Teeth Cavities: Symptoms, Causes, Prevention & Treatment

Teeth Cavities: Symptoms, Causes, Prevention & Treatment

Teeth Cavities: Symptoms, Causes, Prevention & Treatment

Poor oral hygiene is an epidemic in our world. Almost half of Americans have gone more than three years without seeing a dentist, which often leads to untreated cavities.

What is a cavity? A cavity is a permanent hole that forms in your tooth. It starts as a small area of tooth decay, but grows larger. Cavities are not painless when they begin but eventually cause pain when not treated.

Are cavities bad? Cavities (AKA tooth decay or “dental caries”) are one of the leading health problems in the world. They’re the #1 most common preventable disease worldwide.

The American Dental Association recommends we brush our teeth for two minutes at least twice a day, which is one way to prevent tooth decay. Yet, only ¾ of Americans brush their teeth twice a day.

On the upside, the incidence of cavities has gone down per person over the past 50 years. This may be attributed to increased access to healthcare, quality of healthcare, fluoride treatment in the public water supply, and increased education.

How can cavities be reversed or healed? Small areas of tooth decay that have not passed the dentin layer may be reversed, in some cases, by promoting remineralization and the health of the oral microbiome. But by the time you feel the pain of a cavity, they are irreversible.

Dentists can treat cavities and stop further tooth decay with the following treatments:

  1. Fillings
  2. Crown
  3. Root canal
  4. Extraction

Symptoms of Cavities/Tooth Decay

Here are the symptoms of cavities/tooth decay:

  • Toothache
  • Tooth sensitivity
  • Visible pits/holes in your teeth
  • Brown, black, or white staining on your teeth

Some symptoms of cavities appear or are exacerbated by eating or drinking something hot, cold, or sweet.

When to See a Dentist

Visit your dentist every 6 months. Even when your teeth don’t hurt and your daily oral hygiene routine is perfect, go to your dentist twice a year.

If you feel tooth pain, make an appointment with your dentist right away.

When are your symptoms bad enough to see a doctor? Any toothache should be examined by a medical professional. It’s most concerning when a toothache is around 1-3 teeth, which is more likely to signal a cavity.

Toothaches or tooth sensitivity throughout the entire mouth may be a sign of a different issue, but it’s still important to work with your dentist to address the pain.

How many cavities are normal? No definite number exists, but the average person gets about four cavities in their life.

What causes cavities?

Plaque causes cavities. The acids in plaque demineralize your teeth, causing little holes to form. These holes can penetrate deeper levels of your teeth and eventually cause constant pain and discomfort.

Can you see cavities?

When a cavity goes untreated, it is easy for a dental professional to spot. Dentists will use a mirror to look in your mouth during a dental exam. They may also use x-rays to most precisely find dental cavities.

Eventually, even an untrained eye can see the discoloration that indicates a cavity.

Can cavities go away?

Since a cavity is a hole, you can’t “brush away a cavity.” Once a cavity develops, the damage is done.

You can slow down tooth decay, but conventional dentists typically believe “drill and fill” is the right answer.

Some functional dentists believe teeth possess the natural ability to remineralize and at least partially fill the cavities.

Risk Factors for Getting Cavities

There are various risk factors for plaque formation, which leads to tooth decay:

  • Consuming sugar (in food or drinks)
  • Snacking in between meals
  • Not brushing or flossing correctly and/or every day
  • Dry mouth, or medications that reduce saliva
  • Anorexia, bulimia, or other eating disorders
  • Acid reflux, heartburn
  • Young age (under 18)
  • Older age (over 65)

Your back teeth are more likely to get cavities than your front teeth. This is because these teeth have a lot of pits and grooves, and they’re also more difficult to effectively brush.

Complications of Untreated Cavities

These are the complications of tooth decay if your cavities go untreated:

  • Persistent tooth pain
  • Difficulty chewing
  • Pus or swelling around your tooth
  • An abscess in your tooth, which can trigger infection
  • Increased risk of breaking or chipping your tooth
  • Lack of self-confidence
  • Tooth loss

How to Prevent Cavities

  1. Brush your teeth at least once a day
  2. Floss daily
  3. Reduce sugary foods and drinks
  4. Dental sealants
  5. Dietary changes
  6.  

These five steps towards cavity prevention can also prevent gum disease and overall dental health.

1. Brush Your Teeth At Least Twice a Day

Ideally, we should brush our teeth after every meal and before we go to bed.

Sonic toothbrushes are more effective than manual toothbrushes.

Soft bristles are a must. Hard bristles can actually damage your gums.

A three-headed toothbrush is a novel approach to getting a better, faster clean. The three-headed toothbrush could effectively replace the traditional toothbrush.

