Dental Cavities (Dental Caries)
Steven B. Horne, DDS
Dr. Steve Horne began his career at Brigham Young University obtaining his BA in English. He earned his Doctorate of Dental Surgery in 2007 from the University of Southern California where his pursuit for academic excellence landed him on the Dean's List. He was recognized for his superior clinical skills and invited to help teach other dental students in courses on restorative dentistry, prosthodontics, and tooth anatomy. During dental school, he provided dental care for underserved populations of Los Angeles and Orange County, Mexico, and Costa Rica with AYUDA. Following dental school, Dr. Horne entered active duty with the U.S. Army and practiced dentistry at Fort Knox, Kentucky, for four years. During this time, he was deployed to Baghdad, Iraq, and received multiple Army Achievement Medals, the Army Commendation Medal, and served as Company Commander. Dr. Horne currently practices full time at Torrey Pines Dental Arts in La Jolla, California, as a general dentist. Dr. Horne is a member of the American Dental Association, the California Dental Association, and the Academy of General Dentistry. Dr. Horne is married to his wife, Christy, and they have a chocolate Labrador named Roscoe.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
- What are cavities?
- What are microcavities?
- How does a cavity form?
- What risk factors contribute to tooth decay?
- What are the signs and symptoms of cavities?
- How are cavities diagnosed?
- What is the treatment for cavities?
- What is CAMBRA?
- Treatment of cavities during pregnancy
- What is the prognosis of a cavity?
- Dental (Oral) Health FAQs
- Find a local Doctor in your town
What are cavities?
What are microcavities?
Teeth are in an environment of constant acid attack that strips the teeth of important minerals and breaks the teeth down. While this attack is constantly occurring, minerals are also be constantly replenished through mineral-rich saliva and fluoridated water and toothpaste. In addition to fluoride, calcium and phosphate also help to remineralize enamel. When the demineralization starts and is confined to the outermost layer of enamel, it is called a microcavity, or incipient cavity. These types of cavities rarely need anything more than very conservative treatment. Only when the cavity breaks through the enamel layer and into the dentin does it really threaten the tooth. So when these microcavities are detected, it is best to try a remineralization protocol to see if they can be reversed instead of jumping to a filling right away. A dentist will help in determining the most effective conservative treatment for these early cavities.
The dentist's goal is to achieve a healthy balance between prevention and restoration. It is a balance between being proactive and reactive. The dentist doesn't want to be so proactive that he is recommending things that don't need to be done -- preventing problems that realistically never would have occurred. But he doesn't want to be so reactive that he simply watches small problems become big problems. One mistake people often make is waiting for pain to dictate the timing of treatment. Once a tooth starts hurting, it is often too late for remineralization or a small filling. Pain usually indicates a need for root canal treatment, a crown, or tooth extraction. There is some variability in how dentists will treat microcavities and when they determine a filling is necessary. Some people are more prone to caries than others. Analyzing one's history of cavities, current diet, and oral hygiene may lead the dentist to be more aggressive or more conservative with his recommendations. This is why it is important that each person finds a dentist that echoes his or her own philosophy regarding aggressive versus conservative dental treatment.
Regardless of the dentist, regular returns to the dentist are key to being conservative so the cavity can be monitored and treated before it grows too much. Small cavities can become root canals within a year under the right circumstances. As a cavity grows, more tooth structure is lost. And lost tooth structure leads to a greater likelihood of fractured teeth, recurrent decay, and tooth loss. When possible, one is always better off getting a small filling than ending up with a large filling, a root canal, or a crown.
Next: How does a cavity form?
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