Cavities and Tooth Decay
Dental tooth Decay causes most of the tooth cavities and holes we regularly see in Teeth, so when the decay is removed the resultant hole left usually is filled-in, with a dental filling. These fillings are often Metal Amalgam fillings or more cosmetic White Fillings using Composite or Ceramic alternatives.
Dental tooth decay and cavities can be detected early with laser probes or X-rays, thus avoiding or minimise the size of your fillings, avoiding deeper root canal treatments, broken rotten teeth and toothache. Poor Diet (too many sugar attacks) and Poor tooth-cleaning lead to Tooth Decay, bad breath, gum diseases and infection, abscesses and extractions - ALL can be prevented or treated early so they don't become even worse.
Please read below for information on Dental decay, cavities and how one can prevent these for better Dental Health.
We even have laser technology that detects decay BEFORE a cavity can be seen in the mouth or on old-fashioned X-rays and any weakened areas can be strengthed with topical Fluorides or Sealants to prevent a Cavity hole from forming too!
The BEST FILLING of all is Healthy Tooth, so avoiding cavities and their causes is STILL a No.1 Priority!
However, if you have Dental Decay and cavities, earlier treatment gives the best result - do NOT wait until in pain or get toothache, as this is a LATE sign of tooth trouble and it only hurts when decay is near the Nerve - then you may need a more complex root canal treatment and large filling too, then also a Crown possibly, or an extraction!
Some people feel guilty if they haven't been to a Dentist for some time, so they stay away even longer until they are in pain, teeth break or tooth decay just rots away teeth to decayed stumps. Yes, regular Dental visits help keep you healthy but even if you've saved up some problems, better to get advice and treatment late than way too late to help. Dentistry has improved greatly in technology and comfort, so please don't put off getting the advice and care you need to get Dentally Healthy and then STAY Dentally Healthy too!
What exactly is Dental decay and Cavities?
A Dental tooth "cavity" is the term used for when hard teeth suffer a form of softening which dissolves the good hard-part of the tooth away when this softer-area caves in there is usually a hole with still some decay in the base. Bacteria cause decay, fed by sugar they grow quickly and produce lactic acids which over time, weakens the same area of tooth, allows the bacteria into the tooth, then continues to dissolve it from the inside, out of reach of your toothbrush, but still being fed by sugar in food and drinks from the mouth.
How do I know if I need a filling?
Usually a patient cannot detect early decay at all if it's not easily visible on the front teeth, because pain isn't an early sign but a late sign when the decay is deep near the nerve - If you know you need a filling, then it is usually a large problem (That you feel with your tongue) rather than a smaller (early) one. Sometimes cavities that have "eaten" enough tooth away can show up on X-rays as dark holes. Because teeth are so "dense" they often mask early holes starting in teeth from the X-rays, just like metal fillings can hide decay and only appears on X-rays when it gets deeper under the filling - but by then it is often a medium or large sized hole, needing a much larger filling than if it had been detected earlier.
Also, once a tooth has a "large" filling in it, all future replacement fillings can only get even larger (never smaller!), thus often needing future Crown work or root-treatment, which is not only more complex and expensive, but means more teeth are ultimately lost in the "decades" ahead. If one's goal is to keep teeth for life, then this MUST include EARLY diagnosis and treatment of decay to either catch the problem early and only need "tiny" fillings and sealing, or even prevent early decay from caving-in and a cavity occurring in the first place!
This is why you need the regular expertise of your Dentist, to find and ideally prevent any problems at an early stage, to save the maximum amount of healthy tooth and find problems as EARLY as possible! This is why we use special laser detecting probes to find those cavities that are starting BEFORE any normal dental probes or X-rays ever could. This is what we mean by early detection and prevention !!! We also treat teeth with Topical Fluoride routinely (that nice tasting gel we place on your teeth at every check-up) because this helps to harden-up Enamel and exposed roots on teeth and makes them more resistant to decay attacks by bacteria.
Decay can start as soon as teeth appear - Not exactly the ideal first visit to us for this Child below now is it?
