Cavities are actually bacterial infections of the hard structures of the teeth, namely the enamel and dentin. Enamel is the hard, white outer coating of the teeth, and dentin is the slightly softer, yellower core structure that makes up the bulk of the teeth. Cavities typically begin in enamel and then spread to dentin, but they can begin in dentin when the enamel is missing.
Cavities always grow and move in one direction: toward to pulp. The pulp is the soft tissue of nerves and blood vessels within the hollow core of the teeth. When cavities get close to or into the pulp, a toothache usually ensues. When left untreated, cavities can destroy the entire tooth, leaving only a rotten root in place.
Cavities are a multifactorial disease, meaning they require several factors to be present in order to occur. In this section, we will describe the four factors necessary for a cavity to develop.
This may seem like a no-brainer, but cavities require teeth. We point this out because cavities cannot develop on dental implants or other dental restorations. They can occur at the edge of a restoration where it meets the natural tooth structure, but cavities are always only on the teeth. There are several aspects of the teeth that influence the risk for cavities, which we will cover in our later section.
The bacteria Streptococcus mutans is responsible for tooth decay. This bacteria lives in dental plaque and produces a strong acid that can soften and break through tooth enamel. The dental plaque that collects on our teeth keeps this bacteria in contact with enamel where it can do the most damage. Without the bacteria, cavities do not happen.
Sugar is the bacteria’s food. By sugar, we really mean any simple carbohydrate, not just sweets. The bacteria mentioned in the previous section “eat” simple carbs and make the acid as its by-product or waste. Without sugar, the bacteria cannot make the acid that harms enamel.
The cavity process is not instantaneous. It takes time for the bacteria to collect on the teeth in the form of dental plaque, ingest the sugar, and produce the acid that can break through enamel. The factor of time is a good thing because it allows us to intervene and disrupt the process, thus preventing cavities from developing.
We all know people who seem to neglect their teeth and eat whatever they want without getting cavities. We probably also know some who take diligent care with their teeth and watch their diet, yet they still develop new cavities. There are various factors that influence your risk for developing cavities. If you fall into the latter category of someone who develops categories relatively easily, we consider you to be “high risk” for cavities. You will need to take additional steps in the prevention process in order to successfully fight them.
Because the bacteria responsible for cavities live in dental plaque, those who do not consistently and effectively remove plaque from the teeth have a higher risk for developing cavities. Plaque is the soft, white buildup that collects on the teeth every single day. It contains bacteria, food debris (that sugar that feeds the bacteria), and exfoliated tissue cells from the inside of the mouth.
We can easily remove most plaque through good brushing and flossing techniques. If we do not do this, and allow the plaque to remain on the teeth, the risk for cavities goes up.
The more sugar you ingest, the more you are feeding the cavity-causing bacteria in your mouth. The more sugar they ingest, the more acid they can produce, which means they can cause more cavities. What you eat, the bacteria in your mouth also eat.
Sugary beverages, like sodas, sports drinks, and juices, are particularly high risk because they continually bathe your teeth in sugar. Similarly, hard candies or sticky sweets that may remain on the teeth pose a higher risk for cavities.
The acid produced by the bacteria is the agent they use to break down enamel. Our body fights that acid with a naturally alkaline pH in the mouth. Saliva is just above neutral, so it can quickly counteract the acid produced by bacteria. The risk for cavities increases when the mouth’s environment is acidic, or below neutral.
This can occur through the constant drinking of acidic beverages (like soda, coffee, tea, bear, wine, sports drinks, juices, flavored water, etc…). It can also occur as the result of stomach problems like severe acid reflux or GERD. These GI issues bring stomach acid, which is highly acidic, up into the oral cavity, making the mouth acidic in pH.
Dry mouth is a serious risk factor for dental diseases, and it commonly occurs as a side effect of many prescription medications. A dry mouth raises the risk for cavities in multiple ways. First of all, piggy-backing on the previous section, a dry mouth is an acidic mouth because it lacks the counteracting alkaline pH of saliva.
A dry mouth also tends to have more plaque buildup. Dental plaque is stickier and more difficult to remove when the oral cavity is dry. More plaque means more bacteria, and therefore a higher risk for cavities.
Enamel is the hardest substance in the human body, but not everyone has naturally strong enamel. Some have enamel that may be thin or weak or even missing. This can occur naturally, or we can cause our enamel to be thin or weak or missing. Enamel is at risk for acid erosion, attrition (a gradual wearing away from heavy forces like clenching or grinding your teeth), or abrasion (using a harsh substance on your teeth).
In order to prevent cavities, you need to fight each of the causes of cavities and minimize your risk factors. In response to the four factors necessary to cause cavities, you can do the following:
Tooth – You can strengthen your teeth, making them more resistant to the attacks of cavity-causing bacteria by using a fluoride toothpaste and seeing your dentist regularly to evaluate the health of your enamel.
Bacteria – You can reduce the amount of bacteria in your mouth, and thus their ability to cause cavities, by practicing great oral hygiene at home every single day. Make sure to use an effective brushing and flossing technique, and never skip a professional teeth cleaning.
Sugar – Reduce your overall intake of simple carbs. Enjoy your sweets or sugary beverages with a meal only so that you get the counteracting effect of saliva production (which is highest during mealtime).
Time – Reduce the time that your teeth are exposed to both bacteria and sugar. Do not allow plaque to remain on the teeth for longer than a few hours. Quickly remove it by brushing and flossing consistently. Reduce the length of time that you have sugar in your mouth by not sipping on sugary beverages for long periods or sucking on hard candies. Enjoy sugar quickly.
Call your nearest Premier Dental of Ohio location today to schedule a consultation with one of our dental experts. We can answer any question you have about cavities and assess your unique risk factors. We love helping our patients stop cavities before they start!