Today I am going to talk about how a tooth develops cavity, from its early stage of enamel demineralization to full blown tooth cavity.
The tooth develops cavity because the bacteria in the mouth digests the food debris on the tooth surface and these bacteria would release some acidic byproduct as part of this digestion process. These acidic byproduct would damage the enamel and slowly leach out the calcium within the enamel. This is the first stage of tooth cavity disease process and is called enamel demineralization.
Acid erosion is a commonly cause for enamel demineralization. (See Acid Erosion in this dental blog.)
When the enamel is demineralized, the tooth surface would appear chalky white.
The right canine tooth (second to the left tooth on the photo) has chalky white spot on its surface.
Luckily the tooth at this stage can still be healed naturally. The treatment would consist of avoiding food and beverages high in acidic content, improve oral hygiene and also most importantly is to receive fluoride treatment at the detnal office. The fluoride treatment is to apply fluoride gel or varnish on the tooth. Fluoride helps to strengthen the tooth and would help initiate remineralization process. Remineralization is the reverse of demineralization. Fluoride helps the calcium to rebuild the weakened enamel.
However, if the demineralization process get worse, the soften patch of enamel may become cavitated. The middle tooth in the above photo illustrates how a cavity looks like. This cavitation is a non-reversible process. It would require dental intervention. At this stage, the tooth needs to be fixed with the composite filling material by the dentist. The dentist would have to clean out any decay or non-reversibly weakened tooth structure. Then dentist would go through the steps in completing the filling.
A cosmetic veneer can also be used to mask out the large area of filled tooth structure. Or if the defect is large, a crown is needed to restore the tooth.
Written by Daniel Tee, DDS, MS
Practicing Cosmetic Dentist Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.
