Tooth Decay & Cavities

A constant in life is tooth decay. No matter how well we take care of our teeth, one of them will eventually become damaged by cavities, also known as caries, and tooth decay. Cavities are a source of embarrassment for children and adults alike. However, they are nothing to be ashamed of, as cavities are a perfectly natural part of life. A lucky few manage to go most of their lives without any sort of tooth decay, but odds are you will have some form of tooth decay during your lifetime. In fact, nearly two-thirds of Americans will likely have at least one cavity by the time they turn 18.

What many people do not know is there are several different varieties of cavities and that they are caused by differing factors. While all cavities are caused by tooth decay, certain types of cavities have become more prevalent in modern times. Dental decay has been around for as long as human existence, and the word caries comes from the Latin word for rot.

When you have tooth decay, bacteria called Streptococcus mutans, Lactobacilli and others excrete acid that damages the hard surfaces of the tooth, usually the enamel, cementum and dentine, and in extreme cases, the pulp. No human is born with this bacteria in their mouth, but it is passed through families and normal contact. Even if you completely sterilized your mouth of all bacteria, you would quickly reinfect yourself through normal day-to-day life.

Originally, cavities were believed to be caused by tooth worms, and it was only in the past few centuries that dentists readily identified the causes of tooth decay and only about 60 years since we identified the bacteria responsible. People used to use various smokes, including those with mercury, to try to clear out cavities and kill the tooth worm. Fortunately, we have come a long way since then. Rather than using smokes and amalgam fillings, we now use composite fillings that can restore your teeth to their natural beauty.

What Are the Symptoms of a Cavity?

Cavities have a few telltale symptoms, but no two cavities are alike — one cavity may have completely separate symptoms from another depending on the part and type of the tooth they are affecting and how severe or deep the cavity is:

• Toothaches and sensitivity
• Visible pits, holes and depressions in your teeth
• Varying severity of pain and sensitivity to hot, cold and sweet foods.
• Pain during biting and chewing
• Dark brown or black spots or other staining

If you suspect you have a cavity, feel free to call us and set up a dental exam.

Oops, I Have One! What Now?

We are always sorry when a patient gets a cavity. We know it can put undue stress on children and adults alike, but the good news is that getting a filling is one of the safest and most routine procedures in dentistry. (If the cavity is small enough, it can even potentially just be remineralized.) When you get a filling, a small amount of the tooth is bored out and the decay is removed. This prevents the decay from spreading and further damaging the tooth and neighboring teeth. Once the decay is removed, you will have a filling placed. In recent years, amalgam fillings have been phased out in favor of resin and composite fillings due to their safety, attractiveness and conservative nature. Amalgam fillings, made of a composite of metals, generally silver and mercury, have come under intense scrutiny as a health concern over the past decade. They also increased sensitivity to hot and cold, as well as required more of the tooth to be drilled, potentially causing weakening in the structure of the tooth. Few dentists work with amalgam anymore, favoring composite.

What Kinds of Cavities Are There?

Throughout most of history, cavities of the smooth surface, the areas on the sides of your teeth, were the most common. While pit and fissure cavities, common in the modern era, existed, they did not occur as often before the advent of readily available refined sugar. Smooth surface cavities have become less common because it takes considerably more time and wear for the bacteria to cause tooth decay and get through the hardened surface of the tooth. These cavities tend to have a double triangular appearance and are often smaller than most other forms of common cavity. Still, they can be very serious if untreated and are very irritating when they occur between teeth due to bad luck or poor flossing habits. Fortunately, early stage decay with these type of cavities responds very well to fluoride and calcium remineralization and can quite possibly be reversed if caught early enough.

Pit and fissure cavities occur because of germs, food particles and other damaging elements getting trapped in the grooves of your teeth. There are seen in the molars and bicuspids. Toothbrush bristles and floss are not fine enough to clear these areas, so great care and minimization of refined sugars and fermented carbohydrates should be practiced. These cavities tend to be a bit larger, as the chewing surface of the tooth is less likely to be thoroughly cleaned and cleared of debris regularly. Sports drinks, soft drinks, candy, and other sweetened and refined products have increased the appearance of these types of cavities immensely over the past two centuries. This is why dentists developed sealants to help prevent decay in adolescents and young adults. Regular and consistent oral hygiene is often neglected by young adults, especially in their college years, which makes getting sealants at a young age and regular maintenance important.

Root decay and gumline or cervical cavities are common among older adults or patients with receding gums and advanced periodontal disease. The cementum and root surface of the tooth is exposed and susceptible to decay as the gumline recedes. The danger of pulp damage and tooth loss is very high with these kind of cavities, as there is less tooth to infect before the bacteria hits the delicate internal structure of the tooth.

More professional parlance has six forms of dental caries, and they are listed here:

• Class I — pit and fissure caries (anterior or posterior teeth)
• Class II — approximal surfaces of posterior teeth
• Class III — approximal surfaces of anterior teeth without incisal edge involvement
• Class IV — approximal surfaces of anterior teeth with incisal edge involvement
• Class V — gingival/cervical surfaces on the lingual or facial aspect (anterior or posterior)
• Class VI — incisal edge of anterior teeth or cusp heights of posterior teeth

It is important to get your cavity addressed soon after it is diagnosed; any cavity can lead to the need for a root canal procedure if not attended to properly.

If you are worried or want to learn more about cavities and tooth decay in Beverly Hills, California, or suspect you have a cavity, do not hesitate to call us at 310-273-2020 or email our appointment coordinator for your appointment with our dentist, Dr. Parsa T. Zadeh. We look forward to hearing from you.