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tooth decay and cavity symptoms, stages and treatments

Tooth Decay and Oral Cavities: What You Need to Know

Dr. Kate DDS

The words many of us dread hearing from the dentist: “You have a cavity.” We may not know how cavities got there in the first place, but we know it’s something we don’t want.

It’s vital that, as adults, we understand how tooth decay happens and causes cavities so that we can practice good oral health. Because while it’s easy to assume that only kids get caries from overeating candy, adults can get them, too. Often, adults will face tooth decay as they age.

If you want to keep your pearly whites strong and healthy your whole life, do yourself a favor and learn as much about oral health as you can. To get you started, in this article, we’ll be going over what an oral cavity is, its causes, treatment options, and how to prevent it in the first place. Before you know it, you’ll be in-the-know on all things cavities and dental health.


What Is Tooth Cavity?

A cavity is a form of tooth decay, or what is otherwise known as dental caries. It happens when there is a build-up of plaque bacteria on the teeth that break down sugar within the mouth and turn it into acids. These acids damage the structure of the tooth, and that damage is what we call a cavity.

If left untreated, cavities will continue to grow and penetrate the tooth. Eventually, they can overtake the whole tooth.

A cavity in tooth also can spread further into the gums. If you have exposed roots or recessions in the gums, the same acids that attack your tooth can attack your dentin (the hard, bony tissue of the tooth beneath the enamel) and cause a root cavity. When this happens, your tooth’s nerves may become exposed, leading to sensitivity or pain when eating and drinking.

If you feel any sort of pain near the root of your tooth, it’s always a good idea to consult with your dentist to rule out cavities or something worse. The earlier you detect caries, the easier they are to treat.


Causes of Decay, Cavity and Caries

Curious about what leads to tooth decay and cavities? It’s not one thing that creates caries; it’s a series of actions that occur in a particular order, which may eventually lead to cavities if not treated.

The major causes of a tooth cavity are sugary drinks and foods. These sugars break down into acids, which lead to decay. That means for 20 minutes after you eat anything sweet, your teeth are at risk of attack by decay.

Dental cavity and decay causes and process illustration

By understanding the causes of dental caries and learning how to care for your teeth properly, you can prevent them from occurring. Some of the significant factors of tooth decay to be aware of include:

  • Poor Dental Hygiene – lack of brushing and flossing allows the build-up of plaque
  • Dry Mouth – saliva helps to keep plaque off the teeth and acts as a buffer against acid
  • Formation of Plaque – the plaque will build up over time, produce acid, and break down the teeth
  • Sugary Food and Drink – foods rich in carbohydrates or sugar can get stuck in the teeth and increase cavity risk
  • Plaque and Acid – when bacteria digest carbs/sugar, they produce acid that will break down the teeth
  • Health Issues – specific cancer treatments or medical conditions may impact cavity formation


Different Types of Tooth Cavity

There are three primary types of cavities: root decay, smooth surface cavity, and pit/fissure decay.

smooth, pit and root cavity

Root decay cavities occur on the surface of the root of the tooth. These caries are more common in adults and seniors who may have issues with the gums.

Smooth surface decay cavities are a form of slow-growing decay on the smooth surfaces of the tooth. These are easier to treat, and you can resolve them with special fluoride treatments. If the cavity makes its way through the smooth surface of the tooth, a filling is necessary.

Finally, pit or fissure cavities are areas of decay in the small grooves of molars, where biting occurs. When you catch these cavities early enough, you can merely seal or treat them with fluoride. If caries deepens, a cavity filling may be necessary.


Cavity Areas: Between Teeth, Front, Molars and Wisdom Teeth

A cavity can take place either between two teeth, on the front teeth, on molars, and even on wisdom teeth.

A cavity between two teeth is an interproximal cavity. This caries usually occurs when food gets stuck between two teeth, and brushing can’t properly clean it.

Cavities on the front teeth are less common but may occur, especially in children who drink sugary drinks.

