It’s safe to say that tooth decay is the most common oral health issue in the United States. According to the National Institute of Dental and Craniofacial Research (NIDCR), 92% of adults ages 20 to 64 have had dental caries (tooth decay) in their permanent teeth. But while tooth decay is widespread, it shouldn’t be considered inevitable. Even if you’ve had at least one filling to treat a cavity, preventing future decay is possible when you know the warning signs of early-stage tooth decay — as well as changes to make in your lifestyle and oral hygiene routines.
Should tooth decay already be underway, being aware of signs of its progression can head off more serious consequences when you schedule an appointment with your dentist for timely treatment.
Signs and Symptoms of Cavities
For far too many people, dental pain is the first symptom of a cavity. We’re getting a little ahead of our usual advice, but visiting your dentist for regular twice-yearly examinations will reveal early evidence of tooth decay so it can be treated quickly. In the meantime, be proactive and keep your eyes open for the following changes, which are provided by Mayo Clinic, Healthline, and Fifth Avenue Dental Arts:
Sensitivity to hot, cold, and sweet foods/liquids — Sensitivity that lingers after eating hot or cold food could be a sign of a cavity. When tooth enamel starts to wear away, it can affect dentin, which is the hard tissue layer below the enamel. Dentin contains tubules, which are hollow microscopic channels that travel from the inside of the tooth (where the pulp is) out through the dentin, ending right beneath the enamel. Without enough enamel to protect the dentin, foods that are hot, cold, sticky, or acidic can stimulate the cells and nerves inside your tooth, creating sensitivity. Our blog post — “Tooth Anatomy 101” — provides a detailed illustration of the layers of a tooth.
Staining on the tooth — If you notice a small white spot on a tooth, it could be the beginning of a cavity. As tooth decay becomes more advanced, the stain can become darker. Staining caused by a cavity can be white, brown, or black, and typically appears on the surface of the tooth.
Hole or pit in the tooth — If left untreated, the white spot on your tooth will develop into a hole that you may be able to see when you look in the mirror or feel when you run your tongue over the surface of your teeth. Some holes —especially those between your teeth or crevices — cannot be seen or felt. But you may still feel pain or sensitivity. If you notice a hole or pit in your tooth, make an appointment to see your dentist. This is a clear sign that you have tooth decay.
Floss shredding or breaking — The texture of tooth enamel changes as decay develops. Cavity margins are rough — or even sharp — as decay ruptures through the outermost layer of enamel. This process can create a jagged edge around the cavity. When you floss, you might notice that the floss starts to shred or breaks apart at the same location every time you use it. Make an appointment to see your dentist, and if possible, use a water flosser until the cavity is treated.
Food getting caught between your teeth — Do you notice an area between your teeth where food tends to become caught after meals? If this is a recent development, it may be collecting inside a cavity.
Irritated gums — If you have a cavity between your teeth or along the gum line, the bacterial infection doesn’t just affect your tooth. Your gums may also become irritated. If bacteria, acids, or food debris are consistently building up in the same area because of a cavity, you’ll probably see that the gums around that tooth are also swollen and irritated.
Toothache — Now that you know the early symptoms, tooth decay hopefully won’t reach this stage. A toothache caused by decay can present in several ways. You may feel pressure and/or pain when you bite down on food, or the pain may be spontaneous — seeming to come and go without stimulus. Left untreated, the pain will increase in intensity and duration as the decay advances into the pulp. Not every toothache is caused by decay, but is always serious, and will require treatment.
Most cases of tooth decay are treated with a dental filling. Our blog post — “Everything You Need to Know About Dental Fillings” — describes this procedure in detail. As you may already know by experience, the basic treatment involves removing the decayed portions of the tooth, then filling it with a special material – the type of which will depend upon your particular situation, as determined by your dentist. Our blog post details the treatment method used by Dr. Nilofer Khan — owner and General Dentist of NK Family Dental — so we invite you to read this in its entirety to learn about her approach to ensuring every patient has a comfortable, pain-free experience and a durable, high-quality filling that will last for years to come.
How Does Tooth Decay Progress?
Tooth decay is a gradual process, which is another factor that often makes it easy to go undetected without regular dental checkups. The following stages are provided courtesy of Mayo Clinic:
Plaque forms — Dental plaque is a clear sticky film that coats your teeth. It’s due to eating sugars and starches, and not cleaning your teeth well. When sugars and starches aren’t cleaned off your teeth, bacteria quickly begin feeding on them and form plaque. Plaque that stays on your teeth can harden under or above your gum line into tartar (calculus). Tartar makes plaque more difficult to remove and creates a shield for bacteria.
Plaque attacks — The acids in plaque remove minerals in your tooth’s hard, outer enamel. This erosion causes tiny openings or holes in the enamel — the first stage of cavities. Once areas of enamel are worn away, the bacteria and acid can reach the next layer of your teeth, called dentin. This layer is softer than enamel and less resistant to acid.