Now we need to use strong antibiotics for the worse part of the infection, then extract some front teeth so the swelling/Access doesn't come back, then check/fix other teeth, improve their Dental health generally via diet and oral hygiene, then monitor other teeth and perhaps seal them against decay to actually prevent it happening in the first place!
Regular monitoring with our "laser" probe will help us monitor and prevent problems early too!
When regular visits and monitoring are the norms from birth for children, they can grow up into adulthood with literally not one decayed or filled tooth, if they follow our advice. Also, there would be no fear or apprehension of the "unknown" or worry that accompanies such Dental visits for children who never come until there is a late or painful problem. Isn't this a shame when modern advice, prevention and any simpler, earlier treatment would have prevented this even happening!Still, at least some "Parents" are more receptive to regular Dental care and Prevention now and bring their children in before it's too late to avoid pain!
How do cavities start?
You're probably familiar with the damage rust can do to metals or acids can do too. The acids caused by plaque bacteria in your mouth can be a big problem too. Plaque is the sticky film of food and bacteria that forms constantly on your teeth. A small amount is actually protective, but too much becomes very destructive. It's hard to see bacterial plaque because it is transparent or tooth coloured.
As I'm sure that you appreciate, plaque bacteria grow very fast in the presence of sugar, which is why Dentists are always saying don't eat or drink sugary things too often. We eat the Sugar but so do the Bacteria that rot teeth! You can see how Bacterial Plaque shows up after you've stained it with the vegetable dye (disclosing tablets you too can use). If you don't remove the plaque thoroughly every day, these bacteria produce acids that will gradually eat through your enamel and give you irreversible cavities unless prevented in time. Finding cavities early is more difficult than you think. For hard-to-find cavities, a laser light detector is best, because it can detect when acids have weakened the surface of enamel and reached the Dentine underneath, long, long before this can be seen by the human eye or even X-rays! More commonly, though, this new technology isn't commonplace yet so most Dentists still rely upon sharp dental probes and X-rays are used too. X-rays are quite good at looking for cavities between teeth, where the teeth curve and meet at a single point, but they are poor at seeing occlusal decay on the biting surface, where decay happens most commonly! This is because the "decay" must hollow the tooth out quite a lot to make enough of a difference in density to show up as a difference in shades. Remember that the direction of the X-ray beam is horizontal across the whole biting surface, through the thickest part of all the enamel on the biting surface. An early hole just cannot be seen, it is simply "masked" from X-rays by the thicker enamel either side of it. Metal fillings and crowns have a similar "masking" effect, with metal showing up as "bright white" on the X-ray. Dental cavities (or air) show up as dark areas which let through the X-rays easier than the denser enamel or fillings. Thus laser light detectors can access the biting surface directly and measure the amount of reflected light, to detect even the slightest changes in density or hardness. This is useful to detect problems early and monitor their progress if early treatment is not the first option chosen.
When do I need treatment?
It's far better to catch and restore decayed areas while they're still small and in the enamel layer of the tooth. At this stage, it may even be possible to reverse the "demineralisation" surface decay caused by the acids without needing any filling at all. However, once decay gets in the softer dentin layer underneath the enamel, it really spreads quickly. If bacterial decay makes it to the middle of a tooth's pulp chamber, where the nerve is, then we have a whole new set of problems and a different, more complex treatment to discuss - root canal treatment therapy.
How does the Dentist monitor my teeth?
The dental profession has created a system of numbers and letters, into a kind of tooth-code, so that they can note and record whats happening in your mouth, from a visit to visit. If cavities are discovered in your teeth, you'll hear your dentist name the numbers and/or letters for each cavity They can also record the "laser" readings and see if your early problems are getting worse and how quickly. This keeps an accurate record of the condition of your teeth, and helps your dentist to monitor early problems or restore them when necessary to their healthy condition. Regular, thorough check-ups are an important way of preventing and monitoring dental diseases so that early prevention or treatment can be done. Waiting until something hurts is a sure way to create bigger problems and costs too. Professional early prevention and monitoring is the best way in our opinion if teeth for life is your goal.
