Cavity vs. Stain, what is the difference between the two?

Question

Why doesn't my dentist fix the little black dots and black lines on my teeth? Aren't these cavities?

What are cavities?

Cavities, or dental caries, are a microbial disease process that results in the localized dissolution of tooth structure due to the acid produced by bacteria.

The demineralization of the tooth structure is initiated when the pH drops below the critical value of 5.5 due to bacterial fermentation of dietary carbohydrates.

The bacteria responsible for cavity formation are primarily Streptococcus mutans and Lactobacillus species.

These bacteria produce acid as a byproduct of their metabolism of dietary carbohydrates, which leads to the demineralization of the tooth structure.

What are stains?

Dental stains are discolorations or darkening of the teeth that can occur due to various factors, such as age, genetics, lifestyle habits, and certain medications. Dental stains can be classified as extrinsic or intrinsic, depending on their location and cause.

Extrinsic stains occur on the surface of the tooth and are caused by external factors such as diet, tobacco use, and poor oral hygiene. Extrinsic stains can be easy to remove and may require professional scaling and polishing dental treatment.

Intrinsic stains, on the other hand, occur within the tooth structure and are caused by factors such as trauma, developmental disorders, or the use of certain medications during tooth development. Intrinsic stains can be more difficult to remove and may require more extensive dental treatment.

How to decide whether Black Line or Blackspot is a cavity or stain?

The black line or black spot is a cavity

If a black spot is present on the surface of the tooth (like in the picture) and your food is getting stuck in that black line or black spot, then it is definitely a cavity due to caries formation. The black line or black spot that does not go away with brushing or cleaning may be a cavity.

Cavity vs. Stain, what is the difference between the two? | Dr. Abi Negi

How does the dentist confirm the Cavity?

Dentists confirm the presence of a cavity through a dental examination that involves visual inspection, probing, and diagnostic imaging.

During the visual examination, the dentist will look for visible signs of decay, such as discoloration, pits, or holes in the tooth surface.

The dentist may also use a dental instrument called an explorer to probe the tooth surface for areas of softness or decay.

If the explorer "catches" on the tooth surface or can be inserted into a pit or hole, it may indicate the presence of a cavity.

In addition to visual inspection and probing, the dentist may use diagnostic imaging techniques such as X-rays or digital radiography to confirm the presence of a cavity.

These imaging techniques can help detect cavities that are not visible to the naked eye, such as those that occur between teeth or under existing dental restorations.

Once the presence of a cavity has been confirmed, the dentist will develop a treatment plan based on the severity and location of the decay.

Treatment options may include dental fillings, root canal therapy, or tooth extraction, depending on the extent of the decay and the overall health of the tooth.

How to decide whether Black Line or Blackspot is a cavity or stain?

Black line or black spot is stain

A black line or black spot that appears on the surface of the tooth (like in the picture) and can be easily wiped away with a toothbrush or dental cleaning tool is likely a stain.

Black Stains are superficial and present due to poor oral hygiene leading to plaque formation.

Black stains on teeth in the form of lines or spots can be attributed to various factors, including :

-Consumption of beverages like tea and coffee,

-Tobacco and smoking

-Certain medications such as antibiotics like tetracycline and doxycycline, antihistamines, ACE inhibitors, calcium channel blockers, beta-blockers, heart rhythm medications, diuretics, and cancer medications.

-Genetic predisposition, high fluoride in water in the area, poor oral hygiene practices like not brushing at night, and improper teeth alignment can also contribute to the development of these stains.

How does the dentist confirm the STAINS?

Dentists typically confirm the presence of dental stains through a dental examination and by reviewing the patient's dental history for gum bleeding, and bad breath.

During the dental examination, the dentist will visually inspect the teeth for any visible signs of discoloration or staining. Also inspecting gum conditions, presence of calculus, level of gum and bone attachment, and mobility of the tooth.

They may use a dental mirror to aid in the examination and may also use a dental explorer to feel for any rough or uneven surfaces on the teeth and dental probe the gum to check for bleeding.

If the staining is superficial and can be removed with polishing or dental cleaning, the dentist may recommend professional cleaning or polishing to remove the stains.

HOW DO I CHECK IN MY Mouth AT HOME?

If you are experiencing food getting stuck in your teeth, it is more likely to be a cavity that requires filling or a root canal treatment.

Conversely, if food is not getting stuck, it is more likely to be a stain on the tooth surface that can be easily removed with brushing, mouthwashes, and dental treatments such as scaling, curettage, and root planning. These stains typically appear as black or brown discolorations and do not require filling.

Proper dental hygiene, including regular brushing and the use of preventative measures for maintaining the right pH of the mouth, can help maintain good oral health and prevent more serious dental issues in the future.

Prevention

Prevention of cavities and stains involves a multifaceted approach, including

-oral hygiene practices (brushing and flossing),

-dietary modifications (reducing frequency and amount of fermentable carbohydrates), and the use of preventive agents (fluoride, antimicrobial agents, and sealants).

Early detection and treatment of cavities and stains are also critical in preventing the progression of the disease and minimizing the need for invasive dental procedures.

For extrinsic stains, professional dental cleanings, teeth whitening procedures, and lifestyle modifications may be effective. For intrinsic stains, more extensive dental treatment such as dental bonding or veneers may be required to improve the appearance of the teeth.

Author-

Dr. Abi Negi

Dentist

10 + years of experience

Certification in Practical Implantology

Certification in Rotary Endodontics

Associate Fellowship in Laser Dentistry Certification in Laser Treatments Diploma in Practical Occlusion and Restorative Dentistry Course Advanced occlusion appliance therapy, TMD Comprehensive Course in Veneers - Ceramic & Composite Aesthetic Certified - Europe, Germany WHO Health Program Certified Certification in Laser Dentistry Fellow of the Academy of General Education (FAGE) Member of the Indian Dental Association (IDA)