What Causes Cavities? Here Are The Best Ways To Avoid Pain, Gum Disease, Dental Emergencies and Implants
Very few people truly understand where their cavities are coming from, reports Dr. Joseph Field at the nationally recognized Peninsula Center of Cosmetic Dentistry. Equating cavities with eating sugar is too simplistic, he notes, and everyone needs to learn the full details if they want to save tens of thousands of dollars in dental bills, not to mention pain.
“I have this conversation daily. Often patients have never heard this information before,” Dr. Field said. Sure, we all learned in elementary school that sugar causes cavities, and that we should all brush our teeth, but that’s only a fraction of the story. “The reality is that based on all the evidence we now know, it’s a lot more involved than that.”
A cavity is a hole in the tough outer layer of the tooth known as the enamel. Left untreated, holes in tooth enamel will widen and deepen into the softer inner part of the tooth, causing pain and sensitivity. The tooth could then break or get infected, requiring costly repairs, root canal surgery or even removal, followed by a bridge or implant.
Your mom was right: sugar does causes cavities, but not directly. Sugar is food for millions of bacteria that live in your mouth. These bacteria excrete acid as waste. It is acid, not sugar, that causes cavities, and bacteria feed on much more than sugar. Mouth bacteria also love carbohydrates like those found in a Saltine cracker, or in bread.
And acid comes from more than just bacteria. Stomach acid reflux, orange juice, coffee, and sugar-free soda all contain acids that demineralize tooth enamel and lead to holes. In the Bay Area, Dr. Field sees a lot of diet soda drinkers who incorrectly assume they’re safe. They’re not.
“The worst drink for your teeth is grape juice,” he said. “It’s both acidic and sugary, attacking enamel in the short and medium term.”
Both the directness and duration of acid exposure affect cavity creation. So, lazily snacking on sour Skittles is awful, while chewing gum with Xylitol after a meal can help. Xylitol wicks bacteria away from the tooth’s surface, Dr. Field said, where saliva moves in to buffer the acid. Saliva plays a major, and underappreciated, role in buffering tooth enamel from acid.
Dr. Field also notes that mouth-breathing can give you cavities as can any medication that causes dry mouth, and physicians do not do enough to inform patients of this side effect. Six months of medication-caused dry mouth between checkups can lead to “rampant” tooth decay.
So to prevent cavities you want to do your best to minimize exposing your teeth to acids. That could mean drinking water after your orange juice, and avoiding sipping coffee all morning. Cut out snacking. Your waistline will thank you, too.
Brush with a fluoride toothpaste after meals, using an electric toothbrush for two minutes, floss at least once each day. A fluoride mouthwash can also help remineralize enamel, and an antibacterial wash can decrease bacteria.
Also, promote healthy mouth bacteria by eating healthy and taking probiotics like yogurt, especially if your system is rebuilding after exposure to antibiotics. “It’s about the whole body,” Dr. Field said.
Clenching and grinding can also damage tooth enamel, leading to cavities. But those behaviors can be identified during regular checkups and treated with sealants or a mouth guard.
Modern technology has lengthened both our lifespans and the expected service life of our teeth. Luckily, we know more now than ever about how to make teeth last, while avoiding pain and costs.
“I’m a big believer in an ounce of prevention is worth a pound of cure,” Dr. Field said.