A cavity, also known as dental caries, is a damaged area on the hard surface of a tooth, forming a tiny opening or hole. These areas of tooth decay can lead to significant health issues if left unaddressed. Understanding the potential consequences of an untreated cavity is important for maintaining both oral and overall health.
How a Cavity Progresses
Cavities begin when bacteria in the mouth convert sugars and starches from food into acids. These acids dissolve the hard outer layer of the tooth, known as enamel, through demineralization. At this initial stage, a small chalky white spot may appear on the tooth surface, often without pain or noticeable symptoms.
If the decay continues, it penetrates the enamel. It then progresses into the dentin, the softer layer beneath the enamel, which contains microscopic tubules leading to the tooth’s nerve. Once the dentin is affected, sensitivity to hot, cold, or sweet foods and drinks develops, and the decay can advance more quickly. As the decay reaches the innermost part of the tooth, the pulp (containing nerves and blood vessels), it causes inflammation and often severe, persistent pain. This stage signifies a deeper infection within the tooth’s core.
Local Complications of Untreated Cavities
Ignoring a cavity allows the bacterial infection to deepen and spread, leading to various localized problems. Persistent toothache is a common and debilitating symptom once the decay has reached the tooth’s pulp, as the inflammation presses on the nerve.
A dental abscess, a painful pocket of pus, can form at the tooth’s root or in the surrounding gums as the infection spreads from the pulp. Abscesses can cause swelling, throbbing pain, and fever. Chronic infection and inflammation from an untreated cavity can contribute to or worsen gum disease, progressing from gingivitis (gum inflammation) to periodontitis. Periodontitis affects the bone and tissues supporting the teeth, leading to gum recession and pockets of infection. A tooth significantly weakened by extensive decay can also become prone to cracking or breaking, especially when biting down on food. If decay is too widespread or the infection too severe, the affected tooth may become irreparable, necessitating extraction and resulting in tooth loss.
Systemic Risks of Untreated Cavities
The dangers of an untreated cavity extend beyond the mouth, as oral infections can spread to other parts of the body, leading to serious health complications. Bacteria from a dental abscess can spread to adjacent facial structures, including the jawbone, sinuses, face, and neck, causing cellulitis (a serious skin infection) or osteomyelitis (an infection of the bone).
Bacteria from the dental infection can enter the bloodstream, a condition known as bacteremia. If the body’s immune response to this bloodstream infection becomes overwhelming and life-threatening, it can lead to sepsis. Sepsis is a medical emergency characterized by widespread inflammation that can damage organs and tissues, with symptoms including fever, rapid heart rate, and confusion. In rare but severe instances, this spread can affect distant organs. For example, bacteria from a dental infection can travel to the heart, causing endocarditis (an inflammation of the heart’s inner lining), particularly in individuals with pre-existing heart conditions. Brain abscesses, life-threatening collections of pus in the brain, can also result from oral bacteria traveling through the bloodstream or sinuses. Chronic dental infections can also negatively impact the management of other systemic health conditions, such as making blood sugar control more difficult for individuals with diabetes, and increasing the risk of respiratory problems like pneumonia, especially if oral bacteria are aspirated into the lungs.