The Truth About Cavities
You know what question I get asked more than any question at the dental office........
“DO I HAVE ANY CAVITIES?” 
If the answer is "no" there is usually an audible exhale.........and it hits me....they've been holding their breath the entire appointment! Amazing! Then the smiles and celebratory dancing come out, with chants of, "No shots, no pain, no more dentist for six months!"
I think a lot of people think that getting cavities or not getting cavities is kind of like a game of chance, like Russian Roulette, where one day your number is landed on, you've gotten away with no cavities long enough, and today is not... your..... day.
Well that's silly, because when you know what I know, you may never get cavities again!
So to become an expert cavity preventer, let's teach you some of the basics.
It has rectangular bricks stacked on top of each other with the glue, or mortar, in-between each brick. The wall is really strong and can’t be pushed over when everything is dry and all cemented together, right?
In your mouth, the white outer layer of your teeth, or the enamel, is like a brick wall. It has cells, much like bricks, stacked on top of each other in a very dense, tight formation. Enamel is so dense, in fact, that it takes drills with diamond studded burs to cut into them. So they're tough! In-between each "brick," or cell, are minerals that “glue” the cells together, just like mortar glues bricks together. The enamel as a “wall” is very strong so that it can withstand the pressure of you chewing your food and not break.
To prevent getting cavities you've got to keep the enamel strong, and this can be done by daily being smart with what you eat, what you drink, when you brush, and getting regular check-ups.
If you are playing “Jenga” and you pull out one piece, does the whole structure fall? No. It is still fine, still sound and strong. Can that mortar be replaced? Yes it can. Your best defense is your saliva, or spit, that floats around in your mouth. It is full of minerals like calcium and phosphorous that help replace what is dissolved.
Acids come from three main sources. First is from what you eat and drink, because what goes in your mouth goes on your teeth. What is the most acidic? All soda pop, Gatorade, and energy drinks are extremely acidic. But basically any pre-packaged drink, whether it’s a fruit drink or a flavored water, even bottled water, has acid in it to preserve it. Then more natural things like lemons, pineapple, strawberries, oranges, grapefruit, vinegar, coffee, and tea are the next most acidic.
The second place acid comes from is bacteria poop. Yup! That's what I said! There are little tiny bugs or bacteria living in your mouth all the time, which everyone has. These little guys stick together around your teeth, especially right next to your gums and in-between the teeth. They surround themselves with a sticky goo called "biofilm"which is like their house. They invite other bacterial friends into their house, and they make more bacteria together. Any time you eat, they eat too, and then they poop out acid onto your tooth into their gooey biofilm. So that acid sits next to your teeth for hours after you have eaten.
But that’s not the only place you get acid from. Your stomach is full of the one of the most potent acids out there, hydrochloric acid. Stomach acid dissolves and breaks down the food you eat so your body can digest it. Most of the time that acid doesn’t bother your mouth because there’s a gate, or valve, between the stomach and mouth. But have you ever heard of heart burn? Acids or even fumes from the stomach can leak through that valve into your throat, making it burn. They fill your mouth with acid and fumes that can dissolve your enamel wall as well.
A castle has a moat and thick outer walls that protect the townspeople and the king inside. When invaders attack the castle they catapult rocks and try to penetrate the wall----thank goodness the moat is there to slow them down. In the mouth your saliva is like the moat, the enamel is like the thick outer wall. Bacteria and acids are like the bad guys that attack your teeth. Acids can't penetrate the enamel if there is good saliva, and saliva is constantly fixing the walls when holes start to form. But if the "moat" dries out or is drained, acids can get right up next to the wall and start dissolving it. If acid is concentrated in one area and breaks through the wall, the battle may be over. Once acid is through the wall and bacteria get inside, they can quickly destroy what's inside.
Depending on the location of the cavity and how well you are keeping the area free of acid and bacteria, it may be impossible to prevent the cavity from getting bigger. In this case, it is best to have the dentist drill out the soft, decayed area of the tooth and replace it with a hard porcelain filling. The last thing you want to have happen is to wait and wait and wait.......that's when the holes grow and get to the very inner portion of your tooth where the nerves are, or the pulp, which is like where the king lives in the castle. If the king is killed, the kingdom falls apart. If the nerve is killed from bacterial and acid invasion, then the tooth dies and abscesses. Abscessed teeth are really bad infections and can cause a lot of pain and even death in extreme cases, so don't even think of going that route!
If the answer is "no" there is usually an audible exhale.........and it hits me....they've been holding their breath the entire appointment! Amazing! Then the smiles and celebratory dancing come out, with chants of, "No shots, no pain, no more dentist for six months!"
I think a lot of people think that getting cavities or not getting cavities is kind of like a game of chance, like Russian Roulette, where one day your number is landed on, you've gotten away with no cavities long enough, and today is not... your..... day.
Well that's silly, because when you know what I know, you may never get cavities again!
So to become an expert cavity preventer, let's teach you some of the basics.
What are cavities?
Cavities are basically holes. Teeth are hard, when they get cavities, they are soft. That's why the dentist takes his little pokey instrument and pushes down on your teeth, he is looking for any areas that are soft. See the cavities in this picture here?
How can I prevent getting caveties?
To understand how to prevent cavities you must understand about walls. Here is a brick wall.It has rectangular bricks stacked on top of each other with the glue, or mortar, in-between each brick. The wall is really strong and can’t be pushed over when everything is dry and all cemented together, right?
In your mouth, the white outer layer of your teeth, or the enamel, is like a brick wall. It has cells, much like bricks, stacked on top of each other in a very dense, tight formation. Enamel is so dense, in fact, that it takes drills with diamond studded burs to cut into them. So they're tough! In-between each "brick," or cell, are minerals that “glue” the cells together, just like mortar glues bricks together. The enamel as a “wall” is very strong so that it can withstand the pressure of you chewing your food and not break.
