Cavities Between Teeth

Cavities between teeth, also known as interproximal cavities, are caries areas that develop into holes. Dental plaque is a sticky colorless film that builds on teeth surfaces, contributing to cavities and gum disease. When plaque and food particles accumulate between teeth, tooth decay may begin. In this stage, you may not feel any pain at all. Over time, dark spots or holes form between teeth. Tooth decay gradually becomes bigger, extending to the dentin layer (second layer) and tooth pulp (inner of the tooth). You may feel tooth pain or sensitivity to sweet, hot, or cold.

Many people brush their teeth regularly to remove dental plaque. However, toothbrushing won’t remove plaque buildup between teeth. So, dentists recommend flossing between teeth at least once daily to prevent cavities.

What are Cavities?

Cavities are permanent damage to the tooth that occurs as a result of bacterial acid attacks. Cavity-causing bacteria in the mouth decompose food debris and produce acids. These acids destroy the tooth enamel (the outer layer of the tooth), causing cavities.

Cavities between teeth start small and gradually become bigger. They appear as dark spots or holes between teeth. Untreated cavities will continue to advance, reaching deeper layers and tooth pulp, which contains nerves and blood vessels, causing tooth pain, dental abscess, and swelling.

Risk Factors for Cavities Between Teeth

Several factors increase the risk of tooth decay and cavities between teeth, including:

• Inadequate flossing and brushing: If you don’t clean your mouth regularly, especially after eating or drinking, food debris will accumulate on and between teeth.
• Certain foods and drinks: Excessive consumption of sugary foods and drinks increases the risk of cavities, for example, soda, fruit juice, cake, cookies, and candies. Also, foods that cling to your teeth for a long time are more likely to cause cavities between teeth.
• Dry mouth: Saliva plays an important role in tooth decay prevention. It washes away food debris and helps resist bacterial acids. Low salivary flow increases the risk of cavities. Things that may cause dry mouth include some medications, certain medical conditions, smoking, mouth breathing, chemotherapy drugs, and radiotherapy.
• Broken tooth fillings: This allows the accumulation of food debris and bacteria easily, causing tooth decay.
• Some medical conditions: Bulimia causes the erosion of teeth and increases the risk of cavities. Repeated vomiting (stomach acids) erodes the tooth enamel, making teeth weaker.

Signs You Have Cavities Between Your Teeth

The signs and symptoms of cavities between teeth depend on the size and extent of the damage. You may not feel anything at all in the early stages. As cavities advance, the holes become large and may reach the tooth pulp, causing tooth pain. 

Common symptoms and signs of cavities between teeth include:

• Food particles get stuck between teeth.
• Bad breath
• Tooth sensitivity to hot, cold, sweet foods and drinks.
• Brown or black holes between teeth.
• Sharp pain without any apparent cause.
• Pain associated with biting or chewing.
• Inflammation of the gum between teeth.
• Continuous pain.
• Gum swelling.
• Facial swelling.

How are Cavities Between Teeth Diagnosed?

Cavities between teeth, also known as interproximal cavities, can’t be easily detected visually in the early stages. The dentist usually detects them by using an x-ray (bitewing x-ray). By using the x-ray, the dentist will accurately assess the extent of interproximal cavities. Methods of diagnosis include:

• Oral examination: The dentist uses a mirror and probe to examine between teeth. The probe catches with cavities. In the early stages of cavities, the dentist may notice white spots or soft spots on the tooth surface. These spots become darker and deeper over time. 
• Bitewing X-ray: This X-ray type helps diagnose gum disease and cavities between teeth.
• Percussion test: The dentist will use a mirror handle to apply pressure on your teeth. This test is used to determine the status of teeth. Pain with percussion may indicate gum disease, inflammation of the pulp, or dental abscess.

Cavities in Children

Interproximal cavities can affect primary or permanent teeth. They are common in children because of excessive consumption of foods containing carbohydrates, for example, cake, cookies, candy, chocolate, and fruit juice. 

Mouth bacteria decompose carbohydrates and produce acids. These acids destroy the tooth enamel, which may lead to the formation of cavities between teeth. If the damage reaches the tooth pulp, this will cause pain, inflammation of the pulp, and formation of dental abscess. Cavities in children look like brown or black holes. The risk of cavities between teeth increases with:

• Improper oral hygiene practices and not cleaning between teeth well.
• Excessive consumption of carbohydrates such as candy, cookies, and cake.
• Dry mouth.
• Bedtime infant feeding.

