Dental cavities (caries) are holes in the two outer layers of a tooth, called enamel and dentin. The enamel is the outermost white hard surface and the dentin is the yellow layer just beneath the enamel. Both layers serve to protect the inner living tooth tissue, called the pulp. This area is where blood vessels and nerves reside. Dental Cavities are common, affecting over 90% of the population. Small cavities may not cause pain, and may go unnoticed by the patient. The larger cavities can trap food, and the inner pulp or nerve of the tooth can become irritated by foods that are cold, hot ,sweet, or sour causing a toothache.
What causes a Cavity?
Cavity causing bacteria in the mouth consume simple sugars, converting them into acid plaque. Acid plaque is different from the periodontal plaque that causes “Gum Disease”. The acid plaque produced by these bacteria causes the hard inorganic layers of the enamel and dentin to soften. The softened layers are then dissolved by your saliva, leaving a hole (cavity) in the tooth. Unless filled by your dentist, the cavity can continue to grow and spread to the inner nerve or pulp of the tooth. Pulp damage necessitates either an extraction o r root canal and crown procedure to be done.
The enamel on baby teeth is not mature and is very porous as well. It is critical to treat cavities on baby teeth early on.
Cavity causing bacteria are difficult to eradicate because they are very similar to the other harmless bacteria that live in the mouth. The many cavity causing bacteria include:
- Lactobacillus Acidophilus bacteria reside in the pits and fissures, or deep groves of our teeth. These bacteria can cause rampant tooth decay in young children between the ages of 3 and 12, causing cavities in both baby teeth and sometimes first permanent molars that erupt around age 6.
- Six species of Streptococcus bacteria attack the smooth surfaces of the sides of our teeth. These (flossing cavities) are usually touching adjacent teeth. Cavities on these surfaces are hard to detect visually, and your dentist will use dental x rays to help verify these hard to see cavities.
- Odontomyces Viscoses bacteria live on the back of the tongue and attack exposed cementum. Cementum is the hard outer layer of the tooth root( the bottom two thirds of the tooth that is normally under dental bone). In older patients and in patients with gum disease, the tooth root and cementum become exposed and vulnerable to attack by these bacteria.
How can you prevent Cavities?
The number of cavities can be reduced by proper nutrition, good oral hygiene, fewer snacks in between meals, the use of oral and topical fluorides, and topical sealants.
- Nutritional Counseling- consuming less simple sugar (sucrose or table sugar) will reduce the number of acid producing bacteria in the mouth. Adequate amounts of dietary Calcium, Phosphorus, Vitamins A,D, and C promote healthy and strong enamel formation.
- Home Care- Brushing your teeth frequently (2 x a day and after meals or snacks) helps reduce acid plaque damage to enamel, while frequent flossing removes acid plaque from the smooth surfaces between teeth. If you cannot brush and floss immediately after a meal, you should try chewing self cleaning foods at the end of meals or rinse with some water until you can brush and floss. These foods include apples and celery, foods that are crunchy help sweep away food debris and plaque. Chewing sugarless gum for a few minutes at the end of a meal can also help.
- Eating fewer snacks between meals- Every snack you eat is followed by an “acid attack” on your teeth. Snacking all day causes the teeth to be bathed in acid continuously. Fewer snacks and eating desserts only with meals helps reduce the number of “acid attacks” on your teeth.
- Fluorides- Topical fluorides fill in the pores of immature enamel or small early cavities and help reduce cavities in already erupted teeth. Topical fluorides are “painted” on the teeth by a member of Dr.Amin’s team and is done in conjunction with your check ups twice a year.
- Sealants- Sealants are plastic coatings painted on the pits and fissures (deep grooves) of chewing surfaces of back teeth (molars), and are highly effective in preventing cavities. Sealants are recommended for all permanent molars in children. They are also used to reduce cavities in baby teeth and in adults that are cavity prone. The procedure is done by eitherDr.Amin or her Hygienists and is simple and painless and requires no anesthesia or “numbing”.
- Eliminating Acidic Drinks- These include but not limited to, Coffee, Sweet Tea, energy drinks, and sodas.