Dental Cavities
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?
Dental cavities are holes in teeth caused by tooth decay. Cavities are also referred to as caries.
How does a cavity form?
Two main factors contribute to tooth decay -- bacteria and a diet high in sugar and starch. There are over 500 different types of bacteria that are normally present in the mouth. These bacteria combine with food and saliva to form a sticky substance called plaque that attaches to teeth. Foods rich in starches add to the stickiness of the plaque, which begins to get hard if it remains on the teeth after a couple of days and turns into tartar or calculus. Bacteria in the plaque convert sugar into acid that dissolves the tooth structure causing holes, or cavities. Because of these two contributing factors, dental caries have been described as a “dietobacterial” disease.
The parts of teeth that are most vulnerable to tooth decay are areas where plaque can accumulate most easily. Plaque tends to settle into the pits and fissures in the tops of teeth, into the areas in between the teeth, and next to the gum line. Where there is plaque, there are bacteria and acid, and eventually destruction of the tooth surface. The cavity starts in the outer layer of the tooth (enamel) and as it gets deeper, penetrates into the softer inner layer of the tooth (dentin.) Typically, it isn't until the decay reaches the dentin that a person will start to notice signs and symptoms of the cavity.
What risk factors contribute to tooth decay?
Saliva helps prevent plaque from attaching to teeth and helps wash away and digest food particles. A low salivary flow or dry mouth leaves the teeth more vulnerable to tooth decay. Genetic factors that affect tooth decay are tooth size and shape, thickness of enamel, tooth position, tooth eruption time and sequence, and the bite.
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