Hi, this is Dr. Abalos from Sunbrite Dental and I often get questions regarding cavities. So today I just wanted to go over some of the common questions that I receive from patients or concerned parents regarding cavities.
What are dental cavities?
So the questions that I get are, what are cavities? Doc, especially from my younger patients, they say, I keep hearing about cavities and all I know is that they're bad and they come from eating sweets. So cavity is just a fancy word. We dentists made up for rot found in our teeth. However, how our teeth rot is the same process that you've seen in fruits and vegetables, meaning once a tooth starts rotting, just like that apple, it never stops on its own. And two, you cannot wash it away just like that Apple. If you see that small part of the apple discoloring and starting to get soft, if you run it under the water, it's not going to go away. It's the same thing with our teeth when they have started rotting or when they have started to get cavities. The reason why I go over that is that because dentists, we dentists did too good of a job trying to sound so smart and professional by calling rot in our teeth cavities that often there's a disconnect on how our teeth rot compared to how fruits and vegetables rot, meaning a lot of patients, when I tell them they have cavities, they will sincerely and genuinely tell me, it's okay, doc, I'm going to brush better, or It's okay doc, I'm going to get that mouthwash and I'm going to rinse more. And when my patients tell me that inside I'm dying, like no. And I continue to think, ah, how do I get my patients to understand what I know about dental cavities? And it finally hit me when I was preparing fruit for my own two boys, meaning if you've ever found yourself in a situation where you're about to eat an apple and you saw a small part of it rotting and you've decided to cut the rotten part out, you actually were starting to use the logic of a dentist, meaning that is the same logic I use when I'm looking at my patient's teeth such as, Ooh, that doesn't look good, but gosh, it would be such a waste for me to throw away the whole tooth, or in your case the whole fruit. So depending on what stage of rot I catch it at, then we'll determine how I will go about treating that tooth.
What causes a cavity and what are the stages of it?
Okay, the next common question I get is, what causes a cavity? I don't get it, doc. I brush my teeth every day. I'm not a dirty birdie. Why are my teeth getting cavities? And so if you remember, cavities are just rot and it really for the most part stems from how much bacteria we have in our mouth. So if you have stayed away from the dentist for a while, then a lot of food that sticks onto our teeth will stay. It will not brush away. Again, think about those crusty dishes and try to clean them with the softer side of the sponge. It's just not going to clean those dishes very well. It's the same thing when chewed up. Food or plaque as we call it, has the ability to stick on teeth. When you go in and try to brush that away, it's not as effective anymore because the food has stuck on to the surface of the teeth.
Now that also becomes like a food magnet for the bacteria. The bacteria will come and just like me and you, no matter where we are in the world after we eat and drink, our waste is always pee and poop bacteria. It's the same thing. Doesn't matter where they are in the body. If they're eating, drinking out of control, their waist is always puss, right? Same puss that you see in pimples, and if you're like me, if you've ever had a big gnarly pimple and it took a while to clear up, once it cleared up, it left a scar or a mark on the skin, that's because puss is very acidic. So when it stays in small amounts on our teeth and it's not getting cleaned off properly, then the acidic, the acid then will start to eat away at the surface of our teeth. The tooth will then start to discolor. That's early stage rot. Middle stage rot. It'll start to get mushy, and then late stage rot is now the tooth will develop a hole, or unfortunately in its weakened state if it's mushy right here, this is where most people often get cavities in between teeth where the toothbrush can't reach very well. If that part of the tooth is mushy, you go down to bite on something solid or hard or crunchy, then the tooth breaks. So that's how all those bad things can happen to our teeth. So if you can again, try to prevent it and then come and see me often because brushing and flossing on your own is not enough, allow us to help you get to those bad bacteria and keep them under control before they start doing damage to your gums and your teeth.
Can a cavity spread to other teeth?
Can cavities spread to other teeth? And the answer to that is absolutely. So again, if you remember, cavity is just a fancy word for rot found in our teeth, but the process of rot is the exact same thing that you've seen in fruits and vegetables. So if you think of strawberries or grapes, right? If one piece of grape is rotting and you don't remove it from the rest of the bunch, then the rot from that one grape can then spread. And as the rot continues from that one fruit and it spreads, then the spreading of the rot can speed up because you are getting more and more teeth with rot in them. So the trick is to prevent and if we weren't able to prevent it, to catch it early and to remove the rot.
Is it possible for cavities to go away? What is the handling for them?
Okay, my next question is, doc, I have these cavities, what do I need to do about them? So the answer to that is to get the proper treatment, and I'm going to go over how I decide to take care of cavities. Every tooth is living in that it has its own blood supply, and actually the design of our teeth is the exact same design as our nails, meaning there's the non-living part. So if you look at your nails, it's the white part, the part that you cut all the time, and when you cut it, it doesn't hurt because it's the non-living part of your nail. Then you've got the living part of your nail, which is the more pinkish part, and that's the part like if you've ever cut too short or torn a nail and it gets to that pink part, it hurts like crazy.
It's the same thing with teeth, right? The outer part, the non-living part. It doesn't hurt when it starts to rot, but if rot is allowed to continue and it gets to the living part, that is when patients will feel pain. So if you look at my model here, you see this small dark spot. You see how it's smaller compared to the rest of the tooth. So this is what I consider early stage rot. I just want to cut it out. And how we dentists cut out rot is probably how you cut out rot in fruit, meaning you don't cut right at the edge, you cut a little into the good part to make sure you got all the rot. It's the same thing. Let me cut out the rot, and since the part of the tooth that I'm cutting out is smaller, that's early stage rot.
That is when I will decide to do a filling. Now imagine the rot has gotten bigger. Imagine this dark area now is half the tooth. I will still use the same logic. Let me cut out the rotten part. It would be such a waste for me to take out the whole tooth, but since I'm cutting out a bigger chunk of the tooth, now I've made the tooth weaker. That is when we dentists decide to put little helmets on teeth, or what we call them professionally is crowns. But the purpose of crowns are exactly the same reasons why football players wear helmets. They can tackle each other without fear of cracking their real skull. It's the same reason why I will plan a crown for that tooth because after removing all that rot, I know I've weakened that tooth and I want to make sure when my patients bite down and enjoy nice, crunchy things like chips, chicharron, right?
I'm not afraid that their teeth are going to crack and break on them. That is what I consider middle stage rot. Late stage rot is when the rot gets close to, or the living part, this part of stage of rot is now where the patient starts to feel sensitivity or pain, and this is what happens to the tooth. The tooth starts to die because now the bacteria has reached the living part and the treatment for this, if I can still save the tooth after removing all the rotten part of the tooth would be a root canal, and this is how the tooth looks like after the root canal that is late stage rot, then end stage rot. That's like when you're looking at the banana and after calculating and you're thinking, man, by the time I remove all the rotten parts of the banana, there's really nothing left. Okay, let me throw away the banana. That is the same. When the tooth is just totally rotten and there's nothing for me to save, then that's when I will decide to take out the tooth and we'll have conversations on how to replace that tooth.
How long can dental treatments like fillings or crowns last?
I have fillings that I've had since I've been in elementary school. I still have silver fillings. And here at Sunbrite Dental, if it's working, it's healthy, we leave it alone. And then I've had other patients that are more prone to cavities I've seen, or they're not maintaining. I've seen we've had to redo those fillings. So the key to the longevity for dental work really is how well can the patient and ourselves keep the bacteria under control so that once we get the patient back to health after treating teeth, how can we keep the bacteria under control so it doesn't come back to do damage to those same teeth that had just gotten dental treatment.