DENTIST CAVITIES

DENTIST CAVITIES AND CARIES:

DENTIST CARIES and DENTIST CAVITIES are synonymous, meaning they are the same. Both refer to DENTAL DECAY, which is what eats away teeth.

WHAT CAUSES DENTIST CAVITIES:

Cavities are caused by acid produced by certain strains of bacteria, when fermentable carbohydrates are left on the tooth surface.  This acid essentially eats away at the tooth structure and causes it to break down, where by holes/cavities are created.

If teeth are kept impeccably clean by brushing and flossing, the bacteria wouldn't have any carbohydrates to use to produce the acid.  Most commonly the biting surfaces of teeth that have lots of grooves and pits, and between the teeth (where flossing cleans), is where cavities form.  They can form on the smooth surfaces of teeth but are less common in those areas.

WHAT IF I DON'T FEEL THE CAVITIES MY DENTIST DIAGNOSES?

It is actually good if you don't have any discomfort from cavities, because that probably means that they are not too deep. If you are having discomfort, the decay likely is very deep and you may end up needing a root canal . If you do not trust your dentist, you can always get a second opinion.

Although, deep cavities can still turn into root canals even if there aren't any symptoms currently.

Often times people are reluctant to fix cavities unless they are having symptoms, because they think if it doesn't hurt then there isn't a problem.  Cavities will continue to progress and eat away your tooth until fixed. 


DIAGNOSIS:

The two ways that most dentists use to diagnose dentist cavities are by visualizing the cavity in your mouth, and by using X-rays.  The X-rays are mostly used to see cavities that show up between the teeth and underneath crowns and fillings, but can also help show how deep the decay is.

Cavities can also be seen with the naked eye.  Usually on the biting surfaces or on the sides of the teeth are the easiest to see.  Anything that is black, brown, or discolored is always checked, but not necessarily a cavity.

Dentists us a very sharp explorer, which helps let the dentist know if the tooth structure is hard (non-carious) or soft (carious, needs to be filled).

If the dentist is poking around, and you feel the instrument get stuck, chances are you have a cavity.


DENTAL XRAYS:

Below are some dental xrays that show early cavities.

Below is a good illustration of both small and large cavities, and how they appear on a standard dental xray or dental radiograph.

DIAGNODENT:

Some dentists use a diagnodent laser dentist cavity detector. There is one that is shaped like a pen, for easier use. The laser is placed over the area of concern, and a number is given which dictates the presence of a cavity or not.  It is not completely black and white, but is just another tooth that is sometimes utilized.

This is used in conjunction with consulting dental xrays and use of the explorer, all of which help the dentist diagnose properly.



DECAY vs ENAMEL AND DENTIN:

Below are two pictures that illustrate how tooth caries can appear small on the outer surface, but actually be really deep.

ENAMEL:

Enamel is the outer layer of tooth structure, and is very hard. Decay progresses slower through this layer than through dentin. Nerves do not penetrate the enamel, therefore there is no sensation felt when enamel is stimulated.

DENTIN:

Dentin is the inner layer, which is softer than enamel; therefore the decay eats away the dentin much faster than the enamel. Dentin is made up of dentinal tubules which when stimulated lead to the pulp, which holds nerve tissue, so stimuli is felt.

CEMENTUM:

Cementum is what the root surfaces of teeth is made of, and is also much softer than enamel. When gums recede and root surfaces get exposed, they are much more likely to get decay. Cementum also is close to the pulp, and can be stimulated.

SEALANTS:

Sealants are often done to prevent cavities on the biting surfaces of teeth. If teeth have deep grooves which are more prone to collecting debris, they are often sealed in order to prevent the debris from causing cavities. They are only done on the occlusal, or biting surfaces of teeth.



Below is an actual tooth, where you can see the tooth decay on the top of the tooth, which appears small, but is probably quite deep as illustrated above.

