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Claims that all cavities can be healed without a dentist are gaining popularity online—but while early decay can sometimes be reversed, deeper damage tells a different story, writes Lucy Stock
People love a conspiracy theory, and the field of dentistry isn’t immune to shifty speculations. One notion currently tumbling around the socials is the idea that all decayed teeth can be healed naturally and never need to be filled by evil dentists.
So, let’s go back in time. In the 1600s, it was postulated that a rotting tooth was caused by having an accident, a sudden dip in temperature or tooth worms.
Modern science has advanced to reveal that our mouth bacteria feast on fermentable sugars, producing acids that dissolve our enamel and soften the underlying dentine, allowing the bacteria to travel into the tooth’s inner nerve tube. This bacterial invasion causes the tooth to die and a painful abscess to form.
At the start of the tooth decay process, the hard outer enamel layer of a tooth softens, causing the enamel to become more porous. At this stage, a white spot appears on the tooth due to the tooth’s minerals being leached out.
In 1980, it was discovered that this early enamel decay could be halted by cutting off the food supply to the bacteria, i.e. stopping the sugar and remineralising the enamel with compounds like calcium, phosphates, hydroxyapatite and fluorides.
So, dentists have known for decades that not all teeth with holes require treatment, and that enamel lesions can remain stable. We can compare the size of decay on X-rays. Notably, the internet claims that “dentine level decayed teeth can be fixed naturally” is not backed up with X-ray evidence (if anyone has these, I am always open to learning).
The surface of the enamel may even go as far as caving in, leaving a small depression. However, if the mouth’s saliva is brought back into a neutral state for long enough, the tooth can remain stable, albeit with an imperfect outer layer. I have many of these “arrested decayed lesions” on my teeth that have been stable since my early twenties.
As decay progresses, it goes into the middle dentine layer. It’s at this stage that dentists treat the tooth and remove the decay. The tooth is then sealed from the bacterial environment with a filling. This reduces the chances of the decay enlarging and the tooth developing an extremely annoying abscess, which would require more involved treatment than a simple filling to heal the tooth.
