Does Your Dentist Keep Finding Cavities?

If every checkup seems to end with news of another cavity, it is natural to wonder whether the problem is your teeth or your dentist. The honest answer is that a real tooth cavity leaves evidence you can see: a shadow on an X-ray, a dark or chalky spot on a camera image, a soft area in the enamel. You are entitled to see that evidence before any filling is placed. And if the cavities are real, the more useful question is why tooth decay keeps coming back, because that cycle can usually be broken.

This article explains how cavities are found at the Timonium office of Dr. Steven W. Haywood, DDS, how you can see what the dentist sees, the common reasons some people keep getting cavities, and what actually helps stop the pattern.

What a tooth cavity is, and how tooth decay starts

Tooth decay is a slow process, not a single event. Bacteria in plaque feed on sugars and starches and produce acid. That acid draws minerals out of the enamel. Saliva helps enamel recover between meals, but when acid attacks come often, the enamel loses more than it gets back. A weak spot forms, and in time the weak spot breaks down into a hole. That hole is a cavity.

Early decay rarely hurts

Early tooth decay usually causes no pain at all. By the time a tooth aches, decay has often reached deeper layers of the tooth. That is why a cavity found at a routine visit can come as a surprise, and why it can feel as if the dentist found something that was not there. The lack of symptoms is exactly what makes early detection worthwhile: a small cavity usually needs only a small repair.

Where cavities like to hide

• Between teeth, where a toothbrush does not reach and decay can be hard to see in a mirror.
• In the grooves of back teeth, which trap food and plaque.
• At the gumline, especially where gums have receded and softer root surfaces are exposed.
• Around the edges of old fillings, where a worn or pulling-away filling can let decay develop underneath.

How a tooth cavity is found at the Timonium office

A diagnosis should never rest on a quick glance and a guess. At the practice, several tools work together, and most of them produce images you can look at yourself.

Digital X-rays you can see on screen

Digital X-rays appear immediately and can be shown on a screen in the treatment room, so Dr. Haywood can point to exactly what is being discussed. They use as much as 90 percent less radiation exposure than traditional film X-rays, and they are more comfortable than biting down on hard film. X-rays are especially useful for decay between teeth and under existing fillings.

Intraoral cameras

An intraoral camera lets the team zoom in on each section of your mouth and show you the image. A stained groove, a crack or a breaking-down filling edge is much easier to understand when you can see it enlarged on a screen.

DIAGNOdent laser decay detection

DIAGNOdent is a laser pen that can detect small amounts of decay at the earliest stages, sometimes before it can be seen on an X-ray. It helps reveal mild problems before any discomfort develops, so there are fewer surprise cavities later.

Read more about these tools on the dental technology page.

Questions worth asking about any cavity diagnosis

Good dental care is a conversation. If you are told you have a cavity, these questions are fair to ask, here or anywhere:

• Can you show me? Ask to see the X-ray or camera image and where the decay is.
• How deep is it? A cavity in the enamel is a different situation from one that has reached the inner tooth.
• What happens if I wait? Decay that has formed a hole does not heal on its own, but it is reasonable to understand the timing.
• What is the most conservative repair? At the practice, the most conservative option that will do the job is always the first recommendation.
• Why do I keep getting cavities? This is the question that leads to fewer fillings in the future.

Why tooth decay keeps coming back

When cavities keep appearing, there is usually a reason, and it is often something that can change. Common patterns include:

Frequent snacking and sipping

How often teeth meet sugar matters as much as how much sugar you have. Sipping coffee with sugar, juice, soda or sports drinks through the day, or grazing on crackers and candy, keeps enamel under almost constant acid attack. Sticky and sour candies are especially hard on teeth; see why gummy bears can hurt your teeth.

Dry mouth and medications

Saliva is one of your best natural defenses against decay. Many medications reduce it, and dry mouth can set the stage for root decay. Decay rates also tend to increase with age, so a mouth that stayed cavity-free for years can change.

Gaps in home care

Brushing that skips the gumline, or no cleaning between the teeth, leaves plaque in exactly the places cavities start. A water flosser or floss picks can make daily cleaning easier to keep up; see why a water flosser might be a good idea.

Old fillings wearing out

Fillings do not last forever. Over time they can wear away, fracture or fall out, and a filling that is worn at the edges or pulling away can let decay develop underneath it. A mouth with many old fillings can seem to produce new cavities when the real issue is aging dental work.

Receding gums

When gums recede, root surfaces are exposed. Roots are not protected by enamel, so they are more vulnerable to decay. Healthy gums are part of preventing cavities.

How to break the cavity cycle

Repairing a cavity fixes one tooth. Preventing the next one takes a plan. Depending on your needs, the practice may suggest:

• Thorough cleanings. Cleaning appointments at the practice last a full 60 minutes, and a professional cleaning every six months is recommended.
• Super sealants. These seal the chewing surfaces and all the pits and grooves of adult and children’s teeth, so bacteria and sugars can’t collect there. They come with a lifetime warranty.
• Calcium rebuilding treatments. The practice avoids fluoride and offers non-fluoride calcium rebuilding treatments to help strengthen enamel for patients of all ages.
• Xylitol. Xylitol mints and lollipops help reduce decay risk.
• Gum care. Treating bleeding or receding gums protects the roots.

See cleanings and preventive care, or read the case for preventive dentistry for the bigger picture.

When a cavity does need treatment

A cavity caught early usually needs only a filling. Dr. Haywood never uses amalgam: fillings are tooth-colored composite, mixed at the time of treatment to match your teeth, bonded in place and completed in a single visit. Air abrasion can remove small areas of decay with a thin stream of air and silica, with no heat, pressure or vibration. Larger areas of damage may call for an inlay, an onlay or a crown. Read when you need a dental filling for how that decision is made, and see restorative dentistry for every option.

Tooth decay in children

If the cavities are showing up in your children’s teeth rather than your own, the causes and fixes overlap but the habits look different. Read are childhood cavities inevitable? and how to prevent cavities in children.

Paying for preventive care and fillings

The practice is out of network with all dental insurance companies. You pay at the time of your visit, and the office files the claim on your behalf so your plan can reimburse you for what it covers. Health savings and flex plans are welcome, and financing is available through CareCredit, with no-interest options for up to 12 months, and Cherry, with payment plans from 3 to 24 months. See financing options.

Frequently asked questions

Do dentists ever find cavities that aren’t there?

Diagnosis always involves judgment, which is why it should be backed by evidence. At the practice, digital X-rays and intraoral camera images are shown on screen so you can see the area being discussed and ask questions before any treatment.

Why do I get cavities even though I brush every day?

Brushing alone misses the spaces between teeth, and frequent sugary snacks or drinks, dry mouth from medications, receding gums and worn old fillings can all lead to decay even with regular brushing.

Can a small cavity heal on its own?

Once decay has broken through and formed a hole, it will not heal on its own. Enamel that is only weakened may be helped by better habits and enamel-strengthening care, which is why early detection matters.

How can I tell if I have tooth decay?

Early decay often has no symptoms. Later signs include sensitivity to sweets or cold, pain when chewing, or dark spots and pits in a tooth. Regular checkups are the surest way to find it early.

See the evidence for yourself in Timonium

If you are worried about a tooth cavity, want a clear look at your own X-rays, or simply want to stop getting new fillings, request an appointment or call (410) 453-9399. The office of Dr. Steven W. Haywood, DDS is at 108 W Timonium Rd, Ste 200, Timonium, MD 21093, and patients come from Timonium, Towson, Lutherville, Cockeysville and Baltimore. New patients are welcome.