The cavities that develop between molars, known as interproximal cavities, are the second most common type of tooth decay. These cavities primarily affect molars and premolars due to the tight contacts between teeth, often impacting two teeth simultaneously.
In this blog, I will discuss how cavities between molars develops, their signs and symptoms, as well as their treatment and prevention.
How do you get cavities between molars?
To understand the science behind cavities that develop between molars, we first need to look at molar anatomy. Molars are square-shaped teeth with elevations and depressions on their surfaces that help grind food into a fine paste. The sides of the molars are slightly convex, allowing them to make contact with neighboring teeth at their widest point.
The small triangular space below the contact point, known as an embrasure, promotes the accumulation of food and plaque. In individuals with healthy gums, these embrasures are covered by gum tissue, making them less visible. The small size of the embrasure also makes it difficult for toothbrushes to clean these areas effectively.
Interproximal cavities can occur between any teeth, but molars and premolars are particularly affected due to the tighter and wider contacts between these teeth. Many people have tight contacts between their molars, causing dental floss to enter the interdental space with a snap, which makes it hard for toothbrushes to reach these areas. Conversely, some people have open contacts where the floss passes through without resistance.
Tight contacts pose a significant risk for tooth decay because they can trap food and lead to plaque buildup, making them more challenging to clean. In contrast, open contacts are easier to clean and are less likely to accumulate plaque.
Many people believe that brushing alone can remove all plaque from their teeth. However, toothbrushes are unable to reach the spaces between teeth, leaving about 35% of tooth surfaces untouched.
The American Dental Association (ADA) recommends brushing teeth twice a day and flossing once a day to effectively eliminate plaque and food debris trapped between the teeth.
Additional factors that contribute to cavities between molars include:
- Increased consumption of refined foods
- Insufficient fluoride in the diet.
Read more: 10 Signs you are eating too much sugar
flossing Statistics
According to data from NHANES (2011-2014), 36% of people over the age of 30, 26% of men, and 37% of women floss daily. Additionally, 68% of people report that they only floss once a week. A national public opinion poll by Delta Dental also found that 20% of Americans never floss.
How to know if you have a cavity between molars?
The spaces between molars can be difficult to see at home because they are hidden behind the gums. Both baby and adult molars can be affected by cavities in these areas.
A cavity between molars typically becomes visible when the tooth wall collapses, resulting in a noticeable cavity. If you experience occasional pain or sensitivity in a tooth that otherwise appears healthy, it could indicate an interproximal cavity. This pain might also stem from periodontal issues (problems with the gums). It’s important to consult your dentist to address any concerns.
Read more: Is Dark Chocolate Good for Your Teeth?
What are the symptoms of a cavity between molars?
The following could be the symptoms of a cavity between molars:
- Sensitivity of tooth to hot or cold food or drink.
- Pain on eating.
- Pain triggered by eating sweets.
- Severe and lingering episodes of pain in the tooth.
- Generalized pain on one side of the jaw.
How to detect cavities between molars?
Dentists typically follow two standard procedures to detect cavities: visual examinations and dental X-rays.
Visual Examination
A visual examination is performed using a dental explorer to identify surface irregularities or holes in the teeth.
Dental X-rays
Bitewing X-rays are one of the most effective tools for confirming cavities between molars and assessing their extent. These X-rays capture the crown portion of six teeth—three upper and three lower—when the patient bites down.
Read more: Can smoking increase the risk of gum disease?
How Do Dentists Fill Cavities Between Molars?
Several treatment options are available for addressing cavities between molars, with the choice depending on the degree of decay and the patient’s budget. The options include:
1. Fillings
Fillings are the simplest and most cost-effective treatment for tooth decay. Composite and amalgam fillings are commonly used for small to moderate-sized cavities.
2. Dental Inlays
For larger cavities in molars, a more durable filling is necessary to withstand chewing forces. Dental composites (white fillings) may not last long in high-stress areas, and many patients opt for tooth-colored ceramic fillings called inlays instead of amalgam fillings due to their silver appearance and mercury content.
An inlay is custom-made in a laboratory, molded to fit the prepared cavity, and bonded to the tooth. Although they are more expensive than direct fillings, inlays can last more than 10 to 15 years.
Read more: What are dental inlays and onlays?
