Why Do I Get Cavities So Easily?

Cavities (or caries) are the blackish discolouration of teeth causing pain, discomfort and can possibly lead to an  infection and tooth loss. This is the most common problem in people of all ages.

The global oral health report states that oral diseases affect 3.5 billion people worldwide, with the most common incidence .

Cavities  lead to secondary issues like periodontal diseases, bone loss and ultimately tooth loss.

The main reason for cavities is the deposition of plaque on and in between the teeth . When plaque accumulates it converts  sugars from food into acids which  damages the teeth .

Cavities of permanent teeth  cause pain, discomfort, and food lodgment, decreasing the quality of life of the affected. 

Cavities of primary teeth (milk teeth /baby teeth)  cause pain and may also affect the permanent teeth underneath the milk teeth. Therefore, cavities should not be neglected and adequate treatment has to be taken.

Increased caries incidence is seen in individuals:

• With increased sugar intake on a daily basis
• Poor oral hygiene
• Dry mouth
• Improperly aligned teeth (as food can easily accumulate in between teeth causing cavities between the teeth)
• Family history of cavities¹ 

What is a cavity?

It is a chronic disease caused by tooth adherent bacteria, such as Streptococcus mutans. This bacteria  converts  sugars into acids that cause damage to teeth  in the form of holes or cavitations.

Tooth is composed of 3 layers, enamel, dentin and pulp. Pulp provides a  rich supply of blood and nutrients to the other two layers.

Enamel is the outermost layer and the hardest tissue in the  human body which is mostly composed of inorganic content such as hydroxyapatite,a mineral form of calcium. 

Enamel is formed right before the eruption of the tooth into the mouth. So, if the  tooth comes out of the socket, it can not form enamel. Enamel due to its chemical composition is proven to be stronger than ceramics.

During cavity formation, the hydroxyapatite  is lost in a process called  decalcification, thus forming holes in the tooth structure.

Dentin  is resilient under enamel and it forms the most bulky part of tooth structure. Due to decalcification, dentin won’t lose its structure like  enamel.²

Risk factors of cavities

There are many risk factors for cavities and the most common  are: 

• Cariogenic and acidogenic bacteria-  Streptococcus mutans and Lactobacillus  
• Reduced saliva (dry mouth)
• Poor dietary habits- frequent snacking and drinking sugary drinks 
• Poor oral hygiene-  regular professional cleansing, brushing twice daily and regular  flossing has to be implemented for good oral hygiene
• Family history- family members with cavities  

Rare cases

In cases of tumours  involving salivary glands, salivary stones formation, saliva production and amount of saliva reaching the oral cavity is reduced, which  can  indirectly cause  cavities.

In radiotherapy patients, because of radiation side effects, saliva production is reduced, which  inturn causes cavities, called radiation caries (but those are very rare).³

Signs and symptoms of cavities

The first sign of cavities is a white spot, indicating subsurface demineralisation of enamel.

Cavities can be categorised into active or inactive based on such characters 

• Active caries- white in early cases, black in late cases, rough in texture, cavitated, has plaque stagnation with gingival bleeding
• Inactive caries- brown, shiny, smooth, non-cavitated with no plaque stagnation or gingival bleeding¹
• Cavities in initial stages may cause sensitivity due to damage of enamel and exposure of dentin to the oral environment
• Cavities in late cases can cause severe persistent pain that can be reduced only after administering proper treatment
• Cavities when incidence is more can also cause gum disease and can cause tooth loss.
• When cavities involve front teeth, they can cause the hampering in aesthetics of an individual thereby affecting their confidence and self esteem¹

Management and treatment for cavities

Management of cavities include

• Detection of early cavities
• Determining the caries activity- active or inactive
• Assessing caries risk -  enlisting diet chart and oral hygiene habits
• Prevention of new carious lesions- application of fluoride for teeth regularly in those with increased risk for cavities and suggesting fluoride toothpastes.
• Preserving dental tooth structure
• Maintaining oral hygiene- regular cleaning by a professional

Treatment of cavities

• Cavities involving enamel-

Removing damaged tooth structure and placing dental restoration that aligns with tooth anatomy

• Cavities involving pulp-

When cavities have involved pulp, root canal treatment has to be performed. In this procedure, pulp will be removed with the help of specialised  instruments, and the pulp channel is trimmed and medicament is placed that prevents further cavities or infection and the cap is fixed onto the tooth.¹

FAQs

How common are cavities?

Caries is the most common disease of teeth. Statistics state that globallly two billion people are having permanent teeth cavities.

What are the complications of cavities?

Cavities can cause severe pain, discomfort, inability to chew, bad breath and loss of decayed teeth . Infection caused by cavities can be severe and may spread to jaw bones causing various infections like an abscess, cyst and granuloma and ultimately can cause infection of bone marrow that can  be fatal. Therefore cavities have to be addressed  by a dentist  as soon as possible.

How can I prevent cavities?

Prevention of cavities can be done by regularly maintaining good oral hygiene. Intake of vegetables and fruits and reducing high sugary food items such as chocolates, sweets. Hampering frequent snacking and brushing twice daily and regular flossing can help in clearing of food lodged in between the teeth. 

Regular visits to your dentist can help in treating early cavities in any case, thereby preventing further complications.

When should I call the doctor?

Oral anatomy is very complex and it is very difficult for anyone to identify cavities formation. Visiting your dentist  once  every six months is ideal to avoid any complications. People with a history of  cavities or relevant family history should visit the dentist every 3-4 months. 

If you  experience  tooth pain, you  should visit the dentist  as soon as possible.

Summary

Cavities are a very common disease affecting teeth. Though they are  treatable, prevention should be the main goal. Eating a healthy diet low in  sugar and good oral hygiene maintenance can help in prevention of cavities.  If there is a family history of cavities, it's best to visit your dentist  every 3-4 months  but if not, visiting a dentist  every 6 months is enough.