What Causes Dental Cavities?

     A lot of times people ask me how they got a cavity. I’m always happy to explain all the factors at play. The oral cavity is complex ecosystem with many different bacteria (some good, some bad), enzymes, and minerals that are constantly changing depending on genetics, diet, and oral hygiene.

     Genetics, diet, and oral hygiene are the main factors when it comes to cavity formation. Genetics play a significant role in determining a person’s susceptibility to cavities. There’s not much anyone can do about this factor, but there are ways to mitigate the effects if DNA is not on your side. All is not lost!

     This brings up the other two factors which everyone can control. Diet is an important determinant of cavity formation. Everyone knows excessive sugar in the diet can lead to cavities, but here’s a brief explanation why. Streptococcus Mutans is the main bacteria that leads to the initiation of cavities. The bacteria use the sugars in foods for energy and release acids as byproducts. These acids cause demineralization of the enamel of the tooth. Fluoride in toothpaste and minerals in saliva aid in remineralization. This demineralization and remineralization cycle happens all the time and is normal. As long as the 2 processes stay in balance, a cavity may never form. The issues occur when demineralization consistently beats out remineralization. Over time, the acids demineralize the teeth to the point of where an opening (cavity) forms in the enamel. From there, the cavity can grow and cause possibly severe problems if left untreated. One can limit this by limiting sugary treats and carbonated beverages. When sugar is consumed, the demineralization doesn’t just stop immediately when a person stops eating sugar. The process can go on for 20 minutes after sugar is consumed. Sticky sugary treats are especially bad as they can cling to surfaces of teeth. It’s important to brush/floss after eating foods containing sugars.

     This brings up the third factor: Oral Hygiene. Most people brush but are you brushing for long enough? Recommendations are for brushing to last for about two minutes twice a day; after waking up in the morning and right before bed. Flossing tends to be neglected but is equally as important. Brushing gets the front and back of the teeth, but what cleans the surfaces between the teeth? Not flossing is like having a surface of your teeth that you never clean! This leaves those areas very susceptible to cavities.

     Some people do not want to visit a dentist until they feel pain, but a lot of times by the time pain develops it may already be too late to save the tooth. A cavity in its early stages can be treated with a filling. Usually, cavities of this variety do not cause a lot of pain. Once they get bigger and deeper, they start to encroach on the pulp of the tooth that houses the nerves. At this point, a cavity can cause severe pain. Unfortunately, by now a filling may not be enough to treat the cavity. At this stage, the tooth may require a root canal or even extraction depending on how severe the damage to the tooth is.  Part of proper oral hygiene is visiting a dentist, every 6 months for a cleaning and exam. Your dentist can instruct you on proper brushing and flossing techniques as well as clean some hard to reach surfaces. Taking x-rays is part of a regular examination and can help dentists catch problems early and prevent further damage. Working together with your dentist can help stop problems before they start!