Anyone who has had a toothache knows how troubling a tooth cavity can be.

A cavity is a loss of tooth structure due to tooth decay or enamel erosion. Tooth decay, also called dental caries by its scientific name, can be caused by too much bacteria sticking onto the teeth and breaking down sugars into acids which causes demineralisation of the tooth enamel. Once the enamel is gone, the dentine (the inside part of teeth) and pulp (nerve centre of the tooth) will be affected. This can cause pain and discomfort if left untreated for a long time. The tooth decay process is slow and gradual. Thus it may be common among older adults due to wearing away the teeth enamel over time. Dental caries result from a combination of factors such as eating sugary foods and drinks, poor dental hygiene, or gum diseases. Understanding these causes helps prevent tooth decay, delay or slow its progress.

What are the consequences of tooth decay?

The consequences of left untreated cavities can cause serious discomfort. As the cavity progresses, it eats the hard outer layer of the tooth until it reaches the pulp and dentine of the tooth or spreads below any existing filling/restoration on your teeth. A deeper cavity can lead to pain, sensitivity, gum disease (gingivitis), and sometimes even bone loss (which is very rare).

Advanced tooth infections can lead to more serious health issues. For instance, a tooth abscess can lead to blood infections which can be life-threatening.

Sometimes if an x-ray is taken of teeth with old dental fillings present; it might show that there is no more tooth structure beneath the restoration which means that all tooth enamel has been removed by bacteria which usually results in loss of restorations, root canal treatment (a procedure where the inside pulp of a tooth is cleaned out) or extraction of said tooth.

There are many ways to treat tooth decay, listed below.

  • Pain medication such as paracetamol or ibuprofen.

  • Rinsing the mouth with warm salt water.

  • Go to the dentist to get it properly treated by filling up the cavity with dental composite resin or placing a crown over it.

What are the symptoms of a cavity?

Some symptoms of a cavity include tooth sensitivity to hot or cold foods and drinks, teeth with dark spots on them, pain especially when consuming sweet food/drinks or even pressure from biting down, bad breath, and in severe cases, infection underneath filling/restoration or within pulp which is very rare. You might also see that fillings have cracks or chips, but most likely, they will look corroded, which is a sign that the inside of the tooth might be infected. If you experience any signs related to a cavity, then it is important to book an appointment as soon as possible with a dentist to have a look at your mouth and diagnose any problems. All these treatments need your co-operation, and you must look after your teeth every day. Taking care of your teeth includes daily brushing twice a day, reducing intake of sweetened food and sugary drinks, flossing your teeth once a day, or even better use an electric toothbrush. If you are unable to pay for dental treatment, then there are the following options:

  • Government assistance.

  • Dental schools that can provide free services.

  • Some private practices also offer payment plans.

You should always visit your dentist even if you do not have any signs of pain every 6 months because it is very important to catch problems early before they escalate into bigger ones. This will help save you money in the long run as well as show you to be responsible which will result in better oral health.

What causes a toothache?

A toothache occurs due to the wearing of the enamel. As tooth decay progresses, it damages the middle layer before destroying the inner layer, also called dentin. Evidence of toothache is a pain when chewing, sharp pain when biting down or when you are trying to bite your back teeth or molars are all signs of a toothache. Toothaches can be very painful and cause problems with eating food, talking, smiling, or even sleeping. Sometimes people have tooth pain for no apparent reason, but the most common reasons include tooth decay/cavities. Other reasons might include the below.

  • Old fillings that have become too large for the cavity causing discomfort.

  • Cracks in teeth.

  • Gum disease (gingivitis), where there is inflammation around the gum area or tooth root, which will result in bone loss around your teeth due to not being able to repair itself.

  • Permanent fillings, which are known to cause pain because the metal in them affects the nerve supply around it.

  • Teeth grinding, which can lead to cracks of teeth or even sharp points on your teeth.

If there are any signs of bacteria, then you should rinse your mouth with warm salt water or see a dentist immediately. This is especially important if you have tooth decay/cavities, gum disease/gingivitis, permanent fillings, dental crowns or braces. If left unattended for too long, it could result in an infection underneath the filling/restoration or within your pulp which could be very serious.

