What does a Massive Cavity look like Under the Surface?

Sometimes a massive cavity can hide under the chewing surface of a perfectly intact tooth. So what does tooth decay REALLY look like underneath it all?

Had this patient not seen his dentist (i.e. me) and had a dental x-ray taken, we would have never detected this cavity. In fact, I didn't even diagnose a cavity on this tooth at first - I thought there was just some stained pits and fissures. However, after looking at the x-ray, I realized massive dental decay was present, and that this tooth had days, maybe weeks, before a toothache would begin.

How is this possible? The bacteria that cause dental caries (aka cavities) can sneak in through a small breach in the enamel surface. Once underneath, it's like having a trojan horse - utter destruction of your tooth under the chewing surface, without you even knowing it. The decay turns hard tooth structure into mush, and all of it needs to be removed in order for the tooth to be safe.

Afterwards, once the cavity has been removed, we need to properly fill the tooth to seal it under ideal conditions, otherwise you can get a cavity underneath the filling.

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