Cavities on the molars and premolars are the most common since these are the teeth that chew food. It’s also harder to reach all of the angles in the back of the mouth when brushing. Areas missed by brushing can lead to these kinds of cavities.

Molar teeth infection
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caries in tooth grooves
dental cavity forming between teeth
Dental caries photos
caries in tooth grooves
dental cavity forming between teeth
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Dental caries photos
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Partially erupted but unextracted wisdom teeth are particularly prone to tooth decay. A partially erupted tooth can create pockets where food particles and plaque can accumulate. If not treated properly, this can eventually produce acid and break down the structure of the wisdom tooth.

Risk Factors and Complications

It’s critical to know what puts you at higher risk for tooth decay and the complications associated with cavities if left untreated.

Risk factors include:

  • Poor oral hygiene
  • Consuming sugary foods or drinks in little bits throughout the day as opposed to all at once
  • Eating and going to bed without brushing your teeth
  • Using sippy cups or bottles filled with sugary drinks for children
  • Giving children a sweet beverage at bedtime
  • Sharing utensils, which can transfer bacteria
  • Dry mouth caused by Sjogren’s syndrome, radiation, or certain medications
  • Losing the ability to care for one’s self

If you do develop a cavity, you’ll want to get it treated as soon as possible. If left untreated, you could experience any of the following complications:

  • Increased tooth sensitivity
  • Pain and swelling
  • Fillings
  • Root Canals
  • Extractions (pulling out the tooth)
  • Dentures or implants


Tooth Decay Stages

Tooth decay doesn’t happen all at once. It happens slowly over time. The earlier on you can catch it, the easier it is to treat. These are the six tooth decay states that usually occur:

  1. White spots start to show on the tooth
  2. The enamel of the tooth begins to decay
  3. The inner dentin tissue starts to decay
  4. The decay affects the pulp of the tooth
  5. An abscess starts to form
  6. The tooth requires removal

Dental decay stages

You can prevent further steps of the process from occurring by making an appointment with your dentist for proper cavity treatment.


Symptoms & Signs of Decay: Cavity Pain, Toothache, and Infection

To avoid a tooth cavity, you’ll want to know the most common symptoms of tooth decay. When you’re able to recognize these as they are happening to you, you can seek treatment faster and avoid further damage.

Start paying closer attention to your teeth and stay on the lookout for any of these signs of tooth decay:

  • Pain: A toothache is usually the first warning sign of a cavity.
  • Pressure: If there is sensitivity and pressure when biting down, that may be pointing to a cavity.
  • Pits: A noticeable hole in the tooth will start to form as the cavity develops.

You also may notice tooth sensitivity from hot or cold items, which can potentially be an indicator of tooth decay. It can also occur for generally sensitive teeth, so a dental professional needs to make the differentiation.


How to Stop or Reverse a Cavity and Stop It Spreading

When you first notice a cavity forming, you’ll want to act fast so that it does not continue to worsen. To stop a cavity from spreading, you will need to get it treated with fluoride, sealed, or filled by a dentist.

If the tooth decay hasn’t created noticeable results in the teeth yet, it might be able to be stopped with just fluoride. In this case, your dentist may recommend fluoride toothpaste or mouthwash as a daily regimen.

If the tooth decay has begun to impact the tooth but not enough to warrant a cavity filling, the dentist may be able to treat it with a sealant. This unique composite material goes over the cavity to seal off the area from further damage by plaque and acids. It also will prevent food particles from getting stuck in this area and creating further damage.

Even if the cavity has started to damage the tooth, you can still do something to keep the tooth intact and prevent it from getting to the point where extraction is necessary. A simple filling can remove the plaque and acid build-up and seal the hole so that it doesn’t get any worse.


