How Tooth Decay Starts
A cavity is a hole in tooth enamel that is caused by tooth decay.
Tooth decay begins with oral bacteria. Most oral bacteria are harmless, but certain types join with food particles to create plaque, a constantly forming biofilm that sticks to the surface of tooth enamel. Plaque creates acid that erodes enamel and causes weak spots. Over time, these weak spots will become bigger and deeper until a hole, or cavity, forms. When it reaches the next layer of the tooth (dentin), sensitivity may start to be experienced.
Bacteria that cause tooth decay starts living in our mouths shortly after the first tooth erupts. Transmission of aggressive bacteria (ones that easily make tooth decay) is easier than more passive tooth bacteria. Aggressive bacteria in families make it look like that cavities or "soft teeth" run in families. Disorders of enamel and dentin are very rare, yet aggressive cavity forming bacteria is common.
Decay causing bacteria eat simple carbs like sugar. Agressive bacteria can break down highly processed carbs found in crackers, prezels and chips. Many items in our diet are advertised as healthy, yet some are full of simple carbohydrates that easily convert to sugar. Snacking frequently on dried processed carbs that get stuck between teeth contributes to a higher cavity experience. Add sugary drinks and acidic ones even without sugar even adds more risk to decay. Infant formulas and breast milk have simple carbs, so if the infant has the wrong type of aggressive bacteria, they will be at risk to nursing caries.
Treating Tooth Decay and Cavities
Once bacteria and acids have created a deep enough cavity, only a dentist can repair it by removing the decayed area of the tooth and restoring the tooth’s structure and function with a tooth colored filling or a crown.
Without treatment, a cavity will continue to grow until it erodes the enamel and spreads into the interior (dentin) of the tooth. When the tooth nerve and blood vessels in the root is exposed by a cavity, inflammation and infection can occur leading to more aggressive treatment.
While there are many options for treating cavities, prevention is always best. It takes 24 hours from perfectly clean teeth for the bacteria to organize enough to start working on decay with acid. So cleaning teeth as clean as possible each day is a great start to preventing decay. Working together with your primary dental team, you can help prevent cavities with healthy dental habits and proactive treatments:
- Brush at least twice a day, for at least two minutes each time, to clean plaque from tooth surfaces.
- Floss or use soft toothpicks at least once each day to remove plaque between the teeth and along the gum line. It is best to do this right after brushing without rinsing to work the fluoride from your toothpaste between your teeth.
- Use fluoride toothpaste, a proven way to strengthen and remineralize enamel. Prescription strength fluoride gels with 5x the level of fluoride are availble.
- Consider professional fluoride treatments if you have a higher risk of tooth decay.
- Regular check ups catch cavites when smaller and can coach you on how to get areas cleaner at home.
- Professional cleanings remove tartar that you can't remove, yet harbor dental bacterias.
- Ask your dentist about sealants to protect molars grooves from decay.
- Eat at tooth-healthy diet rich in nutrients like calcium, phosphorus, and vitamin D and low in simple sugars and acids.