Using three brush heads, these triple-headed toothbrushes clean hard-to-reach areas of your mouth, and your teeth are clean in (less than) half the time.

A triple-headed brush can efficiently remove plaque that could otherwise harden into tartar.

An average person brushes their teeth marginally better with a three-headed brush. However, caregivers who must brush someone else’s teeth seem to have more success with a three-headed toothbrush.

Also, mothers seem to be able to brush their child’s teeth more effectively with a triple-headed toothbrush.

Many dentists and government organizations recommend fluoride toothpaste because it helps remineralize teeth.

However, some worry about fluoride’s toxicity in large amounts and when swallowed, especially by children.

Your dentist may also recommend a mouthwash. But don’t your mouth immediately after brushing your teeth because it can rinse away fluoride that needs to “sit” on your teeth. That is, if you’re using fluoride toothpaste (or an alternative like hydroxyapatite toothpaste).

2. Floss Daily

The overwhelming consensus in the dental community is that flossing daily is required to prevent early stages of gum disease, and reduce risk of tooth decay.

Only about one third of American adults floss daily, which may contribute to the prevalence of cavities in the US.

Floss daily to remove plaque that grows in between your teeth, where toothbrushes may not reach.

If for some reason, you can’t brush your teeth after a meal, flossing is a good alternative. Don’t make a habit of it, but if you’re on the go, flossing can pass for cleaning your teeth after eating.

If you have sensitive gums, you can find a soft floss that is kind to your gums but tough on plaque.

For children, it is generally accepted that children can begin flossing their own teeth by the age of six or seven. Until then, parents should floss the child’s teeth — starting when the child has two neighboring teeth.

Can’t find the motivation to floss? Check out this article!

3. Reduce Sugary Foods and Drinks

High-sugar foods and drinks feed the bacteria that forms plaque and eventually tartar. Starving the bacteria of sugar is an effective way to slow tooth decay.

Sugary foods include:

  • Cereals
  • Condiments (like ketchup or BBQ sauce)
  • Salad dressing
  • Dried fruit
  • Peanut butter
  • Sweet potato
  • Jams and jellies

Sugary drinks include:

  • Non-diet sodas
  • Fruit juices
  • Energy drinks
  • Coconut water
  • Sweet tea
  • Beer
  • Tonic water
  • Coffee drinks

Ultimately, drinking water is a great way to prevent dry mouth (which leads to plaque formation) and avoid sugary drinks. Also, most of the water supply in America has been mineralized with enough fluoride treatment to promote a healthy tooth surface.

4. Dental Sealants

Dental sealant is a plastic coating that dentists often put over your back teeth.

They seal off the pits and grooves that easily collect food particles and are less easily brushed, protecting your tooth enamel from dental plaque and acid.

According to a systematic review, the best sealant at a 12-month checkup is made of composite resin.

5. Dietary Changes

Eating certain kinds of foods may help prevent tooth decay:

    • Dairy products are often rich in calcium and promote saliva.
    • Leafy greens contain calcium, folic acid, and other great vitamins and minerals that help fight plaque and support dental health.
    • Fiber-rich vegetables help keep your teeth and gums clean. They also promote saliva production.
    • Xylitol is a good substitute for sugar. Bacteria cannot use xylitol for energy, like they do with sugar. Xylitol gum after a meal has been shown to produce saliva and dispose of food particles.
  • Fluoride can be found in seafood, raisins, wine, and tap water. Fluoride strengthens teeth, even though it can be toxic when ingested in large amounts.

Green tea and black tea are both anti-inflammatory sources of fluoride that can also reduce plaque-forming bacteria and acids that lead to cavities. Of course, the tea needs to be unsweetened to do you any good.

And of course, reduce your sugar intake. The bacteria in plaque feeds off of sugar.

These dietary changes can help fight tooth decay and supplement your other dental care practices.

Cavity Restorations (Fillings, Root Canal, Extraction, etc.)

Cavity restorations are important in preventing further tooth decay and relieving chronic pain, sensitivity, and discomfort.

  1. Fillings
  2. Crown
  3. Root canal
  4. Extraction

These are the four cavity treatments a dentist may perform to treat a cavity, along with the cost and invasiveness of each.

Fillings

Dental fillings replace the decayed part of your tooth, closing off the vulnerable parts of your teeth from bacteria.

A dental professional will remove decayed portions of your tooth, and fill it in with gold, porcelain, silver amalgam, or a composite material.

Invasiveness

Although considered “non-invasive,” a dentist will need to keep your mouth open for an extended period of time to fill in a cavity.

