A dental cavity, also known as tooth decay, is a hole that forms in the tooth’s surface. This occurs when acids, produced by bacteria feeding on sugars and starches, erode the hard outer layer of the tooth called enamel. Neglecting a cavity can lead to escalating problems affecting oral health and broader bodily well-being.
Initial Deterioration and Symptoms
The process of a cavity begins with demineralization, where minerals are lost from the tooth enamel, often appearing as small, white, chalky spots. At this very early stage, a cavity typically does not cause any pain or noticeable symptoms. However, if left unaddressed, the decay progresses, breaking down the enamel further and forming a more visible hole.
Once the decay penetrates the enamel and reaches the underlying layer called dentin, the progression of the cavity can accelerate because dentin is softer than enamel. At this point, individuals may begin to experience increased tooth sensitivity. This sensitivity often manifests as discomfort or pain when consuming hot, cold, or sweet foods and drinks. As the decay deepens into the dentin, the visible spots on the tooth may also change from white to a darker brown or black.
Deep Infection and Pain
As a cavity deepens past the dentin, it eventually reaches the innermost part of the tooth, known as the pulp. This soft tissue contains nerves, blood vessels, and connective tissue. When bacteria from the cavity invade the pulp, it leads to inflammation, a condition called pulpitis.
Pulpitis often causes persistent pain, which can be throbbing, aching, or sharp, especially when chewing or biting. The pain might also radiate to the jaw, neck, or ear. If untreated, the infection can spread beyond the pulp, leading to a dental abscess. An abscess is a pocket of pus that typically forms at the tip of the tooth root. Symptoms of an abscess can include facial swelling, tenderness, and fever, indicating a more severe infection.
Wider Health Complications
If an ignored dental abscess is not treated, the infection can spread beyond the tooth. Bacteria can travel from the periapical region into the surrounding jawbone and soft tissues of the face and neck. This spread can lead to conditions such as cellulitis, a bacterial infection of the skin and underlying tissues, characterized by redness, swelling, and pain. Untreated infections can also cause osteomyelitis, an infection of the jawbone itself, which presents with symptoms like pain, swelling, and difficulty opening the mouth.
In rare instances, the infection can enter the bloodstream, leading to systemic complications. This can result in bacteremia, where bacteria circulate in the blood, and potentially progress to sepsis, a life-threatening condition where the body’s response to infection damages its own tissues and organs. Although rare, an untreated dental infection can even lead to cavernous sinus thrombosis. This condition involves a blood clot in the cavernous sinuses at the base of the skull, which can cause severe symptoms and has a notable mortality rate even with treatment. Ultimately, prolonged and untreated decay can destroy the tooth’s structure, leading to permanent tooth loss.
Increased Treatment Complexity and Cost
Delaying treatment for a cavity increases the complexity and invasiveness of dental interventions. A small cavity affecting only the enamel or outer dentin can often be treated with a simple dental filling, which involves removing the decayed portion and filling the space with a restorative material. This procedure is straightforward and less time-consuming.
However, once a cavity progresses to involve the pulp, a more extensive procedure like a root canal becomes necessary. This involves removing the infected pulp, cleaning the root canals, and then sealing the tooth, often followed by placing a crown to restore its strength and function. If the tooth is too severely damaged or the infection has spread extensively, extraction may be the only option. These advanced treatments are more involved, require more dental visits, and are more expensive than addressing a cavity early.