Cavities in between Teeth: Causes & Treatment

Cavities in 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 in between teeth, dental caries may begin. In this stage, you may not feel any pain at all. Over time, brown or black holes begin to form in between teeth. They gradually become bigger, extending to dentin (second layer) and tooth pulp (inner of the tooth). In this stage, you may feel pain and/or sensitivity to sweet, hot, or cold. Many people brush their teeth regularly to remove dental plaque. However, toothbrushing won’t remove plaque in between teeth. So, dentists recommend the use of dental floss at least once daily for the prevention of cavities in between teeth.

So, What are Cavities?

Cavities are permanent damage to the tooth that occurs as a result of bacterial acid attacks. Bacteria in the mouth decompose food debris and produce acids. These acids destroy the tooth enamel (the outer layer of the tooth), causing the formation of cavities. Cavities in between teeth start small and gradually become bigger. They appear as holes or tiny openings in between teeth. These cavities will continue to progress and reach the tooth pulp, which contains nerves and blood vessels, causing pain, dental abscess, and swelling.

Risk Factors for Cavities in between Teeth

Several factors increase the risk of cavities in 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 in between teeth.
• Certain foods and drinks: excessive consumption of sugary foods and drinks increase 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 in between teeth.
• Dry mouth: saliva plays an important role in the prevention of dental caries. It washes away food debris and helps counter the 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 more easily, causing dental caries.
• Not getting enough fluoride: fluoride protects the tooth from bacterial acids and reverses the early stage of dental caries.
• Some medical conditions: bulimia causes the erosion of teeth and increases the risk of cavities. Repeated vomiting (stomach acids) erodes the tooth enamel which makes teeth weaker.

Symptoms of Cavities in between Teeth

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

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

Diagnosis of Cavities in between Teeth

Cavities in 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 will use a mirror and probe to examine in-between teeth. The probe catches with cavities.
• Bitewing x-ray: this type of x-ray helps diagnose gum disease and cavities in 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

Cavities in between teeth are common in children because of excessive consumption of foods containing carbohydrates. For example, cake, cookies, candy, chocolate, and fruit juice. Bacteria in the mouth decompose the carbohydrates and produce acids. These acids destruct the tooth enamel, which may lead to the formation of cavities in between teeth. If the damage reached 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 in between teeth increases with:

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

Treatment of Cavities in between Teeth

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

• Fluoride application: Fluoride can reverse the early stage of dental caries (remineralization). However, if cavities begin, caries can’t be reversed and further treatment will be needed such as tooth fillings or root canal treatment.
• Tooth fillings: under local anesthesia, your dentist will clean cavities in between teeth with a dental drill. Then, they will place the tooth fillings in between teeth using a special technique. Types of tooth fillings include amalgam and tooth-colored fillings. Amalgam can’t be used for the treatment of cavities in front teeth because they are unaesthetic (have a silver color). So, the dentist may recommend tooth-colored fillings for a more natural look.
• Root canal treatment (RCT): If the damage reached the tooth pulp, your dentist may recommend the removal of infected, inflamed pulp tissues (RCT).
• Pulpotomy/pulpectomy: if cavities in baby teeth reached 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 porcelain fused to metal, all-ceramics, and zirconia. Usually, dentists recommend dental crowns after root canal treatment.
• Tooth Extraction: the dentist may extract the tooth if it is severely damaged and can’t be restored at all. After tooth extraction, your dentist may suggest a dental bridge or implant for the replacement of the missing tooth.

Prevention

To prevent cavities in between teeth, you should:

• Brush your teeth regularly: you should brush your teeth at least twice a day with a soft-bristled toothbrush to remove dental plaque.
• Floss your teeth regularly: many people brush their teeth. However, not everyone flosses their teeth, which can lead to the formation of cavities in between teeth. So, you should floss at least once a day.
• Drink plenty of water: to keep your mouth moist.
• Limit sugary foods and drinks: for example, candy, cake, cookies, soda, and fruit juice.
• 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 check-up.

Summary

• Cavities in 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 in between teeth.
• They will continue to progress and reach the tooth pulp, which contains nerves and blood vessels.
• 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.
• You should brush and floss your teeth regularly to remove dental plaque.