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Dental Cavities

Last updated March 27, 2018

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The structural damage caused to the teeth, leading to the formation of holes or cavities in the teeth, is termed as Dental Cavities. It is a common disorder responsible for tooth loss in young individuals.


What are the other Names for this Condition? (Also known as/Synonyms)

  • Dental Caries
  • Dietobacterial Disease
  • Tooth Decay

What are Dental Cavities? (Definition/Background Information)

  • The structural damage caused to the teeth, leading to the formation of holes or cavities in the teeth, is termed as Dental Cavities. It is a common disorder responsible for tooth loss in young individuals
  • It is characterized by severe pain in the tooth, especially after eating sweets or consuming foods/drinks that are hot or cold. Visible holes or pits in the teeth are also observed
  • It is caused by a bacterial infection that causes demineralization (abnormal loss of minerals) and destruction of hard tissues of the teeth, like enamel, dentin, and cementum. The bacteria most responsible for causing Dental Cavities are Streptococcus mutans, Streptococcus sobrinus, and lactobacilli
  • The parts of the teeth susceptible to Tooth Decay are areas where plaque can easily accumulate. These include  the pits and fissures in the teeth, areas in between the teeth, and next to the gum line
  • A cavity starts in the enamel (outer layer of the teeth), and then penetrates deep into the dentin (softer inner layers of the teeth). An individual may notice signs and symptoms of Tooth Decay only at this stage. If left untreated, Dental Cavities can lead to pain, tooth loss, and infection
  • Dental fillings, dental crowns, and root canal procedures, are some of the treatment methods adopted to prevent further injury from a Dental Cavity

Who gets Dental Cavities? (Age and Sex Distribution)

  • Any individual may be affected by Dental Cavities; but, generally children and young adults are most frequently affected
  • Changes that occur with ageing can make older individuals more vulnerable to the condition
  • Both males and females are equally affected. Racial, ethnic, or geographical predominance is not observed

What are the Risk Factors for Dental Cavities? (Predisposing Factors)

The risk factors for Dental Cavities include:

  • Low salivary flow or a dry mouth increases the risk. Saliva helps digest and wash away food particles, preventing plaque from attaching itself to the teeth. A dry mouth will mean less flow of saliva
  • A few genetic factors that may influence Tooth Decay include: Tooth size, tooth shape, thickness of the enamel, position of the tooth, tooth eruption time, sequence, and the bite
  • Location of the tooth: Decay generally affects the premolars and molars (teeth located at the back), which have lots of grooves, pits, and crannies that help teeth grind food. However, food particles can get accumulated in these spaces and allow the build-up of plaque, in which bacteria thrive
  • Certain food and drinks: Foods, which can cling to the teeth for a longer time, like milk, ice cream, and honey, can more easily cause Tooth Decay, than other food types
  • Frequent snacking or sipping: This habit tends to worsen the situation and can cause the bacteria present in the mouth, to produce more acids that attack teeth and cause Tooth Decay
  • Bedtime infant feeding: Parents and caretakers who feed their infants milk or juice, in bottles during bedtime, put their children to a risk of Dental Decay. Such liquid foods cling to the teeth for long hours, allowing bacteria to thrive and spoil the milk teeth
  • Inadequate brushing can allow plaque to settle in the tooth and start the initial process of decay
  • Inadequate fluoride makes the teeth more vulnerable to the condition
  • Generally, children and teenagers, who have poor eating and oral habits, are at high risk for contracting Tooth Decay. But, as individuals get older due to aging, they too are vulnerable
  • Some medicines taken by elderly adults, for various other diseases/conditions, may reduce the flow of saliva. This puts them at high risk for Tooth Decay
  • Worn out fillings and dental devices: With time, the oral devices or fillings done earlier may get worn out and weaken. This causes them to breakdown, allowing for the easy buildup of plaque
  • Eating disorders, such as anorexia and bulimia, can lead to tooth erosion and cause cavities. Individuals with eating disorders may have regular habits of drinking soda or other acidic drinks throughout the day. This creates an acidic coating over the teeth, increasing the risk of Dental Cavities. Eating disorders also decrease the production of saliva, which in turn increase the risk for cavities
  • Gastroesophageal reflux disease and heartburns, can cause stomach acid to flow into the mouth, leading to tooth enamel damage
  • Radiation therapy administered to the head or neck (as part of cancer treatment), also decrease saliva production

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Dental Cavities? (Etiology)

The main cause of Dental Cavities includes bacterial infection and a diet rich in sugar and starch.

  • The bacteria Streptococcus mutans, Streptococcus sobrinus, and lactobacilli, are mainly responsible for Dental Cavities
  • Bacteria found in the mouth, acts on the food debris accumulated on the tooth surface and convert them into acids. Bacteria, food particles, acids, and saliva, combine to form a sticky substance ‘plaque’, which sticks to the teeth. The acids in the plaque damage the enamel covering the teeth, causing holes or cavities in them
  • Foods rich in starch and sugar adds to the stickiness of the plaque
  • Plaque, when not removed from the teeth turns into a substance known as tartar. Plaque and tartar together, irritate the gums leading to cavity formation or Tooth Decay

What are the Signs and Symptoms of Dental Cavities?

The signs and symptoms of Dental Cavities include:

  • Increased sensitivity of teeth to foods, which are cold, hot, or sweet
  • Cavities may sometimes cause toothache; but with further decay, constant pain may be observed
  • Visually observable cavities, seen as light or dark brown spots

How are Dental Cavities Diagnosed?

