While tooth enamel can undergo remineralization in its early stages, an established cavity, a physical hole in the tooth, cannot heal on its own. Once tooth structure is compromised, professional dental intervention is necessary to address the damage.
Understanding How Cavities Develop
Cavities, also known as dental caries, begin with a sticky film of bacteria called plaque that forms on your teeth. When you consume foods and drinks containing sugars and starches, the bacteria in this plaque feed on these carbohydrates. These bacteria produce acids, such as lactic acid.
These acids attack the tooth enamel, the hard, protective outer layer of your teeth, leading to the loss of minerals like calcium and phosphate in a process called demineralization. Continuous acid attacks gradually erode the enamel, causing it to weaken and eventually form tiny holes. If left untreated, the decay can progress deeper into the tooth, reaching the softer dentin layer beneath the enamel, where the decay process accelerates.
Early Tooth Decay Versus Established Cavities
The initial stage of tooth decay is known as demineralization, where acids from plaque begin to strip minerals from the tooth enamel, making it porous and soft. At this point, there isn’t a physical hole in the tooth; you might notice small, white, chalky spots on the enamel surface.
This early demineralization is the only stage where the tooth has the potential for “remineralization” or reversal. Minerals from saliva and fluoride can be redeposited into the weakened enamel, helping to strengthen it and stop decay progression. However, once demineralization progresses and a physical hole in the enamel forms, it is considered an established cavity. At this point, natural healing cannot repair the structural damage.
Why True Cavities Cannot Self-Heal
A true cavity cannot heal independently because tooth enamel, unlike bone or skin, is not living tissue. It does not contain living cells capable of regenerating lost tissue once damage occurs. While the outer layer of enamel can be strengthened with fluoride, it cannot naturally replace lost structure.
Once a cavity has penetrated the enamel and reached the softer dentin layer, the damage becomes permanent and requires professional intervention. Relying on home remedies or dietary changes to reverse an established cavity is a misconception, as these methods cannot repair a physical hole in the tooth. Without professional treatment, an established cavity will only continue to worsen, potentially leading to increased pain, infection, and even tooth loss.
Professional Care and Prevention
For established cavities, professional dental intervention is necessary to prevent further damage. Dentists treat cavities by removing the decayed material from the tooth and then filling the cavity with a durable material such as composite resin, amalgam, porcelain, or gold. For more extensive decay or when a tooth is severely weakened, a dental crown, which is a cap, may be recommended to restore its shape, strength, and function. In cases where decay reaches the innermost layer of the tooth, the pulp, a root canal may be performed to save the tooth.
Prevention is important for maintaining oral health and preventing new cavities. Regular brushing twice a day with fluoride toothpaste helps remove food particles, plaque, and bacteria. Daily flossing cleans between teeth and under the gumline where toothbrushes cannot reach. Limiting sugary and acidic foods and drinks reduces the fuel for acid-producing bacteria, and drinking plenty of water helps rinse away food particles and stimulate saliva production, which neutralizes acids. Routine dental check-ups and professional cleanings, typically twice a year, detect early signs of decay and remove stubborn plaque and tartar.