Dental MythBuster #12 – I can’t have a cavity because there is no hole in my tooth!

This Dental MythBuster is slightly unfair, as it relies upon the slang term cavity that has been used for decades. However, it is still a myth, and like all dental myths, this myth needs to be identified and busted!

Let’s start by looking at a photo:

high res photo showing teeth with dental decay but not cavities

Photo showing decay on front teeth but no “cavities” present.

If you look at the above photo, everyone would agree that something is not right. The brown/grey areas where the teeth touch one another look awfully suspicious. When I informed this patient that she needed fillings with those teeth, she looked at me perplexed and said “Why… I can’t feel any cavities there?!?”

I hear this dental myth about once per week in my office. Once I show either an x-ray or photo of the cavity, they understand immediately. Wouldn’t you if you saw the above photo?

Cavities, Caries, and Decay

Part of the reason why this dental myth exists is because there is some confusion and misuse of various dental terms. And we dentists are part of the problem! Let’s look at definitions:

Dental Caries – also known as dental decay, this is an infectious disease leading to the progressive destruction of tooth structure. This is seen in the photo above.

Dental Cavities – a carious lesion or hole in a tooth. Although this term is used quite often, it is generally considered to be a slang term.

So, what does an actual dental cavity look like? See below:

photo showing teeth cavities visible in the actual mouth

Two cavities present. In this case, there are actual holes in the teeth!

In the above photo, you can see actual holes in the teeth. These are areas of dental decay that have progressed to the point where the tooth surface actually collapsed in, creating a cavity. This patient was actually able to feel and see the cavities.

Another Dental Myth Goes Down

So far, we’ve seen two photos: one showing decay without holes and one showing decay with holes.

In both cases, the patients required fillings and/or other work to restore. I don’t think anyone would disagree with that.

So, let’s dispel this myth with this simple statement:

Dental cavities can be present with our without actual holes in your teeth. You don’t need an actual hole in your tooth to need a filling.

So if your dentist tells you that you have decay (or cavities) and you can’t see or feel a hole, it doesn’t mean there is no cavity. It is definitely there. Ask your dentist to show it to you on an x-ray or have him/her take a photograph of it. I do it all the time.

I hope you enjoyed this post. I’m already working on Dental MythBuster #13!

Comments

  1. I’ve had three experiences with dentists in my lifetime and I’m 33 years old now. First time was at 7 years old and all I remember was horrific pain and my mother coming in after about 2-5 minutes, stood to assess what was going on (she’s never been overprotective but she will not hesitate to stop if there is obvious distress), and when she saw blood streaming down my cheek and me passing out from pain, she grabbed me and we left. What happened was that I told the dentist I could still feel him poking after being numbed twice, but he said I was fine and I was just anxious and started drilling. As I’ve always tolerated pain quite well, it was not only obvious to my mother when she came in and realized I wasn’t numbed enough to start, but two of his nurses were screaming at him to stop because I was not numbed properly and my mother had grabbed me once the nurses had grabbed him and pulled him away from me. We found out later that his wife had just called and told him she was divorcing him and taking the kids to Nevada to her parents house only 10 minutes prior to starting the work. I was born in 1981, my second dental visit was in 2009 and required more work that was done, but all the dentist could do at the time was 9 extractions, two root canals, and two stents on my front teeth (I think that’s what they’re called). The dentist took 3.5 hours to do it and I was given Triazolam so I don’t remember much, except the sound of my teeth breaking. The shots to numb were not bad at all because he took his time, so all in all, it was a good experience considering the infection I’d had and the high anxiety I was dealing with.
    My most recent experience (5/26/2015) was not that great, but to be honest, I didn’t really care after the fact. I’ve always looked at a stressful situation, such as dental work as, the quicker it’s done the better I’ll be. Senior actions were painful to the point of white knuckling, even with my husband there, but I assume that is because of the infection and not the dentists lack of care. Senior actions were painful to the point of white knuckling, even with my husband there, but I assume that is because of the infection and not the dentists lack of care. It was explained to me by the nurses at the numbing may not take because of the infection, I let them know I completely understood and if it wasn’t possible to do it because of that then so be it. The second numbing went into the pallet and I think I yelped because it hurt so badly it was explained to me by the nurses at the numbing may not take because of the infection, I let them know I completely understood and if it wasn’t possible to do it because of that then so be it. The second numbing went into the pallet

    • (Cont…)
      And I think I even yelped because of the pain. I am completely aware of these statistics regarding dental work when there’s an infection. As I said before, I have very high anxiety when it comes to dental work, and I started hyperventilating once he started The extraction on Tuesday I went in for so he stopped and told me to open my eyes and look at him. I did and he said that everything’s fine, which I knew, but The extraction on Tuesday I went in for so he stopped and told me to open my eyes and look at him. I did and he said that everything’s fine, which I knew, but I had forgot to convey to him that even though I look like I’m hyperventilating, I promise I am not one of those people that passes out. It is simply a physical reaction to the trauma that I have dealt with my whole life, the only thing I felt was pressure and the only thing I heard was the scraping of tools against my t hyperventilating, I promise I am not one of those people that passes out. It is simply a physical reaction to the trauma that I have dealt with my whole life, the only thing I felt was pressure

      • And the only thing I heard, even though I had an earphone and to listen to loud music, was the scraping of the tools on my teeth, which is actually what causes my anxiety. I told him don’t worry about me,

        • And that’s when he told me about another tooth needing extraction and if I wanted him to get it? I said, “do what you have to do.”
          I believe is it judging a dentist by one performance is not right because just because you might of had a bad experience doesn’t mean that all of them will be bad and in the process you could veI believe is it judging a dentist by one performance is not right. Just because you might of had a bad experience doesn’t mean that all of them will be bad and in the process you could ruin their career by bad mouthing them. Go on a 5-10 year ride with them and then assess.

  2. Thank you so much for your informative article. I definitely learned something. I just had a dentist appointment last week. The doctor looked at my X-rays and looked at my teeth and told me how great they look. Then she took some kind of laser and said I had seven cavities that need to be filled. She rushed through my cleaning and didn’t show me where these cavities are. Are you familiar what this device is? I bought one of those dental mirrors just to look in my own mouth and I don’t see any discoloration on any of my teeth. I brush and floss regularly. I think I am going to get a second opinion. What are your thoughts? Thanks so much.

    • Hannah,
      It is hard to tell what is going on without seeing you and evaluating x-rays. What I believe you are describing (the laser thing) is a device called the DiagnoDent. Keep in mind that diagnosing some types of cavities is a bit subjective. The Diagnodent attempts to eliminate the uncertainty. However, my review of the device as well as the research suggests it is not accurate. That is my opinion only though. In fact – I even own one – I inherited it from the dentist from whom I bought my office – and it is sitting in the closet collecting dust. If you went from zero cavities to 7 cavities in 6 months and it was based on the diagnodent – I would get a second opinion.

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