Cavities

A cavity is the damage or hole that forms in a tooth due to acids produced by cavity-causing bacteria present in the mouth. The damage begins in the enamel (the outer protective layer) and can progress to the dentin and, eventually, the nerve.

Cavities are irreversible lesions because dental layers do not regenerate. The formation process can lead to severe pain, infection, and, if left untreated, tooth loss.

Depending on the location and progression of the decay, different types of cavities can be identified:

• Crown cavities: The most common type, forming on the chewing surface of the teeth, the crown. It is easy to detect due to discoloration.
• Fissure cavities: Bacteria penetrate small cracks in the tooth surface, damaging dental tissue. Common in back teeth and molars.
• Interdental cavities: These occur in the space between two teeth. Because this area is hard to reach, prevention and detection are more difficult.
• Root cavities: Occur when gum recession exposes the tooth root, which lacks enamel protection. One of the leading causes of tooth loss.
• Recurrent or secondary cavities: Develop in areas where a previous filling or crown was placed.
• Enamel cavities: The initial stage of cavities, affecting only the enamel, forming a small white or black indentation.
• Dentin cavities: In an advanced stage, cavities reach the dentin, showing a yellowish discoloration.
• Rampant cavities: Progress rapidly, potentially reaching the pulp and inner tissues, leading to nerve necrosis or even tooth loss. They appear brown or black.

Cavities are one of the most common dental conditions, affecting even baby teeth.

Symptoms

Early cavities do not cause symptoms, but as they progress, the following may appear:

• Visible holes or cavities in the teeth.
• Tooth sensitivity, especially when consuming hot, cold, or sweet foods.
• Brown, black, or white stains on the tooth surface.
• Pain, particularly when biting or chewing

Causes

Cavities result from the action of cavity-causing plaque on the teeth. Plaque forms when bacteria in the mouth interact with sugars and starches from food. These bacteria produce acid, which attacks the enamel, causing it to lose minerals and erode.

Risk Factors

Anyone can develop cavities, but certain factors increase the risk:

• Poor oral hygiene: Not brushing after meals allows plaque to build up.
• High sugar and starch intake: Foods and drinks rich in these substances contribute to plaque formation.
• Sticky foods: They adhere to teeth longer, increasing the risk of cavities.
• Dry mouth: Reduced saliva production facilitates plaque accumulation.
• Genetics: Enamel hardness is hereditary.
• Age: Over time, teeth wear down and gums may recede.
• Fluoride deficiency: This natural mineral helps prevent cavities.
• Previous fillings: Fillings may weaken or break over time, leading to increased plaque buildup.
• Orthodontics and dental devices: Misaligned appliances can encourage plaque accumulation.
• Acid reflux and conditions involving frequent vomiting: Stomach acids in the mouth can damage enamel.

Complications

If cavities are not detected or treated in time, they can lead to complications such as:

• Nerve infection: Causes severe pain and swelling and increases the risk of tooth fracture, loss, or nerve necrosis.
• If bacteria enter the bloodstream: Can lead to heart problems, rheumatoid arthritis, or gastrointestinal issues.

Prevention

Good hygiene and diet are key to preventing cavities:

• Brush teeth after every meal.
• Use fluoride toothpaste.
• Use dental floss or interdental cleaners.
• Reduce consumption of sugar- and starch-rich foods.
• Avoid frequent snacking, as bacteria become active every time food is consumed.
• Use fluoride rinses or treatments if at high risk for cavities.
• Schedule regular dental check-ups.

To prevent childhood cavities, limit sugary or sticky foods and drinks and reduce pacifier or bottle use at night. Additionally, clean a baby’s teeth as soon as they appear, using gauze or a special brush for infants, and fluoride toothpaste as they grow.

Which doctor treats cavities?

Cavities are diagnosed and treated by professionals in dentistry and stomatology.