque. Plaque is filled with billions of bacteria and can be a combination of bacteria and food. The bacteria take in what we eat, especially sugar. That's why you hear sugar is bad for your teeth because it fuels the bacteria. We can enjoy sugar as long as we clean and brush our teeth.
Other things that can fuel bacteria include carbohydrates, which break down to sugar. Examples are pasta, rice, potato chips, crackers, and even fruit. You don't need to stop eating these; just ensure you maintain proper oral hygiene. Other causes are acids and sodas that weaken the teeth, allowing bacteria to invade.
In a dental office, we check for cavities by taking X-rays. Your tooth is supposed to be a solid structure with different layers: enamel, dentin, and the nerve and blood vessel at the center. Did you know your tooth is actually an organ? We take an X-ray to see all those layers and check for shadows indicating breakdown, often caused by cavities. X-rays help us hone in on areas, but we also perform an exam to feel for weakened spots. We want to catch any issues early to prevent pain, infection, or the need for advanced treatment. We explain the different stages of a cavity, as treatment depends on the stage.
There are five stages: E1 and E2 (enamel) and D1 through D3 (dentin). As you progress through stages, it means the cavity is deeper. In our practice, if you have an E1 or E2 cavity, we can heal and reverse it without drilling, fillings, or crowns. We can regrow your enamel, providing conservative treatment. When cavities reach the D1 through D3 stage, they're in the dentin and irreversible, often requiring a filling. At the D3 stage, the cavity may be near the nerve, causing pain and possibly needing a root canal or crown. We aim for conservative treatment, using a procedure to heal and protect the nerve, preventing root canals and sensitivity. We ensure you receive the best care with long-lasting, comfortable outcomes.
Can cavities spread to other teeth?
It's important to know cavities can spread to other teeth. A cavity is caused by bacteria, making it a bacterial infection. Bacteria on one tooth can spread to others. The mouth is a community. If one tooth has a cavity, it can easily spread. When cavities go untreated, they multiply. We want to catch it when it's just one, preventing it from growing to more. It's costly and unpleasant to deal with multiple cavities.
If you ask if a cavity can go away by improving oral hygiene, the answer depends on the stage. An E1 lesion might improve with brushing and flossing, but typically, we need to add something to help it go away. We use remineralizing agents and hydroxyapatite, a mineral in our teeth, to repair lesions in enamel. Once a cavity reaches the dentin, it's there to stay and will grow until treated.
How can we stop cavities from progressing?
Prevention is key in my practice. While I can fix teeth all day, my job is to prevent problems. Hygiene is the most important factor. Imagine a car never cleaned or serviced; it will eventually break down. The body is the same. If neglected, it will deteriorate. Good oral hygiene is essential. Many tools can improve hygiene, and I provide patients with the best options.
Tools include electric toothbrushes, water picks, and better oral care products than over-the-counter options. If you've never had a cavity, over-the-counter products might be fine, but if you've had cavities, prevention is crucial. No matter your dental history, you can stop the progression. My goal is not just to fix teeth, but to empower you to control your oral health and prevent future issues.
How long does a cavity filling last?
If you research this, you'll find a cavity filling typically lasts about seven years. That's not long. If you're in your 20s or 30s and have a filling, you'll need it replaced multiple times over your life. You can extend a filling's life by maintaining good oral hygiene. Flossing, brushing, using quality toothpaste, and regular cleanings help. Cleanings ensure thorough cleaning, extending the life of a filling. Our goal is to minimize unnecessary dental treatments, keeping them limited to what's necessary. That's how long dental fillings last.
Do dental cleanings prevent cavities?
Yes. When we perform a cleaning, we're thorough, removing things that could cause cavities. Research shows that saliva tested before a cleaning has high bacteria levels. After a thorough cleaning, bacteria levels drop. Cleanings are recommended every six months because that's how long it takes for bacteria to return to pre-cleaning levels. Regular cleanings reduce bacteria, preventing cavities and making you more resistant to other diseases. It's important to attend cleanings on schedule to maintain oral health.
What should I do if I suspect I have a cavity?
If you suspect you have a cavity, whether at home, on the road, or at a restaurant, you should call Inspire Dental. If you feel sensitivity to pressure, cold, hot, or sweets, it could indicate a cavity. The best action is to address it immediately. Coming in for an appointment, even if it turns out to be nothing, provides peace of mind. If there is a cavity, catching it early ensures smaller, less expensive, and less painful treatment. Early detection also ensures the treatment lasts longer. That's the best course of action if you suspect a cavity.
Is toothbrushing the only way that we can prevent a cavity?