Complications

Complications of cavities between teeth can range from minor discomfort to serious dental issues. Some common complications include:

• Tooth sensitivity: As cavities progress and expose the dentin layer beneath the enamel, you may experience increased sensitivity to hot or cold temperatures.
• Tooth pain: Cavities can cause toothaches, especially when they reach the nerve in the tooth pulp. The pain can be sharp and throbbing, making it difficult to eat or drink. 
• Tooth abscess: If a cavity is left untreated and the infection spreads to the tooth root, it can lead to a tooth abscess. This can be extremely painful and may require more invasive dental treatment, such as root canal therapy.
• Tooth loss: In severe cases, untreated cavities can cause tooth loss. When a cavity becomes too large or damages the tooth beyond repair, the tooth may need to be extracted.

Treatment Options for Cavities Between Teeth

The treatment of cavities between teeth depends on many factors, such as the size and extent of the damage. Common treatment options include:

• Fluoride treatment: Fluoride gel or varnish can reverse the early stage of tooth decay (remineralization). However, if cavities begin, caries can’t be reversed and further treatment will be needed, such as tooth fillings or root canal treatment.
• Dental filling: Under local anesthesia, your dentist will clean cavities between teeth with a dental drill. Then, they will place a filling material, such as amalgam or composite resin. Amalgam can’t be used to treat cavities in front teeth because they are unaesthetic (has a silver color). So, the dentist may recommend composite resin fillings, which mimic the natural tooth color.
• Root canal treatment (RCT): If the damage reaches the tooth pulp, your dentist may recommend the removal of infected, inflamed pulp tissues (RCT).
• Pulpotomy/pulpectomy: If cavities in baby teeth reach the tooth pulp, the dentist may recommend the partial removal of pulp tissues (pulpotomy) or complete removal of pulp tissues (pulpectomy).
• Dental crowns: Your dentist may suggest a dental crown if the tooth is damaged and can’t be restored by tooth fillings. Types of dental crowns include all ceramic and porcelain fused to metal crowns. Usually, dentists recommend dental crowns after root canal treatment.
• Tooth Extraction: Your dentist may recommend extraction if the decay extends to the tooth root or the tooth is severely damaged and can’t be restored. After tooth extraction, your dentist may recommend a dental bridge or dental implant to replace the missing tooth.

How to Prevent Cavities Between Teeth?

To prevent cavities between teeth, you should maintain good oral hygiene practices.

• Brush your teeth regularly: You should brush your teeth at least twice a day with fluoride toothpaste to remove dental plaque and maintain healthy teeth.
• Floss your teeth regularly: Many people brush their teeth. However, not everyone flosses their teeth, which can lead to the formation of cavities between teeth. So, you should use dental floss at least once a day and make it part of your daily oral hygiene routine. 
• Drinking plenty of water: Drinking water helps to rinse away food particles and neutralize acids in the mouth, reducing the risk of cavities.
• Limit sugary and acidic foods: Foods high in sugar and acids can contribute to the formation of cavities. Limit your consumption of sugary snacks, sodas, and acidic foods to minimize the risk of developing cavities between teeth.
• Visit your dentist regularly: Your dentist can spot dental early. So, you should schedule an appointment with your dentist at least once every 6 months for professional cleaning and regular dental checkups to maintain good oral health

Key Points

• Cavities between teeth, also known as interproximal cavities, are caries areas that develop into holes.
• Bacteria decompose food debris and produce acids, which destroy the tooth enamel.
• Cavities start small and gradually become bigger. They appear as holes or tiny openings between teeth.
• Cavities will continue to progress and reach the tooth pulp, which contains nerves and blood vessels, causing tooth pain and a dental abscess.
• Cavities are caused by a combination of factors, including bacteria in the mouth, sugary foods, and not cleaning your teeth well.
• The dentist usually detects them by using an x-ray (bitewing x-ray).
• The treatment depends on the size and extent of the damage, including dental filling, root canal treatment, and tooth extraction.
• You should brush and floss your teeth regularly to remove dental plaque and maintain oral health.
• Use a toothpaste with fluoride to strengthen the tooth enamel and protect against cavities.
• Limit your intake of sugary foods and drinks, as they can contribute to the development of cavities.
• If you notice any signs of a cavity such as tooth pain or sensitivity, make an appointment with your dentist as soon as possible.
• Visit your dentist regularly for professional dental cleanings and checkups.