- Dr. David Alfaro
What causes cavities?
I always encourage people to get second opinions when it comes to dentistry, and people often contact our office for this reason. Sometimes......we get phone calls where they want to send in some radiographs (x-rays) for me to look at....... without coming in for an exam. But....we do insist on a proper consultation appointment at my office along with a comprehensive dental examination because "cavities" are much more complicated than they seem.
What is a cavity and what causes them?
"Cavity" is a common term for the tooth decay that happens as part of dental caries, but it only describes the later stages of the process. As everyone knows, the mouth is full of bacteria, and there are a couple of types that cause tooth decay, streptococcus mutans in particular. These "sugar bugs" (as we tell the kids) metabolize carbohydrates and create acid as a byproduct. This acid then attacks the teeth, leeching out the minerals within them, making them weaker. If frequently exposed to acid, the tooth begins to demineralize and decay, eventually getting weak enough that the outer layer, the enamel, gets a hole in it; a "cavity".
Teeth can have tooth decay before there is actually a "cavity"!
How do dentists detect tooth decay?
It is actually not that easy! Many people think that we can just check some radiographs (x-rays) and can tell if there is tooth decay right away. Radiographs, however, only give us some of the information we need, particularly about the areas where the neighbouring teeth contact each other. They are not so good at showing tooth decay on the biting surfaces of the teeth. Furthermore, the tooth has to have quite a bit of demineralization for the tooth decay to show up on a radiograph, so we may not be able to see smaller "cavities". X-rays can be deceiving!
Dentists therefore have to perform a clinical examination, including a dietary, dental, and medical history in order to properly evaluate someones "caries risk". This includes evaluating symptoms, assessing old dental work, visual and tactile inspection of the teeth, and also the use of many other tools including special lights and dyes that can help point out areas of decay. This takes time to be properly completed.
How do I decrease my dental caries risk?
Since sugar is the main culprit, cut back on the frequency of simple sugars. It is not bad to have a sweet treat from time to time, but if you are sipping on a sugary coffee all day, that is a recipe for tooth decay.
Then there is home care. You need to keep things spotless or else the bacteria make themselves a lovely home in the plaque and calculus that covers your teeth. Brush with a FLUORIDATED TOOTHPASTE!
Those two are pretty obvious, but, one thing that many people do not realize is that there are hundreds of medications that cause dry mouth, and this significantly increases dental caries risk. As we live longer, more of us are taking medications for chronic conditions, and as a result, are getting more cavities. It is a serious problem that I deal with every day at the office. Obviously we cannot ask people to stop taking these medications, but, there are many conditions that can be improved with diet and lifestyle changes, with resultant decreases and sometimes even the elimination of the need for these drugs. Oral health and general health are one and the same.
We need to look beyond x-rays and teeth to properly take care of our patients!
Check out this quick video about dental caries:
Thanks for reading!
Dr. Dave
