People come to my office, and others, wanting all kinds of dental solutions for prevention, pediatric care, crooked teeth, dark teeth, missing teeth, infected teeth, gum problems, TMJ problems, missing teeth, bad breath, even headaches. By far the most common problem I see is cavities…lots of cavities. Unfortunately some patients will have almost as many cavities as they have teeth. Even patients, or their parents, who are not aware of any problems usually have several areas of decay. I hope to answer some questions you might have about this problem in this article.
So how many people in Howard County have active tooth decay? My estimate for those folks who have not seen a dentist in several years would be 90 percent.
So wouldn’t these people have pain or at least sensitivity? No, cavities almost always produce no symptoms until they are huge! Sometimes the whole tooth can decay down to the root with no pain.
So what is a cavity anyway? The scientific name for tooth decay is dental caries. It is the demineralization and eventual cavitations (hole formation) of first the enamel (outer layer), the dentin (middle layer), and then the pulp (nerve) of the tooth. Not until the pulp is involved do symptoms usually appear, often in the form of severe pain or infection (abscess).
So what do cavities look like? First, by the time you can see cavities at home, they are usually getting large. In the grooves on the chewing surfaces they look like brown or black spots. Brown or white spots near the gum line are usually cavities. Black looking areas around old fillings are also. Cavities on the in between surfaces generally can’t be seen without x-rays.
Where do cavities occur most commonly? In descending frequency, they occur in the grooves, on the in between surfaces, then the surfaces that face the cheeks and tongue. In middle aged and elderly patients they often occur on the roots under the gums.
So why so many cavities? I’ll discuss this in my next article in detail, but briefly here are the main contributing factors. Diet ( both content and frequency of ingestion), effectiveness of home care, exposure to fluoride, frequency of dental visits, types of plaque bacteria, amount and quality of saliva, the quality of enamel all play a part in whether or not cavities form
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