Destruction continues — As tooth decay develops, the bacteria and acid continue their march through your teeth, moving next to the inner tooth material (pulp) that contains nerves and blood vessels. The pulp becomes swollen and irritated from the bacteria. Because there is no place for the swelling to expand inside of a tooth, the nerve becomes pressed, causing pain. Discomfort can even extend outside of the tooth root to the bone.
What Increases Your Risk of Tooth Decay?
While everyone can develop tooth decay, Mayo Clinic identifies the following as particular risk factors:
Tooth location — Decay most often occurs in your back teeth (molars and premolars). These teeth have lots of grooves, pits and crannies, and multiple roots that can collect food particles.
Certain foods and drinks — Foods that cling to your teeth for a long time — such as milk, ice cream, honey, sugar, soda, dried fruit, cake, cookies, hard candy and mints, dry cereal, and chips — are more likely to cause decay than foods that are easily washed away by saliva.
Frequent snacking or sipping — This gives mouth bacteria more fuel to produce acids that attack your teeth and wear them down. Sipping soda or other acidic drinks throughout the day creates a continual acid bath over your teeth.
Bedtime infant feeding — When babies are given bedtime bottles filled with milk, formula, juice, or other sugar-containing liquids, these beverages remain on their teeth for hours while they sleep, feeding decay-causing bacteria. The same occurs when drinking from a sippy cup filled with such beverages for prolonged periods.
Inadequate brushing — If you don’t clean your teeth soon after eating and drinking, plaque forms quickly and the first stages of decay can begin.
Not getting enough fluoride — Fluoride is a naturally occurring mineral that helps prevent cavities and can even reverse the earliest stages of tooth damage. Because of its benefits for teeth, fluoride is added to many public water supplies. It’s also a common ingredient in toothpaste and mouth rinses. But bottled water usually does not contain fluoride. If your dentist determines you are at increased risk for tooth decay, he or she may recommend a fluoride toothpaste that’s available by prescription only. Prescription fluoride toothpaste contains a higher concentration of fluoride (5000 parts per million) than over-the-counter brands, which is the maximum strength.
Younger or older age — Cavities are common in very young children and teenagers. Older adults also are at higher risk. Over time, teeth can wear down and gums may recede, making teeth more vulnerable to root decay. Older adults also may use more medications that reduce saliva flow, increasing the risk of tooth decay.
Dry mouth — Saliva helps prevent tooth decay by washing away food and plaque from your teeth. Substances found in saliva also help counter the acid produced by bacteria. Certain medications, some medical conditions, radiation to your head or neck, or certain chemotherapy drugs can increase your risk of cavities by reducing saliva production.
Worn fillings or dental devices — Over the years, dental fillings can weaken, begin to break down or develop rough edges. Plaque builds up and makes it harder to remove. Dental devices can stop fitting well, allowing decay to begin underneath.
Heartburn — Heartburn or gastroesophageal reflux disease (GERD) can cause stomach acid to flow into your mouth (reflux), wearing away the enamel of your teeth and causing significant tooth damage. Exposing more dentin to be attacked creates tooth decay. Your dentist may recommend that you consult your doctor to see if gastric reflux is the cause of your enamel loss.
Eating disorders — Anorexia and bulimia can lead to significant tooth erosion and cavities. Stomach acid from repeated vomiting (purging) washes over the teeth and begins dissolving the enamel. Eating disorders also can interfere with saliva production.
The Take-Home Message
Tooth decay is an insidious process that can advance before you’re aware of it. Being proactive with your oral health will help you recognize its early signs – and will allow your dentist to identify it during your twice-yearly examinations so it can be treated before doing additional damage.
NK Family Dental is proud to offer our patients advanced cavity detection technology during every one of our complete checkups. We utilize DIAGNOdent technology to thoroughly check for the presence of cavities. DIAGNOdent utilizes lasers that are highly effective in detecting cavities. With DIAGNOdent, we are very successful in locating cavities early, allowing our patients to seek quick treatment and prevent serious oral health problems from occurring later.
At NK Family Dental, it is our mission to provide the highest quality and most compassionate oral care to our Chicago patients, including both dental and periodontal services. Our practice is trusted for advanced oral surgery procedures and comfortable root canal treatment.
Our team of experienced, dedicated dental professionals will help address your oral health concerns, and determine the best solution for you based on your individual situation. We strive to identify treatment options that fit your needs. Our dental specialists include our general dentist, Dr. Nilofer Khan, our endodontist, Dr. Sabek, and our periodontist, Dr. Amir Danesh. Dr. Danesh is a board-certified periodontist and Diplomat of the American Board of Periodontology. He has contributed to the publication of two books, as well as published over 20 papers in prestigious dental research journals.
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