3. Dental Onlays
An onlay is an excellent choice for teeth that have lost their cusps. Similar to inlays, onlays are fabricated in a laboratory but provide greater coverage by also covering the cusps of the tooth.
4. Root Canal Filling
If bacteria invade the tooth nerves, a root canal treatment may be necessary. This procedure cleans and fills the root canals of the tooth that have become infected.
Read more: How do you know if you need a root canal?
5. Crown
A crown completely encapsulates the tooth’s crown to prevent further damage, often used for teeth that have undergone root canal treatment and are at a higher risk of fracture. Crowns are crafted in a laboratory and mimic the appearance of natural teeth.
6. Extraction
If a tooth is extensively damaged, reaching down to the roots, extraction may be required.
How to prevent cavities between molars?
The following measures can help prevent cavities between molars:
- Flossing daily helps prevent cavities between molars. Thread floss is primarily used to remove plaque from between the teeth.
- Water flossing device can be a great alternative if you’re not comfortable using traditional dental floss. Studies have shown that it can be more effective than regular flossing.
- If your teeth do not have very tight contacts, you may also consider using an interdental brush instead of floss. These brushes come in various sizes, and your hygienist can recommend the one that is best suited for your dental needs. Since interdental brushes are not standardized, it’s important to choose a brand that your hygienist advises.
- Avoid using toothpicks as they cause more damage to the gums.
- Using a gum stimulator helps keep your gums healthy and your interdental areas clean. The tip of the gum stimulator is designed to massage your gums along the gum line. By sliding the tip between your teeth, you can effectively remove plaque and food particles that may be stuck between them.
- Occasional use of plaque-disclosing tablets helps identify plaque deposits and improves brushing and flossing. These tablets stain the plaque deposits on teeth.
- Interproximal grinding of baby molars lowers the risk of cavities between them by reducing the surfaces contacting each other.
Read more: What is the minimum age for root canal treatment?
General measures to prevent cavities
The following measures may help prevent cavities from developing:
- Eating a healthy and well-balanced diet helps prevent cavities. Replace refined carbohydrates with fiber-rich complex carbohydrates because cavity-causing bacteria thrive on the simple sugars found in refined foods. Including complex carbohydrates in your diet promotes the growth of good bacteria.
- Regularly brushing your teeth twice a day for two minutes with fluoridated toothpaste helps keep cavities at bay, especially between teeth. Practicing good oral hygiene reduces harmful bacteria in the mouth.
- If you live in a community without fluoridated water, consider adding fluoride supplements to your diet.
- Chewing sugar-free Xylitol gums that contains xylitol after meals can help increase saliva production. Saliva is beneficial because it contains enzymes and minerals that can remineralize demineralized tooth surfaces by providing essential calcium and phosphate ions.
- It is advisable to avoid brushing your teeth for at least 20 minutes after consuming sugary foods, as this can help prevent damage to the enamel from toothbrush bristles.
- Additionally, scheduling an annual dental checkup is important for the early diagnosis and treatment of interproximal tooth decay.
Frequently asked questions
Why do I keep getting cavities between my teeth?
Cleaning between your teeth is essential for preventing cavities between teeth. If you neglect to floss, you miss cleaning about 35% of your tooth surfaces.
Aim to floss at least once a day. Initially, it may feel uncomfortable and could cause some bleeding if there is plaque buildup between your teeth.
If you have gaps between your teeth, consider using interdental brushes as well.
Crowded or misaligned teeth that overlap can create larger, unhealthy contact areas, leading to increased plaque buildup. These larger areas also make it more difficult for floss to slide between your teeth. In such cases, orthodontic treatment may be necessary to restore proper tooth alignment and maintain the health of your teeth.
How much does a cavity between teeth cost?
A cavity between teeth often affect two teeth simultaneously. Consequently, both teeth need treatment to eliminate and restore the damaged areas, which means you will be charged for two cavities.
The cost of treatment varies based on the amount of tooth structure that has been lost. For instance, if both teeth require fillings, the cost may range from $200 to $600, depending on the size of the cavities—often one cavity is larger than the other.
In a different scenario, if one tooth requires a root canal while the other needs a filling, the costs will be different. Without insurance, a root canal can range from $600 to $1,600, while a filling typically costs between $200 and $500.
Why do I feel pain between teeth after filling?
