You’re sitting in the dentist’s chair. Things have been going okay. You’ve mumbled some almost coherent sentences about daily life around some shiny metal instruments that have been making their way around your teeth. Everyone has been pleasantly chatting with you. Then, it happens. The tool stops. The same spot on your tooth is examined several times. You know what this means. It’s a cavity. But, what exactly is a cavity, and how did it get there despite all your careful brushing and flossing?
At its most basic level, a cavity is a hole in the tooth enamel. The enamel is the hard, outer shell of the tooth that both protects the parts of the tooth underneath and makes a tooth strong. In fact, enamel is the hardest substance in the human body. Once a cavity makes its way through the enamel, the entire tooth can be destroyed. But how can a hole, something defined by the absence of something spread?
The answer, of course, lies in what caused the hole in the first place. Your mouth is home to many types of bacteria. It’s like a neighborhood. Some bacteria are good neighbors for your overall health. Some bacteria are not good health neighbors. And, it turns out, bad neighbors tend to chase away good ones.
Good and bad bacteria
Unhealthy bacteria can take up residence in the biofilm, the microscopically thin living layer that clings to your teeth. The bacteria that cause cavities love acidic environments, and they make more acid when they digest the foods in your mouth. This production of acid kills off the non-cavity causing bacteria that would otherwise make up the biofilm. Tooth enamel does not love acid. The acid weakens and eventually makes a hole in the enamel. Now, you have a cavity.
The cavity won’t stop there. The bacteria and their unhealthy acids are going to continue eating away at your tooth, but now they can eat it from the inside out. It’s vital at this point to have the cavity professionally treated to clean out the infected, damaged tissue and stop further bacteria intrusion. That process is what happens when your dentist gives you a filling. However, a filling does not get rid of the bad bacteria in the biofilm—it simply patches the hole. It is like putting a Band-Aid on an infection without any antibiotic to treat the underlying problem. Treatment of the bacteria is often an overlooked but critical step in the process.
What about prevention?
Brushing and flossing are important tools to clean away unhealthy bacteria. But, they alone may not be enough to prevent all cavities. In order to truly reduce the likelihood of developing a cavity, it’s a good idea to lower amount of time your mouth is in an acidic state.
We often think of sugar as a cavity culprit, which it can be, but the research tells us that anytime we eat or drink anything, the pH in our mouth drops below the critical demineralization point of 5.5. So even many healthy foods, like fruits, veggies and meat can cause a high acid environment in your mouth. Brushing twice a day won’t prevent the growth of bacteria if you’re eating six times a day. However, the right cavity prevention system could save you some serious heart (or tooth) ache
Beyond the foods and frequency that you eat, there are other health risk factors that can cause cavities. A dentist trained to check your overall cavity (called caries by your dentist) risk can help you develop a plan to reduce or eliminate risk factors so you can reduce or eliminate those unpleasant moments in the dentist chair.