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What are dental cavities?

Dental cavities, or caries, to use their scientific name, are holes in the teeth that are usually caused by decay. The outer part of the tooth is a hard layer of enamel. The inner portion is soft and contains nerves and blood vessels. A cavity occurs when decay extends through the hard, outer enamel into the soft interior of a tooth. A toothache — which can be excruciatingly painful — occurs when the decay reaches a nerve.

What causes dental cavities?

In a word, acid is the cause; it eats through the enamel into the tooth. The acid may come from food or drink. For example, people who eat large amounts of sweets are particularly prone to develop cavities because saliva begins to break down the sugar in the mouth, producing acid.

More commonly, however, the acids are produced by bacteria that thrive in the mouth. These bacteria secrete acid, which eats into the teeth, forming cavities.

How are dental cavities diagnosed and treated?

Cavities often can be detected by a dentist's visual examination. But x-rays of the teeth are the best way to detect cavities. Full-bite x-rays of all the teeth are generally recommended every other year.

Treatment entails removing the decayed tooth tissue and replacing it with a special filling material.

What can I do myself?
The first step you should take if you have a toothache or suspect you have a cavity is to call your dentist. A nonprescription painkiller such as aspirin, acetaminophen, or ibuproten can be taken. A warm or cold compress on the face may also help. Do not use toothache relievers containing eugenol (oil of clove). If they contain a strong enough dose of this anesthetic to relieve the pain, they may permanently damage the tooth.

When should I see my dentist?
As soon as possible if you have a sore tooth. Otherwise, you should see your dentist at least

once a year for a checkup.

What will the dentist do?
After your dentist examines the tooth and x-rays it, he or she fills the cavity. This entails removing the decayed tissue with a special dental drill. Special bonding material can then be inserted into the cavity to hold a filling, which is likely to be an amalgam of silver and other metals.

Today, there are a variety of anesthetics that are used to deaden the pain. Many patients are troubled by the noise of dental drills, a problem that has been minimized by quieter, high-speed drills.

Filling a dental cavity should immediately stop a toothache because the filling covers the exposed nerve.

The course of dental cavities

A dental cavity will not go away or get better on its own. It will only get worse until it is fixed by removing the decay and filling the tooth. Once fixed, that cavity should not bother you again, although fillings sometimes get loose and must be replaced. Occasionally, in the case of a very deep cavity, the dentist may put in a temporary filling to give the tooth interior a chance to heal before attempting a permanent filling.

Are dental cavities dangerous?

Not if they are promptly fixed. Leaving the tooth open and the nerve exposed can lead to a tooth root infection that may destroy the tooth. The infection might spread down the nerve root into the underlying bone, creating a potentially serious situation if an abscess forms.