Tooth Cavities: can they REALLY be ignored?

You get up in the morning and sleepily brush. You see a small black spot in your tooth!! Panic and brush vigorously. Promise yourself that you would brush twice a day, and ACTUALLY do that! (for a week….)

Sounds relatable?

But that’s how our brains are designed. We give immediate responses in distress and then when we get the feeling that things are fine again we regress back to our regular schedules.

“The brain is a bad master but an amazing slave”

 So it’s time to train the brain to the facts that it needs to follow when you actually see that “black spot”

What are tooth cavities?

According to the definition of Mayo Clinic, “Cavities are permanently damaged areas in the hard surface of your teeth that develop into tiny openings or holes.”

They are the most common disease in the world after common cold and are progressive and irreversible.

Step 1: Next time you see that small black spot on your tooth, register that just brushing will not help.

Why do tooth cavities occur?

The mouth contains  millions of bacteria. All of them are not bad. Some of the bacteria help in initiating digestion of the food, whereas others help to prevent the bad bacteria from growing in the mouth.

Tooth cavities are formed due to thousands of bad bacteria invading the hard (calcium rich) surface of the tooth.

These bacteria stick to the surface of the teeth and produce strong acid. The acid dissolves the hard surface of the teeth exposing the underlying structures which are the again open to attack by the bacteria causing progressive damage to the tooth. 

Cavities are more common in people who

·         Do not brush regularly

·         Do not use the correct method of brushing

·         Have sweets at a greater frequency (the amount of sweet consumed isn’t as important as the frequency at which sweets are consumed)

·         Have reduced salivary flow (the bacteria tend to form colonies if the salivary flow is reduced). Find out the reasons for Reduced salivary flow

·         Smoke

·         Have less of water intake

Step 2:  Check what is the reason you got the tooth cavity?

Where can tooth cavities occur?

Cavities occur on the hard surface of teeth. The tooth has multiple surfaces exposed in the mouth and cavities can occur on any of those surfaces

·         On the chewing surface of back teeth: These are the most common types of cavities

·         Between two teeth: These generally cannot be seen by the person having them and are ignored until some symptoms surface. A dentist can locate such a cavity with proper history based questions.

·         In front teeth: These cavities are rare in adults but aesthetically very disturbing. Cavities in front teeth are more common in infants and children up to the age of 5 years.

Step 3:  Locate the region of the cavity

How do cavities progress?

The tooth is made up on multiple layers

Layer 1 Enamel:  This is the outermost layer. It is mainly composed of calcium and is the first layer to be attacked by the bacterial acid to form a cavity.

The cavity at this stage appears as a small decolouration of the involved tooth surface and does not present with any other symptoms.

Layer 2 Dentine: This is the second layer of the tooth. It is less mineralized than enamel and has nerve endings.

The cavity at this stage appears as a brown hole with some soft black/brown stuff in it, Since, dentine has nerve endings at this stage the tooth might be sensitive to hot/cold things.

Initially, the tooth sensitivity might disappear once you stop eating the hot/cold stuff. But, as the disease progresses the tooth sensitivity will get converted into pain and might continue for minutes to hours after eating something.

Layer 3 Pulp:  This is the innermost layer of the tooth. It is soft and has no mineral content. The pulp contains of lots of blood vessels and nerves.

In the cavity progressing to the junction of dentine and pulp and subsequently to the pulp, Initially, there is intense tooth pain. This tooth pain generally starts at night or when the person is lying down and lasts for a very long time. The pain is generally unbearable.

This tooth pain would subside on taking pain killers, but would resurface once the effect of the painkillers subsides. Complete proper medication needs to be taken in order to get relief from the pain


Once the bacteria are entirely in the pulp they move towards the underlying bone in which the tooth is attached. This can further progress swellings around the tooth to swellings in the face and neck region.

Treatment of a tooth cavity

Since tooth cavities are progressive and irreversible, they need to be treated at the earliest.

The treatment of a cavity depends on the stage to which it has progressed and can start from simple home based remedies to arrest the progression of the cavity to fillings to root canal treatments or removal of the tooth.


The major things to take care of if you have a tooth cavity include

·         What stage is it at?

·         What is the best treatment possible now?

It is best to take treatment at the earliest if you believe you have got a tooth cavity.

Please let us know if you have any further questions and DO NOT ignore if you feel you have got one.

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