Dental Cavities (Dental Caries)

  • Medical Author:
    Steven B. Horne, DDS

    Dr. Steve Horne began his career at Brigham Young University obtaining his BA in English. He earned his Doctorate of Dental Surgery in 2007 from the University of Southern California where his pursuit for academic excellence landed him on the Dean's List. He was recognized for his superior clinical skills and invited to help teach other dental students in courses on restorative dentistry, prosthodontics, and tooth anatomy. During dental school, he provided dental care for underserved populations of Los Angeles and Orange County, Mexico, and Costa Rica with AYUDA. Following dental school, Dr. Horne entered active duty with the U.S. Army and practiced dentistry at Fort Knox, Kentucky, for four years. During this time, he was deployed to Baghdad, Iraq, and received multiple Army Achievement Medals, the Army Commendation Medal, and served as Company Commander. Dr. Horne currently practices full time at Torrey Pines Dental Arts in La Jolla, California, as a general dentist. Dr. Horne is a member of the American Dental Association, the California Dental Association, and the Academy of General Dentistry. Dr. Horne is married to his wife, Christy, and they have a chocolate Labrador named Roscoe.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

View Cosmetic Dentistry: Before and After Slideshow Pictures

Treatment of cavities during pregnancy

Hormonal and bacterial quantity changes during pregnancy put pregnant women at greater risk for gingivitis and periodontal disease. Therefore, it is very important that pregnant women continue to get regular dental cleanings during pregnancy. Pregnant women have generally been counseled to avoid elective dental treatment during pregnancy unless they are experiencing an emergency like pain or infection. In this case, the second trimester is the best time for treatment to keep the expectant mother as comfortable as possible. Local anesthetics and other materials used during dental treatment don't increase risk to the fetus, but untreated oral disease has been shown to lead to adverse pregnancy outcomes. If X-rays are necessary, a protective apron will be placed over the woman's stomach and thyroid. If antibiotics are necessary, tetracycline should be avoided because it will cause staining in the baby's developing teeth.

What is CAMBRA?

CAMBRA stands for caries management by risk assessment. It is a method for assessing a person's risk for developing dental cavities and making dental treatment decisions and recommendations based on the patient's caries risk. The dentist performing CAMBRA will perform tests for oral bacteria and take X-rays. He will then determine the patient's level of caries risk by analyzing caries history, current caries condition, dietary habits, hygiene habits, prescription medications, salivary flow, and medical conditions. Treatment will then be tailored to the patient based on managing the risk factors through behavioral, chemical, and minimally invasive procedures. No two cavities are the same because no two people are the same. Thus, diagnosis and treatment planning requires risk assessment in addition to caries detection.

What is the prognosis of a cavity?

Dental cavities are a preventable and treatable disease. By making simple changes in diet and hygiene, one can minimize the risk of developing caries. If a person has been diagnosed as being at high risk for dental cavities, the dentist may prescribe a prescription toothpaste or fluoride varnish to protect the restored teeth from getting recurrent caries and prevent new ones from forming. Consistent evaluation and follow-up with a licensed dentist combined with attentive oral hygiene will help a person affected by dental cavities to have a very favorable prognosis.

Medically reviewed by Kenneth Rotskoff, MD, DDS; Board Certified Dentistry, Oral/Maxillofacial Surgery

REFERENCES:

"For the dental patient: oral health during pregnancy." Journal of the American Dental Association 142.5 (2011): 574.

"Tooth Decay." American Dental Association. <http://www.ada.org/3031.aspx?currentTab=1#jada>.

Brambilla, Eugenio, et al. "Caries prevention during pregnancy: results of a 30-month study." Journal of the American Dental Association 129.7 (1998): 871-877.

Diniz, Michele B., et al. "The performance of conventional and fluorescence-based methods for occlusal caries detection: an in vivo study with histologic validation." Journal of the American Dental Association 143.4 (2012): 339-350.

Michalowicz, Bryan S., et al. "Examining the safety of dental treatment in pregnant women." Journal of the American Dental Association 139.6 (2008): 685-695.

Zero, Domenick T., et al. "The biology, prevention, diagnosis and treatment of dental caries: scientific advances in the United States." Journal of the American Dental Association 140.Suppl 1 (2009): 25S-34S.

Medically Reviewed by a Doctor on 3/15/2016
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