Dental Caries: Symptoms, Causes & Treatment

Dental caries, also called tooth decay or cavities, occurs when acids produced by bacteria in the mouth damage the tooth surface. It can cause symptoms such as tooth pain, tooth sensitivity, and white, brown, or black spots on the teeth.

Depending on how advanced the cavity is, a person may also have bad breath or a bad taste in the mouth. Other possible symptoms include red, swollen, or bleeding gums around the affected tooth, facial swelling, or fever.

If you have signs or symptoms of dental caries, it is important to see a dentist. Recommend treatment may include fluoride treatment, a dental cleaning, or a filling, depending on how advanced the cavity is.

Cavity symptoms

The main symptoms of dental caries include:

• Toothache

• Small pits in one or more teeth

• White, brown, or black spots on the tooth

• Tooth sensitivity

• Holes or cavities in the teeth

• Bad breath or a bad taste in the mouth

In cases of advanced dental caries, a person may also have red, swollen, or bleeding gums around the affected tooth, facial swelling, or fever.

Cavities in children

Cavities are very common in children and teenagers. They are usually caused by acids produced by bacteria in the mouth, which wear down and damage tooth enamel.

Cavities in children can happen due to a high intake of sugar and poor oral hygiene, which are common at this age. According to the CDC, cavities are the most common chronic disease of childhood in the United States.

Children are also more likely to develop cavities because the enamel on baby teeth is more sensitive and less resistant to acid.

Another important cause is putting babies to bed with a bottle containing milk, formula, juice, or sweet tea. These liquids can sit on the teeth for hours, feeding the bacteria that cause cavities.

Tooth decay stages

The main types of dental caries include:

1. Inactive caries

Inactive caries is an area of tooth damage that has stopped progressing. It is in a balanced stage or a natural mineral repair process in the tooth enamel, known as remineralization.

Inactive caries usually appears as a white or brown lesion that is shiny and smooth.

2. Early-stage caries

Early-stage caries, also called a white spot lesion, is the earliest stage of tooth decay. It affects only the tooth enamel and is often reversible.

In the early stage, dental caries often does not cause any symptoms. However, it may cause dull white, brown, or yellowish spots on the teeth near the gumline.

3. Deep caries

Deep caries, or advanced caries, happens when tooth decay reaches the innermost part of the tooth, called the pulp.

Because the pulp contains nerves and blood vessels, deep caries can cause severe, constant pain, dark or black spots, and swelling.

How to tell if you have a cavity

A dentist diagnoses dental caries through a clinical examination using specialized instruments.

If caries are suspected, a dental X-ray may be requested to confirm their location and assess the extent of tooth damage.

What causes cavities?

Dental caries is caused by acids produced by bacteria that naturally live in the mouth.

Some factors that can increase the risk of dental caries include:

• Poor oral hygiene

• Frequent intake of sugary and/or acidic foods

• Fluoride deficiency

• Dry mouth (xerostomia)

• Conditions such as gastroesophageal reflux disease (GERD) or eating disorders, such as bulimia

Although dental caries itself does not spread directly from person to person, the bacteria that contribute to cavities can pass through saliva, such as through kissing or sharing utensils.

This may increase the risk of dental caries and other oral health problems, especially when combined with poor oral hygiene or frequent sugar intake.

Treatment options

Treatment for dental caries depends on the stage of the lesion and may include:

• Fluoride treatment with fluoride toothpaste or fluoride varnish applied in the dentist’s office, in cases of early caries

• Improvements in diet and oral hygiene, in early cases

• Dental fillings, in cases of advanced caries

• Root canal, in cases of advanced caries when the nerves are affected

In the most severe stage of dental caries, if root canal treatment is not possible or the damage is too extensive, the dentist may recommend tooth extraction.

When a permanent tooth is extracted, it can be replaced with an option such as a dental implant, bridge, or denture to help maintain chewing, speech, proper nutrition, and self-esteem.

Prevention tips

Some important steps to help prevent dental caries include:

• Brush your teeth at least twice a day. According to the American Dental Association, brushing twice a day with fluoride toothpaste and cleaning between the teeth daily can help prevent tooth decay.

• Floss every day, especially before going to bed.

• Limit how much sugar you consume and how often you consume it.

• Drink plenty of water throughout the day.

• Choose fluoride toothpaste every time you brush your teeth.

• Chew sugar-free gum if you have a condition that causes dry mouth, as this may help increase saliva flow.

It is also recommended to see a dentist every 6 months to help detect cavities early and remove plaque through a professional dental cleaning.