COMMON CONDITIONS

Cavity

A cavity is a permanently damaged area in the hard surface of a tooth that develops into a tiny hole or opening. Cavities are caused by a combination of factors, including bacteria, frequent snacking, sipping sugary drinks, and inadequate cleaning of teeth.

(KAV-i-tee)

Also known as: Dental caries, Tooth decay

This article is for educational purposes and is not medical advice. Consult Dr. Durrett, Dr. Wilson, Dr. Danielle Durrett, or Dr. Vasconez for diagnosis and treatment specific to your situation.

Quick Facts

alsoCalled:: Dental caries, tooth decay
primaryCause:: Bacterial acid breaking down tooth enamel
commonSymptoms:: Toothache, sensitivity, visible holes or pits, brown/black staining
diagnosis:: Visual exam, dental X-rays, laser fluorescence
primaryTreatment:: Dental filling (composite or amalgam)
prevention:: Brushing twice daily with fluoride toothpaste, flossing, regular cleanings, limiting sugar

Overview

Cavities are one of the world's most common health problems. They're especially prevalent in children, teenagers, and older adults, but anyone with teeth can get cavities, including infants. According to the Centers for Disease Control and Prevention, more than 90% of adults in the United States have had at least one cavity in their lifetime. Despite being so common, cavities are largely preventable with good oral hygiene and regular dental visits. When left untreated, cavities get larger and affect the deeper layers of teeth, eventually leading to severe toothache, infection, and tooth loss. Modern dentistry offers many effective treatments, and the earlier a cavity is caught, the simpler and less expensive the treatment will be. The team at Lakeview Family Dentistry uses digital X-rays and visual exams to catch cavities at their earliest stages, when treatment is most conservative.

How cavities form

Cavities don't appear overnight. They develop gradually through a process called demineralization, which unfolds in stages. The mouth naturally contains hundreds of types of bacteria. Some of these bacteria, particularly Streptococcus mutans and Lactobacillus, feed on sugars and starches from the food you eat. As they digest these sugars, they produce acid as a waste product. This acid clings to teeth in a sticky film called plaque. Within minutes of eating, plaque acid begins attacking the outer layer of your teeth, called enamel. Enamel is the hardest substance in the human body — even harder than bone — but it can be dissolved by repeated acid exposure. Each acid attack lasts about 20 minutes after eating, during which time the pH in your mouth drops below 5.5 (the threshold where enamel begins to demineralize). Over time, repeated acid attacks cause the enamel to lose minerals, creating a tiny weak spot that eventually develops into a hole. Once the cavity reaches the softer dentin layer below the enamel, decay progresses much faster because dentin is less mineralized and more porous.

Causes and risk factors

While the basic cause of cavities is bacterial acid, several factors significantly increase your risk. Diet plays a major role: foods that cling to teeth (like candy, chips, dried fruit, and cookies) cause more decay than foods that are easily washed away by saliva. Frequent snacking and sipping sugary drinks throughout the day is especially harmful because it keeps your mouth in a constant acidic state. Inadequate brushing and flossing allows plaque to build up and begin the decay process. Not getting enough fluoride leaves teeth vulnerable, since fluoride helps remineralize early decay and makes enamel more resistant to acid. Dry mouth (xerostomia) increases cavity risk because saliva neutralizes acid and helps wash food particles away. Many medications cause dry mouth as a side effect. Age is also a factor: in younger children, cavity risk is high because tooth enamel is still maturing; in older adults, gum recession exposes the softer root surface, which is much more vulnerable to decay. Acid reflux disease (GERD) can erode enamel from stomach acid. Eating disorders involving frequent vomiting can do the same. Worn dental fillings or dental devices can also create areas where plaque accumulates.

Signs and symptoms

In their earliest stages, cavities often cause no symptoms at all — which is why regular dental exams are so important. As decay progresses, you may notice tooth sensitivity, especially to sweet, hot, or cold foods and drinks. You might feel mild to sharp pain when biting down or experience a persistent toothache. Visible signs include white spots on teeth (the first sign of demineralization), brown or black staining, or visible holes and pits in your teeth. Some people experience pus around a tooth, which indicates that infection has reached the inner pulp. If you're experiencing tooth pain or sensitivity, don't wait — early intervention is always less invasive than late-stage treatment.

How dentists diagnose cavities

At Lakeview Family Dentistry, cavity diagnosis combines several methods. A visual examination is the first step: the dentist examines each tooth surface with a small mirror and a dental explorer, looking for soft spots, discoloration, or visible damage. Dental X-rays reveal cavities that aren't visible during a visual exam, particularly cavities between teeth or beneath existing fillings. Our 3D digital imaging system uses up to 75% less radiation than traditional X-rays while producing detailed images that help us catch decay early. In some cases, a laser fluorescence tool may be used to detect early demineralization that isn't yet visible on X-rays. The dentist will classify the cavity by its location (smooth surface, pit and fissure, or root surface) and severity (early enamel decay, moderate dentin decay, or advanced decay reaching the pulp). This classification guides the treatment plan.

Treatment options

Treatment depends on how far the cavity has progressed. For very early-stage decay (white spots on enamel), fluoride treatments may reverse the damage by remineralizing the enamel. Lakeview's Cavity Prevention Program helps restore the mouth's natural mineral balance to prevent and reverse early decay. For moderate cavities, the most common treatment is a dental filling. The dentist removes the decayed tooth material with a small dental drill or laser, then fills the space with a restorative material. Modern fillings are typically tooth-colored composite resin, though amalgam (silver) and gold fillings are also options. For larger cavities or weakened teeth, a dental crown may be needed. The crown covers the entire visible portion of the tooth, restoring its strength and appearance. When decay reaches the inner pulp of the tooth, traditional treatment is a root canal — though Lakeview Family Dentistry does not perform root canals in-office and would refer to a trusted endodontist. In severe cases where the tooth cannot be saved, extraction may be necessary, followed by a bridge, partial denture, or implant to restore the missing tooth.

Prevention

Cavities are highly preventable with consistent oral hygiene and smart choices. The fundamentals: brush twice daily for at least two minutes with a fluoride toothpaste, floss at least once daily to remove plaque from between teeth, and visit your dentist every six months for professional cleanings and exams. Diet matters enormously: limit sugary and starchy foods, especially as snacks. If you do consume sugar, do it with meals rather than throughout the day — saliva produced during meals helps neutralize acid. Drink plenty of water, especially fluoridated tap water. Chew sugar-free gum after meals to stimulate saliva flow. For higher-risk patients, dental sealants applied to the chewing surfaces of back teeth provide a protective barrier. Fluoride treatments in the dental office offer extra protection. At Lakeview, our Cavity Prevention Program uses the CAMBRA (Caries Management By Risk Assessment) protocol to identify patients at elevated risk and tailor a personalized prevention plan.

Long-term outlook

When detected and treated early, cavities have an excellent prognosis. A small filling can last 10 to 20 years or longer with proper care. The key is consistency: brushing, flossing, and regular dental visits remain essential even after a cavity has been treated, because new cavities can develop on other teeth. Untreated cavities lead to progressively serious problems: severe pain, dental abscesses, infections that can spread to other parts of the body, tooth loss, and eventually expensive restorative work. The financial cost grows dramatically as treatment is delayed — a small filling might cost a few hundred dollars, while the implants, crowns, or bridges needed after tooth loss can cost thousands. The good news is that with modern dental care, cavities are entirely manageable, and most people can maintain a healthy, functional smile throughout their lives.

References & Further Reading

Medically reviewed by the doctors at Lakeview Family Dentistry.
Last reviewed: 2026-05-12