Tooth Decay in Children and Toddlers

Tooth decay is common among children, as they have less oral hygiene and tend to eat more sugary foods and drinks. Child-specific risks associated with cavities are:

  • Higher levels of cavity-causing bacteria in the mouth
  • Consuming too many sugary or carbohydrate-rich foods and drinks
  • Limited fluoride in the water supply
  • Poor oral hygiene routine
  • Less saliva than normal

If your child complains of a toothache, demonstrates sensitivity to certain foods or drinks, or shows any signs of visible damage on the tooth, don’t hesitate to bring them into the dentist’s office for a checkup.


Treatment Options and Cost

As mentioned above, the most common treatments for tooth decay are fluoride treatment, sealants, and fillings. If the cavity gets especially bad, a root canal, crown, or full tooth removal may be necessary. Let’s explore more about cavity fillings, crowns, root canals, and extractions and their costs.

  • Filling: Also called dental restorations, fillings are the most common treatment once a cavity gets past its first stage. A filler of either composite resin or porcelain fills the hole left by caries. This procedure can cost between $50-150 per tooth.


  • Crown: If the tooth has sustained extensive damage, it may need a custom crown that will replace the decayed area of the tooth. A crown prevents the need for extraction. These cost about $1200 without insurance.


  • Root Canal: A root canal may be necessary when the decay starts to reach the tooth pulp. This procedure can save an infected tooth from being pulled. There is a wide range of costs, but a root canal costs anywhere from $300 and upwards of $1500.


  • Extraction: When a tooth has passed the point of saving, it will require a full removal. An implant or bridge can replace the gap left behind. A non-surgical extraction without insurance could be $75-$300.


How to Prevent Tooth Decay and Cavities with Good Oral Hygiene

We’ve covered the available treatment options and how you may be able to stop a tooth cavity in its tracks. However, the very best treatment is always prevention. Just as we tell our children, good oral hygiene is crucial in preventing a mouthful of cavities.

To create a proper oral health routine that will prevent cavities, you’ll need a few items in your arsenal. Hopefully, you already have all of these things at your home, but be sure to pick them up at the drug store if not:

  • Toothbrush – soft bristles won’t damage the gums while cleaning the surfaces of your teeth
  • Toothpaste – select a toothpaste that treats plaque, cavities, gingivitis, halitosis, and tooth sensitivity
  • Floss – choose a floss coated in wax for smoother use; if using floss picks, be sure to clean the pick after flossing each tooth
  • Mouthwash – mouthwash is a great way to finish off your oral hygiene routine and kill any bacteria left in the mouth

Now that you have all the tools you’ll need, these are the steps you’ll want to follow to complete your comprehensive oral hygiene routine:

  1. Brush your teeth—often. Brushing twice a day should be your bare minimum. Immediately after you finish a delicious dessert, for example, is an excellent time to brush your teeth.
  2. Limit the sugary items you consume. Things like sodas, candy, or carb-rich food will create plaque bacteria in your mouth. Limiting the amount of these items that you consume will reduce your risk of cavities.
  3. Choose good-for-your-teeth foods. Some foods naturally clean teeth and keep plaque away. Raw fruits and vegetables like apples, strawberries, and celery are a few excellent options.
  4. Floss daily. Flossing picks up where brushing leaves off and takes care of the plaque and build-up that also occurs between the teeth. Pick a time to floss every day, and be strict about it.
  5. Rinse when you can. Rinse with mouthwash every day if possible. Whenever you can, give your teeth a quick rinse for extra fresh breath and fewer bacteria.
  6. Visit the dentist. You should be getting your teeth cleaned every six months from your dentist. Coming in for these regular appointments removes the build-up of plaque and prevents it from getting worse. It also gives you more chances for early detection if you do have any cavities forming.



Your teeth are vital for your oral health. When you neglect your oral hygiene routine, dental decay can occur. If this decay goes untreated for a while, cavities will form and break down the structure of your teeth. Luckily, with proper prevention tactics and early dental detection, you can treat cavities before things get too bad.

Be sure to practice good oral hygiene and always visit your dentist if you have any reason to believe you might have cavities.