What are cavities and microcavities?
Dental cavities are holes in teeth caused by tooth decay. Cavities are also referred to as caries. They occur when the bacteria in your mouth produce acid that attacks the outer layer of your teeth, known as the enamel. Over time, this can create a small hole, or cavity, in the tooth.
If you have a cavity, your dentist may recommend a filling, crown, or other treatment to restore the tooth and prevent further damage. In severe cases, a root canal or tooth extraction may be necessary.
What are microcavities?
Microcavities, also known as incipient caries or initial enamel caries, are the earliest stage of tooth decay. Teeth are in an environment of a constant acid attack that strips the teeth of important minerals and breaks the teeth down. While this attack is constantly occurring, minerals are also constantly replenished through mineral-rich saliva and fluoridated water, and toothpaste. In addition to fluoride, calcium, and phosphate also help to remineralize enamel. When the demineralization starts and is confined to the outermost layer of enamel, it is called a microcavity, or incipient cavity. These types of cavities rarely need anything more than very conservative treatment. Only when the cavity breaks through the enamel layer and into the dentin does it really threaten the tooth? So when these microcavities are detected, it is best to try a remineralization protocol to see if they can be reversed instead of jumping to a filling right away. A dentist will help in determining the most effective conservative treatment for these early cavities.
The dentist's goal is to achieve a healthy balance between prevention and restoration. It is a balance between being proactive and reactive. The dentist doesn't want to be so proactive that he is recommending things that don't need to be done -- preventing problems that really never would have occurred. But he doesn't want to be so reactive that he simply watches small problems become big problems. One mistake people often make is waiting for the pain to dictate the timing of treatment. Once a tooth starts hurting, it is often too late for remineralization or a small filling. The pain usually indicates a need for root canal treatment, a crown, or tooth extraction. There is some variability in how dentists will treat microcavities and when they determine a filling is necessary. Some people are more prone to caries than others. Analyzing one's history of cavities, current diet, and oral hygiene may lead the dentist to be more aggressive or more conservative with his recommendations. This is why it is important that each person finds a dentist that echoes his or her own philosophy regarding aggressive versus conservative dental treatment.
Treating microcavities early on is important to prevent further decay and potential tooth loss. In many cases, the decay can be reversed through a process called remineralization, which involves applying fluoride treatments or using dental products that contain fluoride.
Regardless of the dentist, regular returns to the dentist are key to being conservative so the cavity can be monitored and treated before it grows too much. Small cavities can become root canals within a year under the right circumstances. As a cavity grows, more tooth structure is lost. Lost tooth structure leads to a greater likelihood of fractured teeth, recurrent decay, and tooth loss. When possible, one is always better off getting a small filling than ending up with a large filling, a root canal, or a crown.