It is normal to feel mild discomfort when chewing after getting a filling. If the filling was placed in a moderately deep cavity close to the pulp, you may experience some pain due to irritation of the nerve fibers in the pulp.
Healing may take a couple of days. However, if you experience severe pain or swelling in the tooth after the filling, please contact the dental office.
The filling between my teeth fell out – What should I do?
Don’t worry if the filling between your teeth comes loose or falls out. Schedule an appointment for a replacement filling as soon as possible. In the meantime, chew food on the other side of your mouth and brush your teeth regularly to keep the area clean. This will help prevent food from getting stuck and reduce the risk of bacterial growth.
What to do if there is a cavity between gum and tooth?
The cavity next to the gums is often shallow and needs to be filled. Please schedule an appointment with your dentist to have it filled.
I have Pain between front teeth but no cavity – What is the reason for it?
Experiencing pain between the front teeth without the presence of cavities may indicate periodontal issues. Plaque buildup above and below the gums can lead to inflammation in the tissues, resulting in discomfort. Inflamed gums often appear red and swollen and may bleed when you brush or floss.
To assess your oral health, check for tartar deposits (yellow, calcified buildup) along the gum line. This accumulation may occur due to inadequate cleaning of the inner surfaces of the front teeth. Make sure to clean the inner surfaces of your front teeth every time you brush.
Additionally, toothbrushes cannot effectively clean the spaces between your teeth, so it’s recommended that you floss at least once a day.
Consider using plaque-disclosing tablets, which contain a dye that stains plaque, highlighting areas that may be missed by your toothbrush.
Why do I have a cavity between molars?
A cavity between molars is often the second most common site affected by tooth decay. Permanent molars are less susceptible to cavities during their first year of eruption. However, the likelihood of developing cavities increases once the tooth fully erupts and becomes functional.
Additionally, first and second baby molars are particularly prone to developing cavities and are often treated with pulpotomy and pulpectomy procedures. Factors such as improper oral hygiene, lack of flossing, and a high-sugar diet are associated with the increased prevalence of cavities between molars.
Can you have a cavity without pain?
In the early stages, a cavity may not cause any pain. Initially, you might notice a brown or black spot on the tooth. However, pain typically begins when bacteria invade the nerves of the tooth.
If you experience sensitivity to hot and cold foods that goes away once the stimulus is removed, this may indicate a moderately deep dentinal cavity.
Do sensitivity in teeth means cavities?
No, tooth sensitivity is not always related to cavities. One of the main causes of tooth sensitivity is root exposure. The roots are covered by a thin layer of cellular cementum, which does not provide the same level of insulation and protection as enamel. This lack of protection can lead to sensitivity when exposed to hot and cold foods and drinks.
How long does it take for a cavity to cause pain?
Episodic pain in a tooth typically occurs when an infection spreads deep into the dentin or reaches the pulp. Everyone’s experience varies, but it usually takes months or even years for the decay to affect the inner pulp. The speed of this progression is directly related to dietary habits and oral hygiene practices.
Are all black spots on teeth cavities?
No, not all black spots on teeth are cavities. These black spots can result from stains caused by chromogenic strains. These bacteria produce hydrogen sulfide, which reacts with iron in saliva to form insoluble iron deposits, discoloring the teeth.
Other causes of tooth staining include:
- Tar from smoking tobacco
- Frequent consumption of tea and coffee
- Excessive intake of iron tonics
- Prolonged use of chlorhexidine mouth rinses
- Chewing betel nut
Tooth staining usually affects several teeth, whereas a cavity typically involves one or two teeth.
Can you floss after a filling between your teeth?
Yes, you can floss after getting a filling. If you have a white or composite filling, you can floss your teeth the same day. However, for amalgam fillings, it is best to wait 24 hours before flossing, as they require that time to reach their maximum strength.
Are cavities always visible?
No, not all cavities are visible, particularly those between teeth. These cavities are often diagnosed late, usually when the tooth becomes painful or breaks down. They are frequently discovered during routine dental examinations.
Summary
Cavities between molars are the second most common type of tooth decay. This issue primarily affects adults, especially those with tightly spaced teeth. The interproximal surfaces, or areas between the teeth, are particularly susceptible to plaque buildup due to limited visibility and a lack of flossing.
Bitewing X-rays are useful for diagnosing these cavities, and regular dental check-ups can help detect and treat interproximal decay in its early stages.