In short, the answer is no. I actually have lots of people who are really good at brushing their teeth and still have cavities. A second part of that goes along with brushing is flossing. Flossing helps loosen up food and bacteria in between the teeth, and brushing is used to brush them away. If we don't accompany flossing to some degree with our toothbrushing, we're still going to be prone to getting cavities.
Also, what is our technique of brushing? Are we using the right technique? Are we using the right type of toothpaste? There are very specific techniques used. A lot of times, people will saw back and forth, and you actually want to create circles when you're brushing. Imagine you're scrubbing every tooth, making a circle. It's not the power in which you scrub, but really the technique and then using the toothbrush long enough to clean the tooth. Other ways that can create cavities include our diet. If we're eating lots of things that are going to weaken the teeth, no matter how much we brush or floss, it's going to weaken our teeth. We're going to be prone to cavities.
There are also medical conditions that can create cavities or promote cavities. Diabetes, for example, when uncontrolled, will cause our saliva to contain sugar. Sugar feeds the bacteria, which then creates a cavity. Even diet can contribute or promote cavities. Lastly, if we have a lot of acid, either if we throw up a lot or have acid reflux, that acid coats our teeth and starts to weaken them, and bacteria thrive in an acidic environment. Even acids and things like that that enter our mouth can weaken the teeth and create cavities.
How worried should I be about a cavity or if I have one?
What I tell patients is the best time to treat a cavity is, one, when it's spotted, and two, when it's not hurting. Very often, I'll show someone, "Hey, you got this cavity in your tooth," and the question I get asked is, "Well, hey, it's not hurting. Do I have to treat it?" If it's not hurting, that is a good sign because it means it's still small. By the time it's starting to hurt, it means it has progressed, and there's a very high likelihood that you're going to need a root canal, a crown, or maybe even need the tooth pulled out. There are times I've seen teeth decayed all the way through with no pain at all. The best time to treat a cavity is not when it's hurting, but actually before that time comes. That is the best time to treat a cavity.
Is it too late to treat a cavity when it's already hurting?
The answer is no. The moment it starts to hurt, it might need more advanced treatment. The best thing is to come in and assess to see where it's at and hopefully we can get it still at a point where it can be treated and the tooth can be saved and not have to be pulled.
How do you treat cavities?
There are many ways to treat a cavity. At its smallest level, it is treated with an agent that heals and repairs the tooth itself. That's called remineralization, and that's done when we have a really small cavity. As the cavity starts to grow and becomes medium to large, those can often be treated with a filling, and sometimes we have to add a protective layer so the tooth is not sensitive after the cavity.
As we move into the larger category, we're running the risk of needing a root canal or a crown to treat that cavity. As things start to grow, more advanced treatment is needed. It's important to note that there does come a time where the tooth has had so much decay that the cavity is so big it's not restorable anymore. When it's not restorable, we're talking about pulling the tooth and then treating it with a bridge, a partial, or an implant. Those would be the life patterns of a tooth and the recommended treatments at the size of the cavity.
Can a cavity that has been treated and filled come back?
It is possible for it to come back. Many people think it's one and done, but it's not. The very thing that caused the cavity to form in the beginning is the very thing that can continue that cavity to form. If we had one before, it means the filling is man-made. When it's put into the tooth, it has a seal. If we are not keeping our mouth clean, that seal breaks down over time. If you look at the average life of a filling, it's about 7 years. The average life of a crown is 10 years.
The number one reason I, as a dentist, have to replace old fillings or crowns is because of new decay, not because something breaks down. It's almost always due to a new cavity. It is important to know that if you had a filling or restoration placed, you must keep it really clean to prevent further decay from coming back.
How do I prevent cavities?
The most important thing, now that we know cavities can come back, is preventing them. How do we prevent them? By coming in for your normal routine cleanings and dental exams. If you have any suspicion, if you start to see discoloration or things feel a little sensitive, come in right away.
As for prevention methods, brushing and flossing twice a day is your number one thing. The best way to brush your teeth is with an electric toothbrush. The best way to floss your teeth is with a water flosser. These are the methods research has proven to be most effective.
Of course, using the right type of toothpaste and mouthwashes, and there are even things like probiotics now to promote good bacteria in the mouth, can help. By doing so, you're less likely to develop gum disease or tooth decay. These are our ways to prevent cavities through hygiene and normal preventative dentistry.
How do I schedule an appointment with Inspire Dental?
The best thing you can do is to schedule an appointment. We are always accepting new patients in our office. We never turn anyone away. The best thing you can do is just give our office a call. We want to get you in, see you, and address that concern immediately.
At Inspire Dental, you come first. Whether you need dental care or simply have questions, call us at (210) 972-0768 or email [email protected] to schedule your visit. Our team is here to help you every step of the way.