Tooth Decay (Cavities):Signs, Causes & Treatment Options

What is Tooth Decay?

Tooth decay is the softening of your tooth enamel and damage to the structure of the tooth due to plaque bacteria. They break down sugar in your mouth subsequently leading to acid creation. Plaque, a sticky film of bacteria, forms on your teeth due to foods and drinks containing excessive sugars. A dental cavity, also known as tooth decay is one of the most common dental diseases.

What Causes Decay in Teeth?

• Poor Oral Hygiene

  Lack of proper brushing allows plaque build-up that attacks the tooth enamel.

• Plaque Formation

  The starch from your foods can overtime adhere to your teeth forming a plaque buildup.

• Dry Mouth

  A dry mouth due to little saliva, is a breeding ground for plaque and tooth bacteria build up.

• Eating & Drinking

  Food particles from too many bad and sugary carbs in your diet are one of the main causes of tooth decay. They are difficult to remove even after brushing and cling onto your teeth risking a tooth cavity.

• Plaque Bacteria and Acid

  The natural bacteria in your mouth digest the carbohydrates that linger on your teeth to form harmful acids.

• Medical Problems

  Some cancers and their treatments may expose the head and neck to radiation developing a tooth cavity.

What are the Different Types of Tooth Decay?

Tooth decay can develop in different areas of your teeth. Understanding these types helps you recognize symptoms early and seek the right treatment.

• Pit and Fissure Decay

  This decay occurs on the chewing surfaces of your back teeth—molars and premolars. These areas have grooves that trap food and bacteria, making them prone to cavities. Dental sealants are a common preventive treatment for pit and fissure decay.

• Smooth Surface Decay

  Found on the flat, smooth areas of your teeth, this type of decay usually develops between teeth or on the fronts and backs. Poor brushing and flossing habits allow plaque buildup here. Fluoride treatments and proper flossing can help prevent it.

• Root Decay

  Common in adults with receding gums, root decay attacks the exposed root surfaces of teeth. Because roots lack the enamel enamel protection, decay can progress rapidly, so early dental care is critical.

More than 80% of Americans have at least one cavity by the time they enter their mid-30s (Source)

What are the Symptoms of Tooth Decay?

• Toothache that is either a continuous pain or an occasional sharp pain
• Tooth sensitivity gives rise to tenderness and mild or sharp pain in the tooth due to hot, cold, or sweet food and drinks
• Grey, brown or black staining on your teeth
• Bad breath
• An unpleasant taste in your mouth
• Visible holes or pits in your teeth
• Pain when biting down

What are the Different Stages of Tooth Decay?

Stage 1: Initial Demineralization 

When a tooth is exposed to acids produced by plaque bacteria, the enamel begins to lose essential minerals. This births a white spot on the teeth indicating tooth decay.

Stage 2: Enamel Decay

Untreated tooth decay leaves the enamel to break down further. The white spot on your tooth will darken to brownish color, forming dental caries in your teeth.

Stage 3: Dentin Decay 

Tooth decay proceeds at a faster rate when it reaches the dentin since it is extra sensitive. When dentin is affected, its connection to the nerves increases tooth sensitivity beyond measure especially when having hot or cold foods or drinks.

Stage 4: Pulp Damage

During this stage, the pulp becomes irritated and swollen. The lack of space between the surrounding tissues to accommodate this swelling leads to pressure on the nerves and excessive pain.

Stage 5: Abscess

These cause severe pain radiating into the jaw, swelling of the gums, face or jaw, fever, and swollen lymph nodes in your neck.

What are the Treatment Options for Tooth Decay?

1. Fluoride treatments 

   Applied to your teeth in the form of a gel or varnish makes your enamel more resistant to the acids in your mouth, reversing a cavity in the early stages.

2. Fillings 

   In dental fillings, the doctor uses a tool to clear away any areas of decay and then filling the hole with materials like resin, ceramic, dental amalgam, tooth-colored composite resins, or porcelain that is the same color as your tooth.

3. Crowns 

   Custom-fitted dental crowns replace your tooth’s entire natural crown by drilling to remove the decay. Crowns may be made of gold, high-strength porcelain, resin, or metal fused porcelain.

