Can a Cavity Start from Inside a Tooth?

Posted by AllSmiles

I relocated three years ago and have switched dentists a few times, trying to find one that I like as much as my dentist in Ohio. After my six-month exam, my new dentist said I have a cavity forming inside an upper molar. I’m surprised. I don’t have a history of cavities, and I see no outward signs of one. Could I have a cavity that started inside my tooth? Thanks. Terry from PA

Terry,

A cavity cannot form inside a tooth without an external point of entry. Tooth decay always begins on the surface and progresses inward. When bacteria reach the inner portion of the tooth, an infection develops, often requiring root canal treatment.

If your dentist described a problem that looks like decay starting from within the tooth, they may be referring to a different condition.

A Rare Condition That Might Resemble Decay

One possibility is internal resorption, a rare condition in which the pulp begins to break down the tooth structure from the inside. The exact cause isn’t fully understood, but it appears to involve inflammation of the pulp. Some irritation usually triggers that reaction.

Without a history of decay, trauma can contribute to resorption, especially if a tooth protrudes and absorbs excessive force.

Because this condition is rare and easily mistaken for other issues, we recommend seeking a second opinion from an endodontist. That approach helps ensure the diagnosis is accurate before you commit to treatment.

When you seek that opinion, keep the process as neutral with these steps:

• Ask for a copy of your X-ray to bring with you.
• Don’t share the name of your current dentist or their diagnosis.
• Let the specialist evaluate the images independently.

Hartford, Connecticut, dentist, Dr. Thaddeus Michalski, sponsors this post. Read why many of his patients say he is one of the best dentists in town.