To prevent getting cavities you've got to keep the enamel strong, and this can be done by daily being smart with what you eat, what you drink, when you brush, and getting regular check-ups.
If my enamel is so strong, why do I get cavities?
Enamel has SUPER strength, but just like Superman, it has a weakness, and that weakness is acid. Every time your teeth get acid around them, within about three seconds some of the “mortar” on the outside of the "wall" gets dissolved. Is this bad? Yes, but no.If you are playing “Jenga” and you pull out one piece, does the whole structure fall? No. It is still fine, still sound and strong. Can that mortar be replaced? Yes it can. Your best defense is your saliva, or spit, that floats around in your mouth. It is full of minerals like calcium and phosphorous that help replace what is dissolved.
Where do acids come from?
Acids come from three main sources. First is from what you eat and drink, because what goes in your mouth goes on your teeth. What is the most acidic? All soda pop, Gatorade, and energy drinks are extremely acidic. But basically any pre-packaged drink, whether it’s a fruit drink or a flavored water, even bottled water, has acid in it to preserve it. Then more natural things like lemons, pineapple, strawberries, oranges, grapefruit, vinegar, coffee, and tea are the next most acidic.
The second place acid comes from is bacteria poop. Yup! That's what I said! There are little tiny bugs or bacteria living in your mouth all the time, which everyone has. These little guys stick together around your teeth, especially right next to your gums and in-between the teeth. They surround themselves with a sticky goo called "biofilm"which is like their house. They invite other bacterial friends into their house, and they make more bacteria together. Any time you eat, they eat too, and then they poop out acid onto your tooth into their gooey biofilm. So that acid sits next to your teeth for hours after you have eaten.
But that’s not the only place you get acid from. Your stomach is full of the one of the most potent acids out there, hydrochloric acid. Stomach acid dissolves and breaks down the food you eat so your body can digest it. Most of the time that acid doesn’t bother your mouth because there’s a gate, or valve, between the stomach and mouth. But have you ever heard of heart burn? Acids or even fumes from the stomach can leak through that valve into your throat, making it burn. They fill your mouth with acid and fumes that can dissolve your enamel wall as well.
Doesn’t sugar cause caveties?
No, sugar does not cause cavities. If you were to take a tooth and put it in a bowl of sugar it would not get any cavities, no matter how long you left it. What causes cavities is those darn little bugs in your mouth. They float around in your mouth and land on your teeth, producing a sugary slimy layer called a "biofilm" to protect themselves and gather friends. When you eat sugar those cute little buggers LOVE LOVE LOVE you! They eat the sugar, which helps them multiply and make their slime thicker, and then like with any creature that lives on the earth, they have to poop. Their poop is super acidic, which gets trapped in their slime, so if you have a bunch of these bugs living in their slime around your teeth and they poop acid, it will dissolve your teeth as well.If I am taking good care of my teeth every day, why am I getting cavities?
With all the places you can get acid from, you can imagine the battle that is being fought around your teeth every day to keep them strong. Acid is poured on from bacteria and what you eat, minerals are lost, saliva increases, minerals are replaced, and so on and so forth. The more acid you introduce to your mouth, the harder it is to keep up the repair process. And then what if you forget to brush your teeth for a day or two? Or what if you get a cold and breathe through your mouth for a week and dry everything out? Like with “Jenga”, taking a few pieces out isn’t devastating, but take enough out and what happens? The whole thing falls. And that’s exactly what a cavity is, the enamel “wall” has had enough “mortar” dissolved around it that it just can’t stay together anymore and caves in.When should I get a cavity fixed?
Cavities can form in teeth and never have to be fixed. Have you ever been to the dentist and had him say he's going to "watch" a tooth until next time? You've got a hole! Oh no! But don't panic, the hole may be there but if the dentist is just going to watch it, it's still in the hard part of the tooth, or the enamel, and is not soft a squishy. Cavities move very slowly in the enamel, and if you step up your efforts to keep the enamel hard, they may never get any bigger. But when cavities cross the enamel into the inner soft part of the tooth, or the dentin, it is a lot harder to keep it from getting bigger, in fact, they move very rapidly when they get through the enamel. When I think of cavities I think castles.A castle has a moat and thick outer walls that protect the townspeople and the king inside. When invaders attack the castle they catapult rocks and try to penetrate the wall----thank goodness the moat is there to slow them down. In the mouth your saliva is like the moat, the enamel is like the thick outer wall. Bacteria and acids are like the bad guys that attack your teeth. Acids can't penetrate the enamel if there is good saliva, and saliva is constantly fixing the walls when holes start to form. But if the "moat" dries out or is drained, acids can get right up next to the wall and start dissolving it. If acid is concentrated in one area and breaks through the wall, the battle may be over. Once acid is through the wall and bacteria get inside, they can quickly destroy what's inside.
Depending on the location of the cavity and how well you are keeping the area free of acid and bacteria, it may be impossible to prevent the cavity from getting bigger. In this case, it is best to have the dentist drill out the soft, decayed area of the tooth and replace it with a hard porcelain filling. The last thing you want to have happen is to wait and wait and wait.......that's when the holes grow and get to the very inner portion of your tooth where the nerves are, or the pulp, which is like where the king lives in the castle. If the king is killed, the kingdom falls apart. If the nerve is killed from bacterial and acid invasion, then the tooth dies and abscesses. Abscessed teeth are really bad infections and can cause a lot of pain and even death in extreme cases, so don't even think of going that route!