4. Root Canal 

   A root canal can help when the decay reaches the pulp. A badly damaged or infected tooth is repaired while the diseased tooth pulp is removed. Medication clears any infection and the pulp is replaced with a filling and covered with a crown.

5. Tooth Extractions 

   Tooth extractions or removals are the only treatment in severe cases, of tooth cavities. The gap allows your other teeth to shift so you can get a bridge or a dental implant.

What Happens if Tooth Decay is Not Treated?

If tooth decay is not treated, it can lead to severe complications including:

• Persistent tooth pain and sensitivity to hot, cold, or sweet foods
• Formation of cavities that enlarge and deepen, causing noticeable holes
• Infection reaching the tooth pulp, leading to inflammation, abscesses, and severe pain
• Spread of infection to surrounding gum tissue, jawbone, and other teeth
• Possible tooth loss due to structural damage or required extraction
• Gum swelling, bad breath, and unpleasant taste due to bacterial infection
• Risk of infection spreading systemically, which can cause serious health problems
• Potential for permanent damage affecting chewing, nutrition, and oral health

Early treatment is critical to prevent these serious issues and preserve natural teeth and overall well-being.

How to Prevent Tooth Decay and Cavities?

• Brush your teeth twice a day using fluoride toothpaste
• Floss daily
• Eat nutritious, balanced meals
• Consider supplemental fluoride and dental sealants to strengthen your teeth.
• Schedule a visit to your dentist twice a year for teeth cleaning.
• Cut down sugary and starchy food and drinks
• Avoid smoking or alcohol
• Talk to your dentist in case of a persistently dry mouth

FAQS

• How is a tooth decay/cavity formed?

  The bacteria in your mouth feed on food particles left amidst the teeth creating an acidic environment and dental plaque. The acids eat the tooth enamel and dentin speeding up tooth decay. If left untreated, the tooth cavity and the bacteria invade the tooth pulp causing sensitivity, pain, and severe complications. Further, your nerves are exposed to bacteria causing pain, dental abscess indicating the infection has spread into the bone.

• How can I tell if I have tooth decay?

  Early signs include tooth sensitivity, mild pain when eating sweets or hot/cold foods, visible white spots or discoloration on teeth, and bad breath. Advanced decay can cause visible holes, persistent toothache, and sensitivity to pressure.

• Can tooth decay be reversed naturally?

  In very early stages, tooth decay can be arrested or reversed using fluoride treatments, improved oral care habits, reducing sugar intake, and consuming tooth-friendly foods rich in calcium and phosphate. Regular dental cleanings also help.

• Is tooth decay contagious?

  While tooth decay itself is not contagious, the bacteria that cause it can be transferred through saliva by sharing utensils, kissing, or close contact, especially from caregivers to children.

• Does fluoride toothpaste prevent tooth decay?

  Yes, fluoride strengthens tooth enamel by making it more resistant to acid attack and can even help remineralize early decay spots, significantly reducing the risk of cavities.

• What foods contribute to tooth decay?

  Sugary snacks and drinks, sticky candies, acidic beverages like soda, and starchy foods that linger on teeth promote bacterial growth and acid production, increasing decay risk.

• When should I see a dentist for tooth decay?

  See a dentist if you experience tooth sensitivity, pain, visible damage, or if you have a history of cavities. Early professional detection helps avoid extensive treatment later.

See your Dentist

As seen above, delaying treatment worsens tooth cavities beyond repair. So, wait no further. Schedule an appointment with your dentist at the earliest to save your teeth.

Dr. Anu Isaac

Dr. Anu Isaac, DMD, runs a successful dental practice in Salem, MA. Dr. Isaac strives for quality on a daily basis and this commitment to quality is reflected in her constant pursuit of advanced training. Her firm belief that even experts need to stay updated about what’s new in the dental field, enables her to provide every patient with optimal oral care. As the founder of Coral Dental Care, she is dedicated to creating healthy, beautiful smiles for her patients and also to educating dental and non-dental community with her engaging articles on all things related to oral health,recent dental innovations, and latest treatment modalities.