The Suprise Cavity
Patients can be surprised when their dentist tells them they have a cavity: “I don’t have any pain or sensitivity,
though.” So how can this be? Let’s begin with a brief description of tooth anatomy.
The tooth is composed of enamel, dentin, a pulp chamber, and root canals. The enamel is the hard exterior layer of the tooth; the dentin is between the enamel and the pulp and is softer than enamel; the pulp chamber contains the nerve.
Bacteria, left unchecked, begin feeding off ingested sugars creating acidic byproducts. These acids create small pits or cavities in the enamel called decay. Decay starts out slowly and can go undetected for some time; the process may take several years before it’s exposed on an X-ray or through a clinical examination.
Once the cavity becomes large enough, bacteria reaches below the enamel into the softer dentin, and the decay will show on an X-ray. At this point, the patient may still be unaware the cavity even exists. That is why dental check-ups and cleanings are so important in preventing smaller issues, such as needing a filling, from becoming out of hand. Further, if the cavity is at an early enough stage, the dental healthcare team may be able to advise the patient on reversing the process through changes in dental hygiene so that the patient can possibly avoid needing a filling.
However, if a patient misses regular preventative appointments, that cavity that has unknowingly entered the dentin will eventually begin a bacteria feeding-frenzy, leading to the pulp chamber and the nerve. Once the cavity gets close enough to the nerve, pain begins. Then the cavity is likely large and a normal filling may not be able to adequately support the remaining tooth structure after the decay is removed; therefore, a crown may be needed. If still left untreated, the patient may need root canal therapy or have the tooth extracted.
So the moral of the story is: allow your dentist to find the cavities before you do! Make your regular checkups and let your dentist know if there are any teeth bothering you. Together we will keep your teeth healthy.