What Causes Cavities?

Ask this question of most children, and you will hear the answer: “SUGAR!”  We train them well to correlate candy with cavities.  There is nothing wrong with teaching the next generation that a high-sugar diet is bad for you.  However, it could lead us to cling to that believe in adulthood, which makes it very frustrating when we get new cavities despite avoiding sugar.

What really causes cavities?  It is a multifactorial process.  Because there are several contributing factors to the development of a cavity, we actually have multiple ways to fight them!

How Does a Cavity Develop?

Several things must be present for a cavity to start.  As we walk through each one, we will explain its role in the cavity process.

1. A Tooth Surface

This one may seem like a no brainer, but we will explain further.  Cavities do not develop on dental implants.  They affect the hard tissues of a tooth, namely enamel and dentin.  The state of the tooth surface has an impact on cavity development.  Enamel that is thin or weak or damaged by acid is less resistant to cavities.  Dentin, which makes up the core of every tooth and lies just below the enamel, is much softer and more susceptible to cavities.  When enamel is missing or gums recede, exposing dentin to the mouth, cavity risk goes up.

2. Bacteria

Specific bacteria present in dental plaque cause cavities when they have contact with the tooth surface.  These bacteria, Streptococcus mutans, are the active component in the cavity process.  A cavity is a bacterial infection of the hard structure of a tooth.  The bacteria penetrate into the tooth, making their way toward the center of the tooth where it contains nerves and blood vessels.

3. Carbohydrates

The cavity-causing bacteria live on carbohydrates, which is why we say that sugar causes cavities.  If you do not “feed” the bacteria with carbs, they will not create cavities.  It’s important to understand that bacteria ingest all carbs.  Simple carbs are the easiest for them to digest, so there is a higher risk for cavities with candy, cookies, chips, etc . . . Complex carbohydrates, like raw veggies, take longer for the bacteria to digest, so the risk for cavities is much lower.

4. Acid

The weapon the bacteria use to destroy enamel and dentin is acid.  They eat carbs and produce acid, which softens and weakens the hard tooth structure in the same way that acid can etch glass.  The more bacteria you have on the tooth and the more sugar you feed it, the more acid it produces.

An important aspect of this particular factor in the cavity process is the overall pH of the mouth.  A healthy mouth is slightly alkaline, which fights the acid produced by these bacteria.  If the mouth is unhealthy and acidic in pH, it is easier for bacteria to create cavities because the enamel is already weak.

5. Time

Thankfully, this process is not immediate every time you leave some bacteria on the teeth and take a sip of a sugary beverage.  It takes time for the plaque to collect on the tooth surface, digest the carbohydrates and produce enough acid to destroy enamel.  This factor of time allows us to intervene and stop the process.

How to Fight Each Factor in the Cavity Process

To prevent cavities, you can fight these various factors that lead to cavities.  We will use the same order to discuss each one.

1. The Tooth Surface

Make sure your enamel is healthy and that you work to prevent any conditions that cause exposure of the underlying dentin.  Keeping enamel healthy involves using fluoride oral care products and reducing exposure to acids of any kind.

You can prevent dentin exposure by acting to stop enamel damage and gum recession.  This may require treating acid reflux, wearing a protective nightguard for clenching or grinding, altering your brushing technique, and having professional fluoride treatments.

2. Bacteria

This one is easy.  Eliminate the bacteria by removing dental plaque through great oral hygiene.  Your home care routine must include brushing and flossing. You can also add an antiseptic mouthrinse to loosen and flush away dental plaque.  Plaque collects throughout the day, every day, so plaque removal must be consistent.

3. Carbohydrates

This is another easy one.  Reduce or eliminate the simple carbohydrates in your diet.  If you do have simple carbs, try to eat them with a full meal, combined with fats and proteins.  Cut sugary beverages out of your diet, and try not to snack between meals.

4. Acid

We fight the acid produced by bacteria with a healthy mouth pH.  A dry mouth is acidic.  A mouth full of Dr. Pepper is acidic.  A mouth attached to a GERD stomach is acidic.  A healthy mouth is alkaline.  Supporting a healthy pH in the mouth involves stimulating saliva with chewing sugar-free gum, drinking plenty of water, and avoiding acidic foods and beverages.

5. Time

The factor of time is interesting because we can apply it to factors #2, 3, and 4.  We reduce the time that bacteria is in contact with the tooth surface by removing plaque every day.  We can reduce the time that bacteria have to ingest sugar by drinking the soda really quickly and eliminating snacking throughout the day.  We also affect the time factor in the pH of our mouths by returning our mouths to neutral frequently throughout the day.

More Questions about Cavities?

Call Prosper Family Dentistry today at 972-347-1145 to schedule a consultation with Dr. Jill, Dr. Cara, and Dr. Summer.  They can answer any question you have about cavities and assess your personal cavity risk after evaluating your teeth.