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Why Do We Get Cavities Anyway?

By Dr. Simon Amir, D.M.D.

Have you ever wondered why we get tooth decay- something that can literally be described as a hole in the head? Cavities are so common that they are just accepted as a way of life. You try to go to the dentist twice a year, he or she finds some problems, then fixes you up till next time, and the cycle repeats again and again. Why do most of us suffer with this affliction? Why are some people seemingly immune? I have some patients who say that their brother or sister never gets ANY cavities but they themselves always have, since they were a kid! To answer this question, we have to delve into the problem a little.

Cavities form when a specific type of bacteria, called streptococcus mutans, consumes sugar, and excretes acid as a waste product. It is this acid which actually creates the damage that we call a cavity or tooth decay. Getting cavities requires having this bacteria- no strep mutans, no cavities. Sugar is what “fuels the fire” of cavities, especially in the presence of additional acids (think the acids added to sodas and sports drinks, or naturally present in juices). Even starches can feed these bacteria- think chips, crackers and pretzels. Starch turns into sugars slowly in the mouth as enzymes in our saliva break it down, and this effectively makes a time-release food for these decay-causing bacteria. Once enough acid has been produced on a tooth over time to break a hole in the protective enamel layer, bacteria start to live inside this hole where your toothbrush cannot reach and the process accelerates rapidly.

In reality, our teeth lose minerals when acid attacks them, but can regain minerals from our saliva pretty easily as well. It is only when our teeth are attacked by acids too often that we end up with cavities. My patients who get the most cavities tend to be sippers or grazers, exposing themselves to sugars or starches too often throughout the day. Those lucky folks that seem to be able to eat or drink whatever they want and not get cavities may less susceptible due to a few reasons- either due to the different bacterial populations in their mouths (there are around 800 known species of oral bacteria!), or differences in how effective their saliva is at fighting acid formation. On the other hand, people with active cavities will have much higher amounts of decay-causing bacteria in their mouths, and this puts their entire mouths at more risk of new cavities. Getting your cavities fixed will reduce your risk of getting new ones.

The most important reason that this disease is so common nowadays is our modern diet. Ancient human diets had VERY little sugar, and studies of ancient human skulls show very little tooth decay. I imagine that ancient humans didn’t have electric toothbrushes, air-flossers, mouthwash, or modern dentistry, yet they still didn’t have many dental problems. In our modern world, we are surrounded by sugar in many tempting forms around us all the time. I’ve found personally that not having sugary snacks around the house, and making my staff take any cookies that we get at the office home is my best strategy for eating less junk food. Any strategies you can use to reduce your sugar intake will go a long way into reducing your dental problems.

Lastly, it is important to note that most cavities don’t give you ANY symptoms until they are pretty far along. Sometimes the first sign that there is something wrong can be a toothache, which is an expensive prospect to fix. Once a tooth is hurting you, it may need a root canal and perhaps a crown. Regular checkups with a dentist can catch tooth decay in it’s early stages, where it can be easily fixed for as little as a tenth of the cost of more advanced problems. At Grand Oaks Dental Care we love to lower our patient’s dental bills by helping them be proactive with their dental health. Call us at 352-877-4926 and let us help you achieve a healthy smile for life!