Dental caries, commonly known as cavities, result from a process where acids produced by bacteria in the mouth erode tooth enamel. However, not all carious lesions relentlessly advance. Sometimes, a cavity can stop progressing and become what is known as “arrested caries.”
Understanding Arrested Caries
Arrested caries are carious lesions that are no longer active, meaning the demineralization process has ceased. They appear distinct from active cavities, often presenting as darker, harder, and sometimes shiny areas on the tooth surface. Unlike active lesions, which are typically soft and lighter in color, arrested caries feel firm and smooth when gently probed.
These inactive lesions can occur in various locations, including smooth surfaces, root surfaces, and within the pits and fissures of teeth. Arrested caries signify that the ongoing loss of minerals from the tooth has stopped, and in some cases, remineralization may have occurred. This leads to a denser, more acid-resistant tooth structure in the affected area, often with pigments incorporated during remineralization that cause the dark discoloration.
How Caries Become Arrested
The progression of dental caries can be halted when the oral environment shifts from being demineralizing to remineralizing. This change often results from improved oral hygiene practices, a reduction in sugar intake, or an increase in salivary flow. Effective removal of plaque through brushing and flossing disrupts bacterial biofilms responsible for acid production, reducing acidic attacks on tooth enamel.
Fluoride plays a significant role in this arrest process by strengthening tooth enamel and promoting remineralization. Fluoride integrates into the tooth’s structure, forming a more acid-resistant material. Saliva also neutralizes acids and provides essential minerals for tooth repair.
Reducing the frequency of sugar consumption is another important factor, as sugars fuel acid-producing bacteria in plaque. Less frequent sugar consumption reduces acid exposure, allowing for remineralization. Some lesions also become self-cleansing due to their location or tooth morphology, hindering plaque accumulation and active decay.
Managing Arrested Caries
Arrested caries typically do not require fillings and are managed through careful monitoring by dental professionals. Regular dental check-ups are important to ensure these lesions remain inactive and to detect any signs of reactivation. During these visits, dentists may visually inspect the area and gently probe it to confirm its hard, non-sticky texture.
Maintaining excellent oral hygiene practices, including consistent brushing with fluoride toothpaste and flossing, is important to sustain the arrested state and prevent new active lesions. Continued fluoride exposure from toothpaste, fluoridated water, or professional applications further enhances tooth resistance to decay. Limiting sugary foods and drinks also supports a favorable oral environment.
In rare instances, a dentist might consider intervention for an arrested lesion. This could be due to aesthetic concerns, if the lesion is causing food to get trapped, or if there is uncertainty about whether the lesion is truly arrested. Recognizing that not all cavities require immediate treatment empowers individuals to prioritize preventive care and professional oversight.