Dental cavities are a common problem, and while they occur most frequently in children and young adults, anyone can be affected, at any age, and a recent review of worldwide data1 has shown the incidence of dental cavities may be increasing. Early signs of dental decay or caries are often difficult to detect, but may include noticing increased sensitivity to hot and cold foods, or a slight toothache. Sometimes it may even be possible to notice the holes developing in the teeth, or that the teeth have developed a pitted appearance. If left untreated, then cavities can lead to dental abscesses developing. This is where the pulp or central part of the tooth is exposed due to the decay and subsequently becomes infected. It is a condition that can become extremely painful, and if not promptly treated may require the tooth to be extracted.
What is the cause of dental cavities?
The cavities are essentially structural damage to the tooth, and are caused by the presence of plaque bacteria in the mouth. Everyone has plaque bacteria, and these build up during the course of the day, creating a sticky layer over the teeth and gums. Whenever you eat something sugary or which is high in carbohydrates, the plaque bacteria will feed on the leftovers still present in the mouth. The result is that acids are created, which in turn will attack the tooth enamel, softening it and gradually exposing the underlying layer of dentin as the process of decay progresses. This acid attack continues for approximately half an hour after eating. After this time the pH levels in the mouth gradually begin to return to normal.
Demineralization and re-mineralization
The actual process whereby the tooth enamel is softened is called demineralization, and is where the acids cause essential minerals to be leached out of the tooth enamel, including phosphorus and calcium. As the mouth gradually becomes less acidic then re-mineralization occurs. This is where the minerals leached out of the tooth enamel are redeposited, helping to re-harden the surface of the tooth.
This process is one reason why dentists don’t recommend brushing your teeth immediately after a meal, as you’ll simply be brushing the softened tooth enamel, and may remove even more essential minerals from the teeth. Leaving the teeth to re-harden before brushing will help ensure damage is kept to a minimum.
Preventing dental cavities from developing
As always prevention is much better than the cure, and the best way to do this is to simply visit a dentist at regular intervals. They’ll be able to detect any early signs of decay, through visual examinations and regular dental x-rays. Professional cleaning also helps lessen the risk of decay through removing the buildup of tartar, or hardened plaque bacteria, on the teeth.
Getting treatment early on for dental decay is far less invasive and less painful than leaving it to develop. Large areas of decay will require larger fillings, and may even mean the tooth needs crowning to restore it to full function. Other common treatments include root canals to remove infected pulps. Extensive areas of decay can weaken the tooth, and can even lead to it fracturing.
This vigilance should continue at home. Good oral hygiene, consisting of brushing the teeth twice a day and flossing once a day, will help remove the plaque bacteria that create the decay.
Use of fluoride in the fight against cavities
Using fluoridated products can help give a little bit of extra protection, as the fluoride helps to harden tooth enamel. After brushing it is best to spit out the excess toothpaste rather than rinse with water. The reason for this is that the fluoride ions will remain in the saliva little longer, helping to give a bit of extra protection. If your dentist thinks you are at risk of developing cavities they may recommend using fluoride mouthwash or other supplements. Substantial research2 has found the use of fluoridated products, and drinking fluoridated water can help to reduce the incidence of dental cavities.
Your diet affects your teeth
Making small changes to your diet can also lessen the risk of developing dental cavities. Sugary and starchy foods tend to be especially bad as they tend to stick to the teeth and gums longer than other foods. Choosing to avoid these foods or to eat them as part of a main meal can help. Frequent snacking is another risk factor for cavities, as it simply lengthens the time the teeth are exposed to acid. It’s better to avoid snacking together, or to choose tooth friendly foods such as cheese or crunchy vegetables with a high water content.
Dental sealants can protect the back teeth
Dental sealants can be very beneficial for protecting the newly erupted back teeth of children and teenagers. The treatment involves painting a thin coating onto the chewing surfaces of the back teeth, as these areas are particularly vulnerable to cavities. Sealants can only be used on teeth that are still healthy, although they may be used on teeth where there are small signs of caries, as studies3 have found this to be successful at sealing in bacteria and reducing the rate of decay.
- The global increasing dental caries. A pending public health crisis Bagramian R.A, Garcia-Godoy F, Volpe A.R. Am Journal Dent 2009; 22:3-8
- Effective use of fluorides for the prevention of dental caries in the 21stcentury: the WHO approach. Petersen P.E, Lennon M.A. Community Dent Oral Epidemol 2004;32:319-321
- The effectiveness of sealants in managing caries lesions. Griffin S.O, Oong S, Kohn W, Vidakovic B, Gooch B.F, Bader J, Clarkson J, Fontana M.R, Meyer D.M, ROzier R.G, Weintraub J.A, Zero D.T. Journal of Dental Research 2008;87: 169-174