Cavities/ Tooth Decay

1 What are Cavities/ Tooth Decay?

Cavities, also called tooth decay or caries, refer to the destruction of teeth primarily caused by bacteria present in your mouth.

Other factors like improper cleaning of teeth, increased consumption of sugary substances can also contribute to the decaying process. Decaying of teeth can lead to formation of holes.

Cavities are one of the most common health problems throughout the world. Though common among children, teenagers and older adults, it can affect people of any age group.

If not treated, cavities can expand and affect deeper layers of your teeth, often resulting in severe toothache, infection and tooth loss. Cavities and tooth decay can be prevented by regular dental check-ups, proper brushing and flossing habits.

2 Symptoms

You may experience a variety of signs and symptoms of Cavities/ Tooth Decay depending upon which part and how much of the tooth is destroyed. The symptoms start appearing as the tooth decay affects a larger area of your tooth.

  • Toothache: Increased sensitivity, pain that worsens when exposed to hot, cold foods or drinks
  • Visible hole or spot in your teeth
  • Brown, black or white staining on any surface of a tooth

When to see a dentist?

The early symptoms of tooth decay may not be noticeable. So, you are recommended to have a regular dental check-up. Visit your dentist immediately if you experience toothache or mouth pain.

3 Causes

Tooth decay that develops over time is the main cause of cavities.


The process of tooth decay involves:

  • Plaque formation: Many bacteria naturally occurring in your mouth feed on the sugars you eat and convert them to acids, forming a sticky coat on teeth, bacterial plaque. The plaque feels rough when you run your tongue along your teeth. The plaque provides a suitable environment for bacterial growth and should be removed when it’s soft.
  • Plaque attack: In the first stage of cavities, acids present in the plaque degrade minerals of tooth’s enamel and erode your tooth, leading to holes in the enamel. After complete erosion of the enamel, the bacteria and acid invade a deeper layer called dentin.
  • Destruction continuation: After invading dentin, the bacteria and acid move deeper into an inner nerve and blood vessel-rich layer, pulp. This is when you start experiencing a severe toothache, sensitivity, pain when biting or other symptoms. An abscess may form in your tooth as your body launches immune attack against the bacterial attack.

4 Making a Diagnosis

If you experience pain or sensitivity in your teeth and suspect cavities/tooth decay, visit your dentist so to receive a diagnosis.

How to prepare yourself for the visit?

Getting prepared for the visit can optimize the therapy and help make the visit more fruitful:

  • Make a list of all medications, vitamins or other supplements.
  • Make a list of the questions to ask your doctor. Some typical question can be:
  • Do I have a cavity? If yes, what’s the severity?
  • Do I need a crown or a root canal?
  • How long will it take for a full recovery?
  • Can I take non-prescription pain reliever for the pain?
  • How long should I wait before I eat or drink after this procedure?
  • How can I prevent cavities?

What your doctor wants to know?

  • Do you experience pain when taking too hot or too cold foods?
  • Does biting down worsen your pain?
  • Does your toothpaste contain fluoride?
  • How often do you floss?
  • Do you eat a lot of sweets or drink sugary beverages or sodas?
  • What are the medications you are currently taking?

What you can do in the meantime?

While waiting for your appointment, you may take over-the-counter pain relievers if your pain is unbearable.

Here are some tips that help you manage the condition before the treatment starts.

  • Thoroughly clean all parts of your mouth and teeth, don’t miss the painful areas.
  • Use warm water to brush your teeth.
  • Use a toothpaste that contains fluoride. You may use a toothpaste designed for tooth hypersensitivity.
  • Avoid pain triggers such as too hot, too cold or too sweet foods or beverages

Your dentist starts the diagnosis by asking about tooth pain and sensitivity. S/he may examine your mouth and teeth, and use dental instruments to look for soft areas. Dental X-rays may be taken to determine the extent of cavities and decay.

5 Treatment

Treatment depends upon location and severity of the cavities and tooth decay. 

