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Dear Patient: Why that little cavity is a big deal

Sept. 30, 2022
Is your little cavity is a big problem? If you don't deal with it, it could be. Amanda Hill explains why the sooner you seek care, the better your chances of reversing tooth decay and preventing its progression.

The American Dental Association reports that one in four people have a cavity hanging out in their mouth untreated. Why is that such a big deal—who cares about a little cavity?

Well, that little cavity will only get bigger if left untreated. Think of it as a little patch of disease. Wouldn’t you much rather that disease be diagnosed and treated when it’s small, less invasive, and with a more successful outcome? Here are some more reasons to schedule that appointment.

Cavities only get bigger

The way a cavity (or decay) works is the bacteria begin to eat through the enamel, or outer layer of the tooth, resulting in a decalcification. If caught early, that decalcification is reversible. But once it breaks through the enamel and into the dentin, you have a cavity. Over time, the bacteria progress beyond the dentin and into the pulp or nerve of the tooth, eventually requiring a more invasive and more expensive procedure or resulting in tooth loss.

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Bad breath

As those bacteria multiply, they eat dead bacteria, and excrete more bacteria and that has a smell. The longer the infection is allowed to grow and the more bacteria there are, the stronger the odor. Arresting that decay should help reverse that problem, unless there are other underlying problems.

More cavities

Once the decay process begins in one tooth, it can spread to more teeth. The mouth likes a balanced environment, and having untreated decay keeps it unbalanced and the pH acidic—leading to more time in the dental chair.

Spread to loved ones

While the decay is spreading through your mouth, it can spread to your loved ones, too. A kiss on the lips or a lick of the baby’s pacifier introduces that decay-causing bacteria to their mouths, which sets them up for cavities, too.

Pain and infection

While you don’t feel that little cavity as it eats through the enamel into the dentin, you certainly will if it continues into the nerve or the pulp. And for some reason, that pain always seems to come at the most inopportune moment, like Friday night or on vacation!

If the decay is allowed to progress, it begins to eat into the nerve of the tooth and infection will set in. That infection will find a path to release the pressure; often a pimple will form on the gum near the tooth. While antibiotics will hold off the initial infection, if the decay goes untreated the infection (and pain) will keep coming back.


This isn’t necessarily common but it can happen, and has. Untreated decay is the same as leaving a gash on your arm that over time will affect your whole body. The infection that started out as a “little cavity” can go to your brain, or your heart.

The best way to avoid these what-ifs is to have regular visits with your dental team. Ask them for tips on how to decrease your risk for decay. This is a preventable disease! And, of course, schedule that appointment when that cavity is “little.”