How to stop cavities from becoming worse

You are more susceptible to cavities if you have braces because there are food particles trapped between brackets and wires. Braces can also lead to misalignment of teeth, so brushing them properly with fluoridated toothpaste is very important. If you currently have braces, then using an electric toothbrush will help prevent plaque residue around the brackets or wires, which could end up trapping food.

You should also use a mouthwash after brushing your teeth as this will kill these bacteria before they get the chance to cause problems for your teeth. There are some foods that you should avoid when having new fillings or dental crowns fixed. These include:
  • Nuts.

  • Popcorn.

  • Fruit that has lots of seeds, e.g., strawberries or raspberries.

If you are experiencing any pain, avoid eating these foods until your dentist tells you it is ok to eat them; otherwise, you could damage your teeth further. You should always see your dentist if there is any discomfort in the mouth because they will give you something for the pain and offer advice on how to take care of your teeth properly.

How can I prevent tooth cavities?

You can prevent cavities in a number of ways.

Brushing daily

Brushing teeth with fluoride toothpaste is a proven way to prevent cavities. The American Dental Association and other dental research institutes recommend brushing after every meal or at least 2 times a day. Brush for at least 2 minutes to remove plaque. Brushing before going to bed will prevent any food sugars from being active on your teeth when you sleep. A mouth wash or use of dental floss work between the teeth is highly effective as well. Introducing young children to brushing helps prevent tooth damage that may show up later in life.

Regular dental visits

Regular dental check-ups are as important as good oral hygiene. Cavities can develop even after following all the recommended tooth care activities. Some risk factors such as antidepressant medication that cause dry mouth, cancer treatments, or genetics can be predisposing factors. Visiting the clinic for regular dental check-ups can help identify the degradation of chewing surfaces due to these factors in the early stages. If early tooth enamel erosion is detected, it can be arrested by administering fluoride treatments or by having dental sealants applied.

Avoid or reduce intake of sugary stuff

Eating sugary foods, drinks and starch can accelerate wearing of the enamel. The decay-causing bacteria native to the mouth gets access to sugar or starch, which releases an acid. It is this acid that causes the enamel to wear out. As such, avoid frequent snacking on sugary foods.

Can a dentist save a rotten tooth?

A dentist can save a tooth with a cavity, but it depends on how deep the hole in your tooth is. If you have teeth that are sensitive when eating hot/cold foods, then visiting your dentist would be best because they will need to remove some of the decay before filling up the space again.

If they cannot entirely remove all of the decay, there might be an increased chance of getting another cavity at this spot.

If the bacteria has reached past the nerve centre in your tooth, then they may not be able to save it, and you will most likely need a root canal or extraction. Root canals are procedures where the nerve centre is removed from your tooth, and root canals are done. The inside of your tooth is cleaned and shaped before filling each space with an inert filling material. This will be able to prevent any further infection from occurring.

A dentist might also need to take out all or part of a tooth if there has been a large amount of decay that they cannot remove themselves or if you have gum/permanent fillings that may infect the root canal.

An extraction would happen if the patient is unable to keep up with routine visits, does not ensure their at-home oral hygiene routine is very strict/good enough or does not want to go through treatment for it anymore. It will depend on how bad the tooth is and if any other teeth around it have been affected. Your dentist will most likely recommend a dental implant for this tooth loss as they offer a more permanent solution to having a false tooth fitted. It will also feel the same as your own teeth. For more information on the costs of dental work, take a look at the Australian Government's Health Direct website.

Which factors increase the chances of getting a cavity?

There are many factors that may contribute to you getting cavities/decay on your teeth, such as:

  • Genetic factors.

  • Eating habits, e.g., eating lots of sugary/sticky foods.

  • Lack of oral hygiene. if you don't brush your teeth properly or often enough, then bacteria won't be able to be removed from your mouth, and this could end up forming a cavity.

  • Not visiting the dentist regularly could lead to more small cavities.