Cavities or Dental caries: Diagnosis, Prevention and Treatment


Dental caries or cavities also known as tooth decay, is a breakdown of teeth due to acids made by specific types of bacteria.

November 10, 2017

Cavities or Dental caries: Diagnosis, Prevention and Treatment

Dental caries or cavities also known as tooth decay, is a breakdown of teeth due to acids made by specific types of bacteria.

Diagnosis of Cavities:

Initially, it may appear as a small chalky area , which may eventually develop into a large cavities. Primary diagnosis involves inspection of all visible tooth surfaces using a good light source, dental mirror and explorer. Large areas of dental caries are visible to the naked eye, but smaller lesions can be difficult to identify.  These methods do not catch cavities when they are just forming. If too much force is used, an explorer can puncture the enamel which could allow the cavity-causing bacteria to spread to healthy teeth.
Dental radiographs (X-rays) may show dental caries those are invisible to the naked eye. It can also catch the caries between the teeth. This method is used for less visible areas of teeth and to judge the extent of destruction. They also show the more advanced decay, including whether decay has reached the pulp and whether the tooth requires a root canal.
Another method to detect the decayed area where dentist brushes the nontoxic dye over your teeth, then rinses it off with water. It rinses away cleanly from healthy areas but sticks to the decayed areas.
Lasers for detecting caries allow detection without ionizing radiation and are now used for detection of interproximal decay (between the teeth).

Can Caries be Reversed?

Caries detected in the very early stages can be reversed.  White spots may indicate early caries that has not yet damage the enamel. If acid damage is stopped and the tooth is given a chance to repair itself naturally, early caries may be reversed.  But once a cavity forms, the lost tooth structure cannot be regenerated.
Most caries will continue to get worse if not treated in the early stage and go deeper. With time, the tooth may decay down to the root. Caries that has destroyed enamel cannot be reversed. The time of decay will vary from person to person. Caries can erode to a painful level within months or years.

Prevention of Cavities:

By reducing the amount of plaque and bacteria in your mouth you can prevent cavities. The best way to do this is by brushing and flossing on a daily basis. You also can use antibacterial mouth rinses to reduce the levels of bacteria that cause cavities by neutralizing the acid in your mouth to make the environment less friendly to the growth of these bacteria.
Sugary or starchy foods should be avoided reduce the amount of tooth-damaging acid in your mouth. Chewing gum that contains xylitol helps to decrease bacterial growth.
Use of fluoride contain toothpaste, which strengthens teeth can also reduce your risk of cavities.
In adults, molars can be protected with sealants. In children, both baby molars and permanent molars can be sealed.

Treatment of Cavities:

The treatment for a cavity is to fill the tooth.  The decayed material in the cavity will be removed and the cavity is filled.  The dentist will numb the area to be filled if a drill is used.  A numbing shot is usually not required if a laser is used.
Usually fillings are made of dental amalgam or composite resin. Amalgam is a silver-gray material made from silver, mercury, copper or other metals where as composite resin is tooth-colored which will have a better appearance. Therefore these can be used for all teeth.Amalgams are used in molars and premolars because the metal is not seen in the back of the mouth.
If a cavity is large, the remaining tooth may not be able to support enough filling material to repair it. In this case, the decay  will removed and the tooth will be covered with a ceramic inlay  or artificial crown. If bacteria infect the pulp inside the tooth, it will need root canal treatment. The pulp will be removed and replaced by an inert material. In most cases, the tooth will need a crown.