Fillings are considered safe for patients with low blood count, such as cancer patients.

Cost

Most dental insurance policies cover fillings.

Without insurance, fillings can cost between $50 and $250, depending on what the filling is made of.

However, if you’re a big spender, you can spend thousands on a gold inlay/onlay — these last the longest of all filling materials, so it may be worth it.

Crown

A crown is a cover put over your tooth. Also known as a cap, a dental crown restores your tooth back to its former shape, size, and/or function. Generally, dental crowns are used in conjunction with fillings or root canals, but can be used on their own.

A crown may be to improve your smile or strengthen your teeth. A crown can be made of porcelain, metal alloys, or a composite resin.

You may need a crown if:

  • Your tooth requires a very large filling
  • You just had a root canal
  • You have a crack in your tooth
  • You have a worn down or weakened tooth
  • You would like to cover up a discolored or oddly shaped tooth

Invasiveness

Crowns are about as invasive as fillings. Considered “non-invasive,” crowns may cause some discomfort. But a crown placement is one of the least invasive dental treatments.

Crowns are considered safe for patients with low blood count.

Cost

Without good dental insurance, a crown can cost between $600 and $3000.

Interestingly, porcelain crowns are more expensive than gold crowns.

Root Canal

A root canal involves the removal and cleaning of decayed or infected pulp (inner tooth).

A root canal may be necessary because of the following:

  • Deep tooth decay
  • Faulty crown
  • Crack or chip in tooth
  • Repetitive dental procedures

Invasiveness

Root canals are designed to be as non-invasive as possible. However, there may still be discomfort with the dental professional working in your open mouth and getting inside your teeth.

The root canal procedure requires more numbing agents than a filling and is sometimes performed under sedation for patients suffering from dental anxiety.

Root canals are non-invasive enough to be considered safe for patients with low blood count.

Cost

Root canals on molars are more expensive than other teeth. The more complex the problem, the more it will likely cost to have a root canal.

Most dental insurance plans provide at least partial coverage for root canals.

Without insurance, a root canal can cost around $1000.

Extraction

“Extraction” is the medical term for pulling teeth. A dentist may need to extract teeth because of infection and tooth decay.

Your dentist may cut away gum tissue to jostle the tooth loose.

It is almost always advisable to get a dental implant after an extraction. Otherwise, teeth may shift due to the newly open space and may negatively impact the bite.

Invasiveness

Extractions may be surgical or non-surgical. They almost always come with anesthesia.

A dental extraction is considered “invasive.”

Extractions are not considered safe for patients with low blood count.

Cost

Without insurance, simple extractions may cost up to $200 per tooth. More complex extractions may cost up to $600.

Certain types of anesthesia can always increase your out-of-pocket cost.

Dental implants may cost considerably more, so you may want to calculate that cost before getting a tooth extraction.

Can you get rid of cavities?

Using the cavity restoration methods above, dentists can treat cavities to effectively get rid of them. They are not “cured,” but the infection that caused the hole is removed and the tooth is restored.

“Functional” or dentistry does have its own ideas about reversing cavities and tooth decalcification.

In short: Teeth in the early stages of tooth decay may be remineralized with a diet rich in vitamins and minerals such as calcium, phosphorus, and vitamins D and K2. These methods also involve management of the oral microbiome and may suggest unconventional treatment strategies like mouth taping or supplementation.

This natural method of healing cavities may appeal to those with fear or apprehension about going to the dentist and invasive dental exams.

How Cavities Form

Cavities form over time, due to dental plaque breaking down tooth structure.

Plaque is a film that forms a sticky coat over your teeth and under your gum line. This film buildup contains a great deal of bacteria in concentrated areas on teeth. Plaque can be removed with good oral hygiene, such as brushing your teeth after meals and flossing every day.

Plaque can eventually form tartar (AKA calculus). Tartar acts as a more permanent layer of bacteria that shields other bacteria. It’s a vicious cycle. Only a dentist can remove tartar.

The acids in plaque and tartar attack the minerals in your teeth. This slowly gets rid of your tooth enamel, leading to small holes in your enamel — that’s the start of a cavity.

The next layer of your teeth is dentin, which is less resistant to acid than the enamel. Your dentin contains direct connections to your nerves, increasing tooth sensitivity.

The bacteria and acid in plaque and tartar eventually breaks through your dentin, all the way to the inner tooth — called pulp. Your pulp contains blood vessels and nerves, which can get swollen and inflamed, triggering pain and discomfort.

What is demineralization?

Demineralization is the process of plaque deteriorating the enamel, then the dentin, then the pulp in your teeth.

When your teeth demineralize, it can eventually form little holes, also known as cavities.