Regular checkups could identify the cavities before they progress into severe forms.

If treated at its earliest, cavity won’t cause serious outcomes like infections or tooth loss. 

Treatment options include:

  • Fluoride treatments: Using fluorides in the earliest stage of cavity may help restore enamel. Medical fluoride treatments have a fluoride content higher than that in tap water, over-the-counter toothpaste and mouth rinses. They are available in various forms like liquid, gel, foam.
  • Fillings: Fillings, sometimes called restorations, are the substances that are filled in the holes in your tooth. These are used when decaying process has reached deeper layers. Commonly, fillings are made of tooth-colored composite resins, porcelain or combinations of several materials.
  • Crowns: If your tooth decay is severe, crowns may be placed over the tooth root to replace your tooth's entire natural crown. Crowns may be made of gold, porcelain, resin, porcelain fused to metal or other materials.
  • Root canals: In root canal treatment (RCT), the infected tooth pulp is removed to prevent further complications. The pulp is replaced with a filling. It is implemented when the decay has reached the nerve rich area of your tooth, pulp.
  • Tooth extractions: This is the ultimate treatment for tooth decay which involves removal of the decayed tooth. The gap left behind may be filled by a bridge or a dental implant.

6 Prevention

Good oral hygiene is the key to prevent cavities and tooth decay.

Some tips to prevent cavities are:

  • Brush your teeth with fluoridated toothpaste, at least twice a day.
  • Rinse your mouth with a mouth rinse that contains fluoride.
  • Get regular dental checkup: Visiting your dentist regularly can help prevent cavities or detect them early.
  • Consider dental sealants: A sealant is a protective plastic coating that protects tooth enamel from plaque and acid. The Centers for Disease Control and Prevention recommends sealants for all school-age children.
  • Drink some tap water: Tap water contains fluoride which is an anti-caries agent.
  • Avoid frequent snacking and sipping: Frequent snacking and sipping can load your mouth with sugars which the bacteria convert to acids.
  • Consider fluoride treatments: If the fluoride you are getting is not enough to prevent dental caries, you may consider fluoride treatments.
  • Ask about antibacterial treatments: Your dentist may recommend special antibacterial mouth rinses if you are at a higher risk of dental caries and tooth decay.

7 Risks and Complications

There are several risk factors associated with Cavities/tooth decay. Risk factors include:

  • Tooth location: Tooth decay commonly affects your back teeth (molars and premolars) because these teeth have lots of grooves and pits that can collect food particles.
  • Certain foods and drinks: Certain foods that are high in sugar content and tend to stay on your teeth for a long time increase your risk of cavities.
  • Frequent snacking or sipping: More sugar can stay in your mouth and give opportunity for the bacteria to produce more acids.
  • Bedtime infant feeding: Sugar can stay longer in your baby’s mouth and increase acid production. This damage is often called baby bottle tooth decay.
  • Inadequate brushing: Plaque formation is frequent and rapid in people who do not brush after eating and drinking.
  • Not getting enough fluoride: Fluoride is an anti-caries agent that makes tooth minerals more resistant to the acids produced by bacteria.
  • Younger or older age: Cavities are common among children and adults.
  • Dry mouth: Saliva helps decrease the contact time between food particles and bacteria. It also contains substances that counter the acid produced by bacteria.
  • Worn fillings or dental devices: Ill-fitted dental devices and old fillings can provide room for the bacteria to grow.
  • Eating disorders: Anorexia and bulimia can lead to significant tooth erosion and cavities.
  • Heartburn. Heartburn or gastroesophageal reflux disease (GERD): The reflux of stomach acid into your mouth can destroy the tooth enamel.

Risks and Complications

  • Pain
  • Tooth abscess Pus around a tooth, especially when you press on your gums
  • Broken teeth
  • Chewing problems
  • Shifts of other teeth after tooth extraction
  • Pain associated with tooth decay can interfere with your daily activities, for example you would not wish to have a dental pain before a major corporate presentation.
  • Tooth loss