Dental Caries

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What are dental caries?

Dental caries, often called cavities, are erosions of the surface of the tooth caused by the combined effects of bacteria, acids, plaque and tartar. Dental caries are common in both children and adults, and they occur most often as a result of poor dental hygiene. Dental caries are usually painless at first, but they may become painful if they spread to the nerve or root of a tooth. Left untreated, dental caries can progress to a tooth abscess, which is a more painful and potentially serious condition.

Dental caries are common, but they can often be prevented by practicing good dental hygiene, including regular brushing and flossing. Dental caries usually do not require emergency medical care unless they become painful, do not respond to over-the-counter pain relievers, or progress to a tooth abscess. Treatment includes removing the decayed material with a drill and filling in the resulting hole with a stable dental material.

Seek prompt medical care if you suspect you have dental caries, if you have a toothache lasting more than a few days, or if your tooth pain cannot be controlled by over-the-counter pain relievers.

What are the symptoms of dental caries?

Generally, you will not experience any serious symptoms from dental caries. When symptoms are present, they may include toothache or sensitivity to hot or cold foods and beverages.

Common symptoms of dental caries

You may experience symptoms of dental caries all the time or just occasionally. At times, any of these dental caries symptoms can be severe.

Symptoms of dental caries are usually localized to the mouth. They include:

  • Holes in the surface of a tooth
  • Pain when chewing
  • Sensitivity to hot or cold foods and beverages
  • Toothache

Symptoms that might indicate a serious condition

In some cases, dental caries can be a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms including:

  • Severe swelling or pain in the jawbone
  • Severe toothache that cannot be controlled by over-the-counter pain relievers

What causes dental caries?

Dental caries are caused by bacteria and damaging substances, such as acid, that come into contact with your teeth. After you eat, normal bacteria in your mouth combine with food remnants and acids to create a sticky film called plaque. If you do not remove plaque regularly by flossing and brushing, it can build up or harden into a substance known as tartar. Plaque and tartar, in addition to bacteria and acids, can degrade the enamel on your tooth, leading to holes in the enamel called dental caries, or cavities. Dental caries usually begin as small, shallow holes; left untreated, they can become larger and deeper and potentially lead to tooth destruction or loss.

What are the risk factors for dental caries?

A number of factors increase the risk of developing dental caries. Not all people with risk factors will get dental caries. Risk factors for dental caries include:

  • Advancing age (older teeth form plaque more quickly)

  • Autoimmune diseases (such as Sjögren’s syndrome, characterized by dry eyes, dry mouth, and connective tissue disorder)

  • Dry mouth (inadequate salivation)

  • Excessive consumption of sugary, starchy or acidic foods or drinks

  • Poor dental hygiene

  • Recessed gums

  • Smoking

Reducing your risk of dental caries

You may be able to lower your risk of dental caries by:

  • Avoiding excessive sugar, starch or acid in your diet

  • Avoiding sticky foods or foods that may become stuck in your teeth (such as peanut butter or popcorn)

  • Brushing your teeth at least twice a day

  • Flossing your teeth at least twice a day

  • Fluoridating the community water supply

  • Going to your dentist regularly for routine cleaning and examinations

  • Having dental sealants, or protective coatings, applied to your teeth if recommended by your dentist

  • Receiving fluoride treatments as recommended by your dentist

  • Seeking treatment for dry mouth symptoms

  • Substituting artificial sweeteners in place of sugar

  • Using antiseptic mouthwash

How are dental caries treated?

Prompt treatment of dental caries by your dentist is important in preventing further damage to your tooth or an infection. A simple dental examination can identify dental caries, and an X-ray may help your dentist to determine the extent of the caries.

Dental caries are typically painless, but a larger or deeper area of destruction in the tooth may be painful. If you have a toothache, over-the-counter pain relievers, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol), may make you more comfortable until the caries are treated by your dentist.

In addition to medications, dental work is necessary to fill the cavity. Your dentist will begin by numbing your mouth with a local anesthetic. After your tooth is numb, your dentist will use a drill to clean out the area of decay and shape the surrounding tooth to allow it to be filled in smoothly with replacement materials. More severe caries may require more extensive dental work, including a root canal or tooth extraction.

What are the potential complications of dental caries?

Dental caries are not normally life threatening. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of dental caries include:

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 4
  1. Decay. ADA: American Dental Association. http://www.mouthhealthy.org/en/az-topics/d/decay
  2. Dental cavities. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/001055.htm
  3. Selwitz RH, Ismail AI, Pitts NB. Dental caries. Lancet 2007; 369:51.
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