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Preventing Cavities & Tooth Decay

Woman eating an appleAt some point in time, most of us have probably experienced a cavity. We went to the dentist, had the decay removed, and the tooth was restored with a filling or crown. The purpose of this article will be to review the causes and discuss the prevention of tooth decay.

Tooth decay occurs when three factors are present at the same time. These factors are bacteria, a food source, and a susceptible host. The bacterium that causes tooth decay can be found in everybody’s mouth-- it’s just part of the normal oral fauna. The bacterium by itself does not cause tooth decay. It needs a food source and a susceptible host.

The food source is any carbohydrate. A carbohydrate is a complex sugar molecule. There is a misconception that only candy will lead to cavities, while in reality, many common items in our diet have the potential to cause cavities. Common carbohydrates in our diet include bread, chips, crackers, pasta, desserts, and cereals. As you can see, carbohydrates can be hard to avoid. The recommendation is to limit the frequency, or how often you are consuming carbohydrates and regulate the kinds of carbohydrates that are in your diet. Natural sugars, the kinds that are found in fruits, vegetables, and whole grains, are more desirable than processed items.

The consistency of the food source for the bacteria plays a role in tooth decay as well. Items that are sticky, chewy, and gooey will stay on the teeth longer, increasing the potential for decay. Parents, we all have kids that love fruit roll-ups and gummy bears. Not only are those snacks high in processed sugars, but they do not quickly clear from your child’s teeth, which causes an increase in cavities for children.

Another question I am asked frequently is, “Which drinks cause tooth decay?” Any beverage that is high in sugar has the potential to cause tooth decay. This is not just limited to soft drinks, but juices are high in sugar as well. Many would think that orange juice is healthy for us, but in reality, it is loaded with processed sugar. In recent years, various energy drinks have been marketed to our youth. These drinks have the potential to cause tooth decay as well because their contents are high in sugar and acid.

The last variable that has to be present for cavities to occur is a susceptible host. This is an area of a tooth that is more likely to decay, for example, a deep pit or fissure in a tooth. Old fillings or crowns that may be rough and not as smooth as they once were can be more prone to decay as well. In some cases, our gum tissues may recede, exposing root surfaces. These root surfaces are softer than the other parts of our teeth, and they can be more susceptible to decay.

As we age, many of us take prescription medications that decrease the amount of saliva in the mouth. This is important because saliva is kind of a natural tooth decay fighter. Saliva is a buffer. This buffer helps neutralize the acidic environment that is necessary for the tooth decay process, helping to prevent cavities. So indirectly, certain medications can cause tooth decay.

This is how the decay process happens. You have a carbohydrate loaded snack, the bacteria in your mouth breaks down the carbohydrate, and this makes the conditions in your mouth more acidic. The more acidic environment weakens the enamel of the tooth and causes tooth decay to occur.

Next, let’s discuss how to prevent cavities. Obviously, diet plays a large role in tooth decay. Good dietary habits will decrease your risk of tooth decay. One example of how diet plays a huge role in tooth decay is baby bottle cavities. When parents put their kids to sleep with a bottle of juice or milk in their mouth, the child’s teeth are exposed to the sugary liquids for an extended period of time, causing rampant tooth decay. This is a condition that is completely preventable. Once children have teeth present in the mouth, they should no longer be put to sleep with a bottle.

We can also reduce the rate of tooth decay in children with the use of dental sealants. Sealants are usually applied to the molars. Sealants cover the little holes and grooves on the biting surface of these teeth, decreasing the number of molar cavities. Fluoride applications and fluoride supplementation in our diets have been shown to decrease tooth decay as well.

Equally important in cavity prevention is oral hygiene. Since carbohydrates are prevalent in most of our diets, consistent brushing and flossing are essential to long-term oral health. One should brush after meals or three times a day with a soft bristle toothbrush. However, there are areas in between the teeth where the brush will not reach, which allows plaque to accumulate. Flossing at least once a day will maintain these areas, helping to prevent cavities from forming in between your teeth.

Unfortunately, at this time, there is no magic pill that one can take to cure tooth decay. However, with good patient education and access to dental care, we can decrease the rate of tooth decay.