Does it matter if I leave a Cavity and the decay gets Bigger?
Well YES, unless you don't mind a bigger filling caused by the decay rotting more of the good tooth away inside, you may find that acceptable. However, there are consequences such as losing more good, strong tooth substance (making the tooth weaker overall, even if it's filled!). Also, larger fillings need replacing more often and usually cost more money. Eventually, this will possibly then need a crown, as it becomes more filling (hole) than tooth.Worse still, if decay is left too long without Treatment, then it quietly rots deeper until it reaches the nerve in a tooth and infects it !!!
That's the trouble with a toothache - it's often a LATE sign of trouble because decay doesn't usually hurt until it's near or infected the nerve centrally.
Once decay has reached the nerve it could cause pain, swelling, abscesses, bad tastes from infection etc. and it will then need a Root Canal Treatment or Extraction - both more complex and costly than perhaps a much smaller filling done in time to prevent this happening and
keep the tooth for life! In short, it is always better to visit your Dentist for regular checks than to wait for the aim to strike - better to visit your dentist late than too late !!!
Regular visits and Prevention
The reason Dentists recommend regular visits ISN'T to do Dental Treatment - it's to spot things going wrong early and PREVENT them becoming bigger or worse or even stop decay making a cavity altogether if it's discovered early enough. That is why we use the latest technology to detect problems as early as possible, so you can get the best, earliest treatment that helps you keep teeth troble free, for life.Regular Professional cleanings also help prevent bad breath, tartar build-up and gum diseases too!
Indeed, at our Practice the usual examination visit is every 4 months (x3 yearly), so that we can check/monitor your teeth with laser probes for early decay, apply topical fluoride regularly, to prevent and reverse decay, do regular Oral Cancer checks and well as monitor your gums and teeth and how well you are brushing and flossing etc.
As we keep reminding people, PREVENTION is better (and cheaper) than Cure, so once you get your problems fixed, PLEASE stick with regular check-ups and follow your Dentist's advice - we are trying to put ourselves out of a job by telling you how to prevent Dental Diseases and the need for more invasive treatments later, because Dental Diseases are preventable, it's just that the SIGNS of dental diseases (broken teeth, pain, swelling etc.) are usually only noticed long after the decay/gum-disease has been there - thus regular check-ups help to discover problems early, treat preventatively and if you do need a filling, it is usually a small one you weren't even aware of, because it wasn't allowed to progress to a big hole or toothache, which at that point of course you cannot ignore.
So ironically, patients visit us MORE often for 4 monthly check-ups to ensure they get LESS dental treatment and stay healthy too.
A Cosmetic Consultation at our SmileSpecialist® Centre costs just £99 and takes 45 mins and we will look at Braces, Whitening, Veneers, Crowns, Bridges, Cosmetic Fillings with Cosmetic Bonding and recontouring etc, etc, to help address the aspects of your Smile you may wish to improve. At the end of that visit you will have an outline Treatment Plan, Estimate of costs and timescales and a good idea of all the alternatives (or combination of options) that would best meet your wishes, needs, budget and timescale overall.
The Importance of good Aftercare and Maintenance !
As well as regular check-ups to your Dentist to prevent problems (or at least catch them very early-on), please follow your aftercare advice and don't neglect your Toothbrushing and Flossing Techniques that reduce Dental Plaque attack on your teeth, gums and dentistry work, especially to prevent new decay coming back!
Want to know more about brushing and Flossing techniques that prevents bad breath and keeps your Mouth and Dentistry Healthier too?
*Dr.Kilcoyne is a UK registered Specialist in Prosthodontics (GDC No.58373) which includes The Functional and Cosmetic Dentistry aspects of Crowns, Dental Implants, Bridges, Veneers, Fillings, Dentures, Bonding etc. Please go to our MAKE an APPOINTMENT page if you'd like to access his Expertise.