What is remineralization?

Remineralization is the natural process of good oral hygiene practices restoring the minerals in your teeth.

Your teeth possess the natural ability to heal themselves through remineralization. There is recent research to back up these claims.

Remineralization and demineralization occur constantly throughout every day (even while you sleep), so preventing cavities means making sure your teeth are remineralized more regularly than they are demineralized.

What do cavities look like?

You may be able to spot a cavity by just looking in a mirror. Cavities can appear black or as dark spots on your teeth.

Cavities/Tooth Decay Statistics

  • 17% of children under 20 years old have untreated cavities, according to the CDC.
  • About 64% of adults in the US have not had a dental visit in the past year.
  • By the age of 64, 92% of adults have had a cavity in their permanent teeth.
  • White adults seem to experience more tooth decay.
  • Black and hispanic adults seem to have more untreated tooth decay.
  • Although smoking is horrible for your oral health and overall health, smoking does not seem to significantly contribute to dental caries. (However, you’ll have bigger problems than cavities if you keep smoking.)

Sources

  1. Kulkarni, P., Singh, D. K., & Jalaluddin, M. (2017). Comparison of efficacy of manual and powered toothbrushes in plaque control and gingival inflammation: A clinical study among the population of East Indian Region. Journal of International Society of Preventive & Community Dentistry, 7(4), 168. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558249/
  2. Zimmer, S., Öztürk, M., Barthel, C. R., Bizhang, M., & Jordan, R. A. (2011). Cleaning efficacy and soft tissue trauma after use of manual toothbrushes with different bristle stiffness. Journal of periodontology, 82(2), 267-271. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/20722532
  3. Azrak, B., Barfaraz, B., Krieter, G., & Willershausen, B. (2004). Effectiveness of a three-headed toothbrush in pre-school children. Oral health & preventive dentistry, 2(2).Abstract: https://www.ncbi.nlm.nih.gov/pubmed/15646943
  4. Ashkenazi, M., Salem, N. F., Garon, S., & Levin, L. (2015). Evaluation of Orthodontic and Triple-headed Toothbrushes When Used Alone or in Conjunction with Single-tufted Toothbrush in Patients with Fixed Lingual Orthodontic Appliances. A Randomized Clinical Trial. The New York state dental journal, 81(3), 31-37. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/26094361
  5. Kalf?Scholte, S. M., Van der Weijden, G. A., Bakker, E. W. P., & Slot, D. E. (2018). Plaque removal with triple?headed vs single?headed manual toothbrushes—a systematic review—. International journal of dental hygiene, 16(1), 13-23. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/28544459
  6. Oliveira, L. B., Zardetto, C. G. D. C., de Oliveira Rocha, R., Rodrigues, C. R. M. D., & Wanderley, M. T. (2011). Effectiveness of triple-headed toothbrushes and the influence of the person who performs the toothbrushing on biofilm removal. Oral health & preventive dentistry, 9(2). Abstract: https://www.ncbi.nlm.nih.gov/pubmed/21842016
  7. Fleming, E. B., Nguyen, D., Afful, J., Carroll, M. D., & Woods, P. D. (2018). Prevalence of daily flossing among adults by selected risk factors for periodontal disease—United States, 2011–2014. Journal of periodontology, 89(8), 933-939. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434526/
  8. Terézhalmy, G. T., Bartizek, R. D., & Biesbrock, A. R. (2008). Plaque?removal efficacy of four types of dental floss. Journal of periodontology, 79(2), 245-251. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/18251638
  9. Condò, R., Cioffi, A., Riccio, A., Totino, M., Condò, S. G., & Cerroni, L. (2013). Sealants in dentistry: a systematic review of the literature. ORAL & implantology, 6(3), 67. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3982302/
  10. Chavan, S., Lakashminarayan, N., & Kemparaj, U. (2015). Effect of chewing xylitol containing and herbal chewing gums on salivary mutans streptococcus count among school children. International journal of preventive medicine, 6. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455121/
  11. Chatterjee, A., Saluja, M., Agarwal, G., & Alam, M. (2012). Green tea: A boon for periodontal and general health. Journal of Indian Society of Periodontology, 16(2), 161. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3459493/
  12. Komar, K., Glavina, A., Vu?i?evi? Boras, V., Verzak, Ž., & Brailo, V. (2018). Impact of Smoking on Oral Health: Knowledge and Attitudes of Dentists and Dental Students. Acta stomatologica Croatica, 52(2), 148-155. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047590/
  13. Philip, N. (2019). State of the art enamel remineralization systems: the next frontier in caries management. Caries research, 53(3), 284-295. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6518861/

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