A Dental Cavity is diagnosed using the following methods:

  • A thorough physical examination of the mouth and teeth, to identify soft tissues and cavities
  • Presence of tooth pain and sensitivity. If the cavity is small, it can be detected only by a dentist, before the pain starts
  • A sharp instrument may be used by the dentist to detect any cavities, and feel  tooth structures softened by decay
  • An x-ray may be taken to detect cavities, which has occurred between the teeth

Other diagnostic imaging tools that may be used to study teeth include:

  • Ultrasound study
  • Fluorescence
  • Fiber-optic transillumination

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Dental Cavities?

Complications due to Dental Cavities may include:

  • Severe pain and infections, due to larger cavities. Inability to bite using affected tooth, causing chewing difficulties
  • Tooth abscess, which may lead to blood infection. This may cause a serious health condition called septicemia
  • Tooth loss, broken or fractured tooth
  • Increased tooth sensitivity
  • Tooth Cavities (or the loss of a tooth) may affect an individual’s appearance (while smiling or talking). This can affect their self-confidence  and self-esteem, interfering with their regular school, work, or social life

How are Dental Cavities Treated?

The treatment for Dental Cavities (also known as Dental Caries) depends on the severity of the cavities. The treatment options include:

  • Use of fluoride:
    • Fluoride is a mineral that helps teeth repair themselves, during the early stages of damage
    • Fluoride treatment may be in the form of liquid solution, gel, foam, or varnish that can be applied/brushed onto the teeth
    • Periodic fluoride treatments may be recommended by the family dentist
  • Dental fillings:
    • When the Tooth Decay becomes larger, a filling may be recommended. Dental fillings are materials that help replace decayed (or even worn down) areas of the teeth, and teeth that are cracked or broken
    • It is one of the main treatment methods used, when the decay has spread beyond the enamel erosion stage
    • The decayed portion of the tooth is drilled and the gap filled, in such a manner as to bring back the shape of the tooth
    • Fillings may be  made of various materials, such as tooth-colored composite resins, porcelain, gold, and amalgam fillings that contain various materials, including mercury
  • Crowns:
    • When the decay has worsened and weakened the tooth, a crown may be needed to restore the tooth
    • A crown is a custom-fitted covering that is meant to replace the natural crown of the affected tooth. The decayed area is drilled away, to fit the crown perfectly
    • Crowns may be made of gold, porcelain, or porcelain fused to metal
  • Root canal treatment: When the pulp of the tooth is severely affected, a root canal therapy is needed, to save the tooth. It is also known as endodontic therapy. Here, the tooth pulp is removed and replaced with a filling, over a few sittings
  • Tooth extractions:
    • When the tooth becomes severely damaged to the extent it cannot be saved, it must be removed
    • When a tooth is removed it may leave a gap. Hence, your healthcare provider may recommend a bridge or dental implant, to replace the missing tooth
  • The use of pain-numbing medication, like lidocaine, may be required to relieve pain, during and after treatment of a decayed tooth

Dental treatment for pregnant women: A great number of hormonal changes take place during pregnancy; hence, pregnant women are at high risk for dental problems.

  • Pregnant women are generally advised to avoid dental  treatment during their pregnancy, unless it is an emergency
  • Under normal circumstances, the second trimester (months 4 to 6) is the best time to undergo any such dental treatment
  • It has been observed that untreated oral disease leads to adverse pregnancy outcomes by affecting the growth and development of the baby
  • If dental x-rays are required, then a protective apron is used to cover the stomach of the pregnant women
  • If antibiotics need to be administered, then tetracycline should be avoided. Tetracycline may create stains in the unborn baby’s developing teeth

How can Dental Cavities be Prevented?

Currently, there are no definitive methods available, to prevent Dental Cavities. However, the following measures may be helpful:

  • Professional oral cleaning is recommended every 6 months, for proper dental maintenance and prevention of unnecessary complications
  • Regularly brush mouth, immediately after eating and drinking, using fluoride-containing paste. This can help prevent Tooth Cavities, by stopping the buildup of plaque. Children must be taught to brush their teeth at least twice a day, as a regular habit
  • Use a suitable mouth rinse (containing fluoride), as recommended by the dentist
  • Floss the teeth daily
  • Fluorides protect the teeth from decay (by preventing the action of acids on teeth) and also aids in tooth repair. An inadequacy in fluoride makes teeth more vulnerable to decay. Use fluoride supplements, which can be in the form of toothpaste, mouth wash, or fluoride added to the drinking water
  • Minimize the intake of snacks as these foods are sticky and they tend to keep a constant supply of acids in the mouth
  • Sugary drinks and sweets/candies must be avoided, whenever possible
  • Avoid feeding milk/juice to infants during bedtime
  • If any Tooth Cavity had developed previously, then it is advisable to have periodic dental check-ups and dental x-rays taken, once a year
  • Use of dental sealants: A sealant is a protective plastic coating applied to the chewing surface of the molars. This helps in covering the grooves and pits, where food particles tend to settle and cause cavity formation

What is the Prognosis of Dental Cavities? (Outcomes/Resolutions)

  • An early diagnosis with prompt treatment can always save the tooth. Untreated conditions may cause tooth abscess and other complications
  • Early treatment is less painful and less expensive; with prompt intervention the outcomes are also favorable

Additional and Relevant Useful Information for Dental Cavities:

  • Nitrous oxide with novocaine and other medication may be prescribed, if the individual fears dental treatment procedures
  • Several new cavity treatment methods are under research. One of them is the use of fluorescent light to detect the development of cavities. This method can detect cavities earlier than the traditional methods of dental x-ray and oral exam. The earlier a cavity is discovered, the sooner can it be filled and the tooth saved
  • Research is also being done on a “smart filling” technique. This technique helps prevent further tooth decay by slowly releasing fluorides over time, around the fillings and in adjacent teeth

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 7, 2013
Last updated: March 27, 2018

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