Beyond the Surface: Understanding Dental Caries and Clinical Longevity
Cavities, which dentists sometimes call dental caries, are spots of tooth decay. They can range in size from tiny to large enough to break teeth.
Dental cavity showing tooth decay in enamel and dentin
Dental caries (cavities) are not merely a result of poor hygiene; they are the byproduct of a complex, dynamic shift in your oral microbiome. While common, they represent an active disease process that can compromise both your oral and systemic health if not treated with a focus on long-term stability.
At CJ Henley, DMD, we don't just "fill holes." We practice medically-informed restorative dentistry, diagnosing the root cause of decay to ensure your treatment holds up for years, not months.
The Physiology of Decay: Why Teeth Fail
Enamel is the hardest substance in the human body, yet it is vulnerable to sustained acidic environments. Decay typically progresses through three distinct layers:
The Enamel Barrier: In the early stages, decay is often painless because enamel lacks nerves. However, this is the most critical time for conservative intervention.
Dentin Infiltration: Once decay breaches the enamel and enters the dentin, sensitivity to temperature and sweets begins. Dentin is porous, allowing bacteria to migrate more quickly toward the center of the tooth.
Pulpal Involvement: When bacteria reach the pulp (the nerve and blood supply), pain becomes throbbing and persistent. At this stage, coordination with specialists may be required to save the natural tooth structure.
High-Authority Risk Factors: The Systemic Link
Not all "sugar bugs" are created equal. Your susceptibility to cavities is heavily influenced by factors that many high-volume practices overlook:
The Saliva Factor: Saliva is your mouth’s natural defense, neutralizing acid and remineralizing enamel. For patients taking medications for blood pressure or anxiety, medication-induced dry mouth (Xerostomia) can cause rapid, "rampant" decay regardless of hygiene habits.
The Microbial Balance: Your oral microbiome is unique. Research indicates that certain bacterial strains can be more aggressive, making some individuals naturally more prone to decay.
Restorative Longevity: A restoration is only as good as the diagnosis behind it. We focus on longevity and function, choosing biocompatible materials and precise techniques that respect the integrity of your natural tooth.
When Treatment Becomes Urgent
If decay is left unmanaged, it can lead to dental abscesses—serious infections that can spread to the surrounding bone or even enter the bloodstream. Signs of advanced infection include:
Severe, unrelenting throbbing pain
Swelling of the gums or face
Fever or a general feeling of systemic illness
A Higher Standard of Care
We believe that patients deserve more than a rushed 15-minute filling. We prioritize an unhurried, two-hour new patient evaluation to identify your unique risk factors and design a care plan focused on clinical longevity.
Reviewed and Updated February 2026
Every Detail Matters.
Every step of ever case matters. Even in simple cases. We strive to make ever case exceptional. Not only beautiful, but made to last for years to come.
Every step of ever case matters. Even in simple cases. We strive to make ever case exceptional. Not only beautiful, but made to last for years to come. Crowns on #13 and #14.
Hurricane Irma - Office Closed
Due to the upcoming hurricane, we will close our office temporarily. We be closed starting Monday (September 11, 2017) and Tuesday (September 12, 2017). Depending on the storm's path we may be closed on Wednesday (September 13, 2017) as well.
Please be safe and know that we are always available even if the office is closed. Please call the office at 904.398.1549. The on call doctor number is on the voicemail.
For More information about the storm please click the links below.
Florida Division of Emergency Management
Due to the upcoming hurricane, we will close our office temporarily. We be closed Monday (September 11, 2017) and Tuesday (September 12, 2017). We anticipate to reopen Wednesday (September 13, 2017).
Please be safe and know that A DOCTOR IS ALWAYS AVAILABLE EVEN IF THE OFFICE IS CLOSED. If you need a doctor please call the office at 904.398.1549 Both Dr. Henley's and Dr. Kelly's phone numbers are AT THE END of the voicemail.
For More information about the storm please click the links below.
Florida Division of Emergency Management
April is Oral Cancer Awareness Month
Oral Cancer awareness in the American public is low. Approximately 49,750 people in the U.S. will be newly diagnosed with oral cancer this year. Every day 132 new people in the U.S. will be newly diagnosed with an oral cancer, and that one person EVERY HOUR OF THE DAY, 24/7/365 will die from it
April is Oral Cancer Awareness Month
Oral Cancer awareness in the American public is low. Approximately 49,750 people in the U.S. will be newly diagnosed with oral cancer this year. Every day 132 new people in the U.S. will be newly diagnosed with an oral cancer, and that one person EVERY HOUR OF THE DAY, 24/7/365 will die from it
While smoking and tobacco use are still major risk factors, the fastest growing segment of oral cancer patients is young, healthy, nonsmoking individuals due to the connection to the HPV virus. We cannot stop this virus from spreading; our only hope to save lives by performing oral cancer screenings on every patient, every time they are in our office.
As a commitment to our patients and our community Dr. Henley serves as member of the Head and Neck Tumor Board at Baptist MD Anderson. The tumor board is a multi-specialty group that works together using the latest in dentistry and medicine to ensure that patients have the best possible outcomes.
To learn more about oral cancer see the links below:
https://www.henleyandkelly.com/head-and-neck-cancer/
http://oralcancerfoundation.org
https://www.baptistjax.com/services/baptist-md-anderson-cancer-center/head-and-neck-cancer
Antibiotics Prior to Dental Work? Maybe Not.
Consumer Reports reported that “new guidelines call for fewer people to get antibiotics before a dental procedure.”
In recent years, recommendations regarding the use of preventive antibiotics before dental procedures have changed significantly.
According to guidance summarized by Consumer Reports, updated clinical guidelines now recommend antibiotic premedication for far fewer patients than in the past. Current recommendations reserve antibiotics primarily for individuals with specific, high-risk medical conditions — such as certain artificial heart valves, a prior history of infective endocarditis, or select serious congenital heart conditions.
For the vast majority of patients, preventive antibiotics before routine dental care are no longer indicated.
Why the Guidelines Changed
The shift reflects a growing understanding of:
the risks associated with unnecessary antibiotic use
antibiotic resistance
the lack of evidence supporting routine premedication for most patients
Modern dentistry places a strong emphasis on evidence-based care — using antibiotics only when the benefits clearly outweigh the risks.
How Recommendations Are Determined
Antibiotic guidelines used in dental care are based on consensus statements and ongoing research from organizations including the American Dental Association, the American Heart Association, and the American Academy of Orthopaedic Surgeons.
These guidelines are reviewed and updated as new evidence becomes available.
An Individualized, Medically Informed Approach
While guidelines provide an important framework, they do not replace individualized medical decision-making.
Dental recommendations in this practice are always made with consideration of:
current clinical guidelines
your medical history
recommendations from your physician or specialist
When there is uncertainty, or when a patient’s medical history is complex, coordination with the treating physician is essential. Physician guidance is never overridden.
Questions About Antibiotics?
If you are unsure whether antibiotic premedication is appropriate before your dental appointment, we encourage you to ask. These decisions are best addressed before treatment, with time for proper review and, when needed, communication with your medical team.
Reviewed and updated January 2026