How Do Dentists Detect Hidden Cavities in Children and Adults?

Tooth cavities are some of the most common chronic diseases in the world. Whilst larger cavities on the flat biting surfaces of your front teeth can be easily seen, there are many cases of hidden cavities. These cavities will start developing in between your tightly packed teeth, under old dental fillings and in the natural grooves of your molars. Over time, these cavities will eat away at the enamel on your teeth, penetrate the softer dentine and reach the sensitive nerve.

As your dental health can heavily impact your general health (an important principle within Google’s ‘Your Money or Your Life’ guidelines), it is a priority to detect decay at an early stage. Dentists use high levels of Experience, Expertise, Authoritativeness and Trustworthiness (E-E-A-T) to detect hidden cavities.

What Are Hidden Cavities and Why Do They Appear?

Hidden cavities are cavities which cannot be seen with the naked eye. This is because the enamel on your teeth is very hard but constantly attacked by corrosive acids from bacteria.

• Inter-proximal – Often cavities develop in the tight spaces between adjacent teeth. As standard toothbrush bristles are too large, they cannot reach into these tiny gaps.

• Recurrent decay – Over time old fillings, crowns and sealants can develop tiny leaks and cracks. This allows bacteria to creep underneath the old fillings and cause damage.

• Pit and Fissure – The flat biting surfaces of the back molars have deep grooves. Bacteria will develop in these tiny grooves and cause decay.

How Do Dentists Detect Hidden Cavities During Clinical Examinations?

All professional dental appointments begin with a clinical examination. Dentists use years of experience and simple yet highly effective tools to fully inspect your mouth.

• Magnifying Loupes – Modern dentists wear special magnifying glasses with bright LED lights. These help to pick up any small discoloration, shadowing or cracks in the enamel.

• Explorers – Dentists use a thin curved metal tool known as an explorer. This is used to gently test how hard the enamel is. Healthy enamel will be very hard and smooth whereas decayed enamel will feel soft, sticky and catching.

• Air Dry – Often early cavity development is obscured by saliva. To help reveal any early enamel loss, dentists will air dry your teeth. This will expose small white chalky spots on the enamel.

How Do Digital Radio graphs Help Dentists Find Hidden Cavities?

Sometimes you cannot see early decay which has developed in between back teeth or under old fillings. Therefore dentists use digital radiography technology to look inside your teeth.

• Bite-wings – Bite-wings are the gold standard for detecting inter-proximal cavities. They clearly show the upper and lower crowns of your back teeth. This will show any early enamel loss as dark spots.

• Periapicals – Periapical images show the whole tooth from the biting crown right down to where the root meets the jawbone. This helps dentists to see any deep infections, hidden decay in the roots or bone loss.

• Low Radiation – Digital radiography reduces the amount of radiation exposure by up to 80% when compared to traditional x-rays. This keeps young children and pregnant patients safe.

How Does Laser Fluorescence Detect Hidden Cavities?

Laser fluorescence is an advanced technology used in children and adult prevention dentistry. A device such as DIAGNOdent uses light to test the enamel.

• Light Reflection – Healthy enamel will reflect light differently to decayed enamel. The laser hand-piece shines a specific light onto the tooth.

• Bacterial By-products – Bacteria which cause cavities create certain by-products known as porphyrins. When the laser light hits this it will cause them to glow.

• Numerical Score – The device will give a precise score on the screen. The higher the number the more severe the bacteria is and dentists can treat early decay.

How Does Digital Fiber Optic Trans-illumination Detect Hidden Cavities?

Digital Fiber Optic Trans-illumination (DIFOTI) is a wholly pain free, non-radiant way of detecting hidden inter-proximal cavities and tiny cracks in the enamel.

• Strong Light – The device shines a bright light through the side of your teeth.

• High Contrast – Healthy enamel will allow the light to shine through easily. However, enamel with decay, demineralisation and cracks will absorb the light and cause dark shadows on the linked monitor.

• Live Video – DIFOTI provides live video and pictures. This means dentists can show you what is going on immediately on the screen.

How Do Cone Beam CT Scans Help Detect Hidden Cavities?

If dentists cannot get enough information from 2D x-rays, they may use advanced technology such as 3D Cone Beam CT scans. This will provide high quality 3D images.

• Full View – This scan provides detailed cross sections of your teeth, nerve canals, soft tissue and bone.

• Hidden Root Decay – Dentists can find hidden decay in the roots, cracked roots and complex infections using 3D imaging.

• Accurate – The 3D imaging allows for greater accuracy. This will prevent any unneeded surgery.

Why Is Early Detection Important for Your General Health?

There is constant research being carried out to prove the link between oral health and general health. By detecting hidden cavities early you stop dangerous bacteria from spreading throughout your body.

• Severe Infection – If a cavity goes undetected it will eventually reach the center of your tooth. This will cause painful abscesses in your mouth which can spread to your jaw, head and neck.

• Inflammation – Constant infection in your mouth can cause harmful bacteria to enter your bloodstream. Medical research shows having active inflammation in your mouth can increase your risk of heart disease, diabetes and negative pregnancy outcomes.

• Natural Teeth – Detecting cavities early means dentists can help you with simple treatments to stop the decay. This can include fluoride to remineralise your teeth or small fillings. This avoids large root canals or extractions.

How Can You Prevent Hidden Cavities?

• Have regular full dental check-ups every 6 months.

• Floss your teeth everyday.

• Brush your teeth twice a day with a safe fluoridated toothpaste.

• Ask your dentist about sealants for your child’s molars with deep grooves.

• Replace old cracked or worn fillings.

• Ask for digital bite-wing x-rays depending on your personal risk.

What Are the Frequently Asked Questions About Hidden Cavities?

Can You Have a Cavity With No Pain?

Often early hidden cavities will not cause any pain or sensitivity. This is because there are no nerves in your enamel. As the decay is inside the enamel on the outside of your teeth there will be no symptoms. Pain usually occurs when the infection reaches further into the sensitive dentine or the center nerve.

Are Digital X-Rays Safe for Children?

Digital x-rays are very safe for children. They use special small sensors for children, thyroid collars and lead aprons to keep radiation to a minimum. A digital bite-wing scan will expose your child to less radiation than they would receive from the sun over a couple of days.

Can Dentists Reverse a Hidden Cavity?

If the cavity is only in the enamel and nothing else then dentists can reverse it. They can apply high concentration fluoride varnishes, recommend prescription re mineralising pastes and improve flossing. This will help to put back the important minerals of calcium and phosphate into the enamel. This will stop the cavity completely without needing to drill.

By using high levels of E-E-A-T, visual examinations and advanced technology such as x-rays, lasers and transilluminators dentists can detect hidden cavities. As hidden cavities can develop without any obvious signs, it is best to have regular professional check-ups. This will help to protect you from painful infections. Keeping your teeth healthy will help protect your natural teeth and keep you healthy in the long run. Contact your licensed dentist to have a full check-up on your oral health.