*NOTICE THE BLACK GROOVES IN THE CENTER OF THIS TOOTH- THIS IS DECAY





This is what another dentist cavity looks like on an xray. The arrows are surrounding a dark shadow, which indicates decay. This is a very deep cavity which may end up causing the tooth to need a root canal. (Many small cavities are not really visible to the untrained eye)

*note, the whitest part on the tooth indicates an amalgam/silver filling.

BACTERIA CAUSING CAVITIES:

There are specific strains of bacteria (streptococcus mutans, streptococcus sobrinus, and lactobacilli) cause cavities. If you have any of those strains of bacteria in your mouth, you can are more likely to get cavities.

If you do not, you are less likely to get cavities.

THIS IS WHY SOME PEOPLE DO NOT BRUSH AND DO NOT GET CAVITIES, WHILE SOME BRUSH CONSTANTLY, AND STILL GET DENTIST CAVITIES!

Flossing :

Flossing is absolutely essential in this effort. Most people brush their teeth, but that is only half of the job. Brushing does not clean in between the teeth, where many dentist cavities form. Only flossing does.


DECAY ALONG THE GUMLINE OF A TOOTH



CAN IT BE TRANSMITTEDYES. You can acquire the cavity causing bacteria from others, say, a spouse, or significant other. Meaning, if you have never had a cavity, but your new significant other has a mouthful of fillings, you may increase your risk of getting cavities.

CONTRIBUTING FACTORS and PREVENTION:

HOME CARE:

Excellent home care can remove plaque and calculus, which disrupts the bacterial colonies, and prevents decay.

It takes plaque about 24 hours to build up, so it is normally recommended to brush at least twice a day, and flossonce a day.

DIET:

Many small meals may be good for your metabolism, but it is also good for the BACTERIA’S. Food spread throughout the day, gives the bacteria a constant source of food as well.

The worst offenders are SUGAR containing products, such as SOFT DRINKS, SWEETENED COFFEE or TEA, CANDIES, or other SWEETS.

XEROSTOMIA/DRY MOUTH:

Xerostomia is the term for dry mouth, or the decrease or lack of salivary flow. Saliva helps to neutralize acids as well as protect the teeth from decay, so if that is not present, the risk of dental decay increases.

This is caused by:

  • Aging
  • Certain drugs
  • Certain diseases or health conditions
  • Radiation to the head and neck

There are products such as Biotene, which are designed to aid in this problem. They make toothpastes, mouthwashes, and gels which can help to mimic saliva and decrease irritations and help protect against dentist cavities. Your dentist probably can provide samples upon request.


PREVENTION:

FLUORIDE:

Fluoride has been proven to be one of the most effective anti cavity agents. It is very important to expose teeth to it both when the teeth are developing and after they have erupted. It is in most toothpastes and in the drinking water of many cities, but some children may need supplements if they are in places where there is not fluoride readily available.

FLUORIDE VARNISHES:

Fluoride varnishes are sticky, concentrated fluoride solutions that are applied at the dental office, and can remain on the teeth for up to 24 hours. This keeps the fluoride in contact with the teeth for very long periods of time, which help reinforce the tooth structure and prevent decay. If this is applied several times per year, it can definitely help reduce the risk of tooth decay, and even help prevent incipient (early stage) cavities from progressing.

ANTI-BACTERIAL PRODUCTS:

Products containing XYLITOL, which is an artificial sweetener found in some sugar free gums, may help reduce the amount of cavity causing bacteria. It is recommended to use these products up to 5x per day, which seems like a lot, but even if you only use them 1-2x/day, it is still better than chewing gum without it.

CHLORHEXIDINE GLUCONATE, PERIDEX:

This is a prescription mouthrise which has antibacterial qualities which can also reduce the amount of cavity causing bacteria. Your dentist can prescribe how to use it and it is normally not used on a long term basis.

Over the long run it can cause some very slight staining of the teeth, but this goes away after it's use is discontinued, and the benefits far outweigh the possible side effects.

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