Dental cavity diagnosis and treatment

Cavities, also known dental caries, are small holes that form in your teeth. They occur when mouth bacteria eat sugar and produce acid, which, if left on the teeth for prolonged periods of time, can lead to tooth decay.

Because cavities can cause pain and eventually lead to oral health problems such as infection and tooth loss, it is important to have them diagnosed and treated as early as possible.

How are cavities found and diagnosed?

Your dentist will discuss your oral health status with you and check for signs of cavities during a routine dental exam. This includes:

Asking about any pain or sensitivity you are feeling.
Reviewing routine dental X-rays when they are needed (typically every 1-2 years).
Looking for white, brown, or black spots, or other signs of tooth damage.
Using dental tools to check for soft areas on your teeth.

When cavities first form, they are not always detectable with the naked eye, which is why taking dental X-rays is so important — they can help your dentist detect cavities early when they are small and easier to treat.

The best way to know if you have a cavity is to visit your dentist for a professional dental exam. If you want to look for signs at home, you can use a mirror to check for discoloration or small holes in your teeth. Also, pay special attention to areas that are sensitive when you eat or brush your teeth, as this may be a symptom of a developing cavity. If you notice signs of a cavity, then be sure to visit your dentist.

What treatment options are available for cavities at each stage?

Cavities develop over five main stages. How far your cavity has progressed through these stages is a major factor in determining your course of treatment.

Stage 1: Demineralization. This begins when the acid produced by bacteria in plaque starts to break down your tooth enamel. At this stage, an actual cavity has not yet formed.
Treatment: At this stage, you may be able to reverse the damage with a consistent daily oral health routine or with fluoride treatments from your dentist.
Stage 2: Enamel decay. This stage begins once a hole has formed in the outermost layer of your tooth (your enamel).
Treatment: Your dentist may be able to treat the cavity with fluoride treatments. In other instances, they will need to remove the decayed area and apply a tooth filling.
Stage 3: Dentin decay. This occurs when the decay from a cavity reaches your dentin, which is the layer below your enamel.
Treatment: Early dentin decay may be addressed with a simple filling. But when the decay extends further into the dentin, or if your tooth cusps are involved, it is more likely that your dentist will remove the decay and use a dental crown to replace and protect the missing part of your tooth.
Stage 4: Pulp damage. After the layer of dentin, the cavity-causing bacteria may infect your tooth pulp (nerve).
Treatment: Damage to your pulp requires a root canal.
Stage 5: Abscessed tooth. Infected tooth pulp, left untreated, can cause an abscess at the end of the root and into the bone.
Treatment: At this stage, your dentist will likely need to drain the abscess, perform a root canal, or possibly even extract the infected tooth.

Do treatment options differ based on the type of cavity?

The type of cavity you have, and how severe it is, will influence the treatment your dentist recommends.

A smooth surface cavity forms on the smooth, flat surfaces on the sides of your teeth.
Treatment: If it has not progressed far, the cavity may only require a fluoride treatment. Otherwise, your dentist may need to remove the decayed area and apply a filling.
A pit and fissure cavity is found in the pits and grooves on the biting surfaces of your back teeth.
Treatment: Your dentist may recommend dental sealants to prevent this type of cavity from forming. Sealants are placed on molar teeth shortly after they come in (around age 6 and again at age 12). If a cavity does form in the pits or fissures of teeth, then the decayed area is removed, and a filling is applied.
A root cavity is located on the roots of your teeth. This type of filling is more common in older adults.
Treatment: Your dentist would remove the decay and fill the cavity. This type of filling is unique in that the filling sometimes dips under the gumline slightly.
A recurrent cavity is one that appears in the same place as a previous cavity did — near or under an existing filling or crown.
Treatment: Your dentist will need to remove part or all of the existing restoration, remove the decayed area, and apply a new filling or crown.

No matter what type of cavity you have, your dentist will discuss treatment options with you.

Can cavities be treated at home?

In the very early stages of a cavity, you may be able to reverse the damage by carefully maintaining a proper brushing routine with a fluoride toothpaste and over-the-counter fluoride rinses. But most of the time, the answer is no — treating a cavity requires the help of your dentist.

Can cavities go away on their own?

Some cavities that are very small and only in the enamel can sometimes be remineralized. However, once a cavity extends into the dentin, it requires treatment from your dentist to restore your tooth and will not go away on its own.

What can you do if you are feeling pain before you can get to your dentist appointment?

While your cavity will likely need treatment from your dentist to be restored, there are ways to help relieve any pain or discomfort caused by the cavity. For mild to moderate pain, you can:

Call your dentist to schedule a dental exam as soon as possible.
Keep your mouth clean by brushing your teeth twice per day.
- Brush gently with fluoride toothpaste and a soft-bristled toothbrush, taking extra precautions around any areas that are experiencing pain.
Avoid very hot, very cold, and acidic or sugary foods and beverages.
Rinse your mouth with salt water.
Put oil of clove (eugenol) on a small piece of cloth and hold it to your tooth for 10 seconds, being careful not to swallow any oil.

If your pain is severe, seek help from your dentist or physician immediately.

Prevent cavities with your dentist

If you think you have a cavity, consult your dentist for diagnosis and treatment. In the meantime, maintain a proper daily oral health routine and visit your dentist for regular cleanings to help prevent cavities from forming and detect any issues early.

If you need a dentist, use our Delta Dental dentist finder tool to locate one nearby.