A true cavity, which is a physical hole in the tooth structure, does not disappear on its own. A cavity represents permanent damage caused by tooth decay that requires professional intervention to repair and restore the tooth’s integrity. While the earliest stage of decay can be reversed, this initial mineral loss is distinctly different from the formation of a literal hole.
The Process of Tooth Demineralization
Tooth decay begins with demineralization, the loss of mineral content from the protective outer layer of the tooth, the enamel. This process is driven by specific oral bacteria, such as Streptococcus mutans, that reside in plaque. When these bacteria consume fermentable carbohydrates, they produce organic acids as a byproduct.
The presence of these acids lowers the pH level on the tooth surface. When the pH drops below a critical point, typically around 5.5 for enamel, the acids begin to dissolve the calcium and phosphate ions that make up the enamel’s hard hydroxyapatite crystals. This leaching of minerals weakens the enamel structure, creating the initial lesion of decay. This continuous cycle of acid production and mineral loss is the basis of tooth decay.
When Healing is Possible Versus True Cavitation
The initial stage of decay, known as a white spot lesion, is characterized solely by subsurface mineral loss without a physical breach of the tooth surface. At this point, the process is potentially reversible through remineralization. Saliva naturally helps neutralize the acids and contains minerals that can be redeposited into the weakened enamel structure.
Fluoride, found in toothpaste and professional treatments, aids this natural repair process by attracting minerals back to the tooth, strengthening the enamel crystals. However, once the acid attack creates a physical opening or hole in the enamel, called cavitation, the damage is permanent. A true cavity cannot be naturally healed or repaired by the body.
Progression and Risks of Untreated Cavities
If a true cavity is left untreated, the decay rapidly advances through the tooth layers. Once the cavity penetrates the enamel, it reaches the underlying layer of dentin, a softer and more porous material. Dentin decays at a faster rate than enamel because the critical pH for its demineralization is higher, making it more susceptible to acid attack.
As the decay progresses deeper, it eventually reaches the pulp chamber, which contains the tooth’s nerves and blood vessels. Infection of the pulp causes severe pain and inflammation. The bacteria can then spread beyond the tooth’s root tip into the jawbone, forming an abscess. Ignoring this advanced infection carries the risk of spreading to other parts of the body, potentially leading to systemic health complications.
Essential Dental Treatments
Since a cavitated lesion cannot heal on its own, professional dental treatment is required to stop the progression and restore the tooth’s form and function. The most common treatment for a true cavity is a dental filling, where the decayed material is removed and the space is filled with a restorative material like composite resin or amalgam. This procedure seals the tooth, preventing further bacterial invasion.
For more extensive decay that has compromised a significant portion of the tooth structure, a crown may be necessary to cover and protect the weakened tooth. If the decay has reached the pulp chamber and caused an infection, a root canal procedure is often performed to remove the infected tissue and save the tooth from extraction. Timely treatment is important to prevent minor decay from escalating to a problem requiring more complex, invasive, and costly procedures.