You probably know that a dental cavity is a hole in a tooth. But did you know that a cavity is the result of the tooth decay process that happens over time? Did you know that you can interrupt and even reverse this process to avoid a cavity?
This web page explains how the tooth decay process starts and how it can be stopped or even reversed to keep your child from getting cavities.
What’s inside our mouths?
Our mouths are full of bacteria. Hundreds of different types live on our teeth, gums, tongue and other places in our mouths. Some bacteria are helpful. But some can be harmful such as those that play a role in the tooth decay process.
Tooth decay is the result of an infection with certain types of bacteria that use sugars in food to make acids. Over time, these acids can make a cavity in the tooth.
What goes on inside our mouths all day?
Throughout the day, a tug of war takes place inside our mouths.
On one team are dental plaque–sticky, colorless film of bacteria–plus foods and drinks that contain sugar or starch (such as milk, bread, cookies, candy, soda, juice, and many others). Whenever we eat or drink something that contains sugar or starch, the bacteria use them to produce acids. These acids begin to eat away at the tooth’s hard outer surface, or enamel.
On the other team are the minerals in our saliva (such as calcium and phosphate) plus fluoride from toothpaste, water, and other sources. This team helps enamel repair itself by replacing minerals lost during an “acid attack.”
Our teeth go through this natural process of losing minerals and regaining minerals all day long.
How does a cavity develop?
When a tooth is exposed to acid frequently — for example, if you eat or drink often, especially foods or drinks containing sugar and starches — the repeated cycles of acid attacks cause the enamel to continue to lose minerals. A white spot may appear where minerals have been lost. This is a sign of early decay.
Tooth decay can be stopped or reversed at this point. Enamel can repair itself by using minerals from saliva, and fluoride from toothpaste or other sources.
But if the tooth decay process continues, more minerals are lost. Over time, the enamel is weakened and destroyed, forming a cavity. A cavity is permanent damage that a dentist has to repair with a filling.
How can we help teeth win the tug of war and avoid a cavity?
Fluoride is a mineral that can prevent tooth decay from progressing. It can even reverse, or stop, early tooth decay.
Fluoride works to protect teeth. It . . .
- prevents mineral loss in tooth enamel and replaces lost minerals
- reduces the ability of bacteria to make acid
You can get fluoride by:
- Drinking fluoridated water from a community water supply; about 74 percent of Americans served by a community water supply system receive fluoridated water. (If you have well water, see “Private Well Water and Fluoride” from the Centers for Disease Control and Prevention.)
- Brushing with a fluoride toothpaste
If the dentist thinks your child needs more fluoride, he or she may –
- Apply a fluoride gel or varnish to tooth surfaces
- Prescribe fluoride tablets
- Recommend using a fluoride mouth rinse
About Bottled Water
Most bottled water does not contain enough fluoride to prevent tooth decay. If your child drinks only bottled water, talk with a dentist or doctor about whether your child needs additional fluoride in the form of a tablet, varnish, or gel.
Keep an eye on how often your child eats, as well as what she eats.
Your child’s diet is important in preventing a cavity. Remember . . . every time we eat or drink something that contains sugar or starches, bacteria in our mouth use the sugar and starch to produce acids. These acids begin to eat away at the tooth’s enamel.
Our saliva can help fight off this acid attack. But if we eat frequently throughout the day — especially foods and drinks containing sugar and starches — the repeated acid attacks will win the tug of war, causing the tooth to lose minerals and eventually develop a cavity.
That’s why it’s important to keep an eye on how often your children eat as well as what they eat.
- Limit between-meal snacks. This reduces the number of acid attacks on teeth and gives teeth a chance to repair themselves.
- Save candy, cookies, soda, and other sugary drinks for special occasions.
- Limit fruit juice. Follow the Daily Juice Recommendations from the American Academy of Pediatrics.
- Make sure your child doesn’t eat or drink anything with sugar in it after bedtime tooth brushing. Saliva flow decreases during sleep. Without enough saliva, teeth are less able to repair themselves after an acid attack.
Make sure your child brushes
Brushing with fluoride toothpaste two times each day is important for preventing cavities.
Be sure to supervise young children when they brush. Here’s what you should know:
- For children aged 3 to 6, you put the toothpaste on the brush. Use only a pea-sized amount of fluoride toothpaste. (In children under age 2, dental experts recommend that you do not use fluoride toothpaste unless a doctor or dentist tells you to.)
- Encourage your child to spit out the toothpaste rather than swallow it. Children under 6 tend to swallow much of the toothpaste on their brush. If children regularly consume higher-than-recommended amounts of fluoride during the teeth-forming years, their permanent teeth may develop white lines or flecks called dental fluorosis. Fluorosis is usually mild; in many cases, only a dental professional would notice it.
- Until they are 7 or 8 years old, you will need to help your child brush. Young children cannot get their teeth clean by themselves. Try brushing your child’s teeth first, then let them finish.
Talk to a dentist about sealants
Dental sealants are another good way to help avoid a cavity. Sealants are thin, plastic coatings painted onto the chewing surfaces of the back teeth, or molars. Here’s why sealants are helpful: The chewing surfaces of back teeth are rough and uneven because they have small pits and grooves. Food and bacteria can get stuck in the pits and grooves and stay there a long time because toothbrush bristles can’t easily brush them away. Sealants cover these surfaces and form a barrier that protects teeth and prevents food and bacteria from getting trapped there.
Since most cavities in children and adolescents develop in the molars (the back teeth), it’s best to get these teeth sealed as soon as they come in:
- The first permanent molars called – “6 year molars” – come in between the ages of 5 and 7.
- The second permanent molars – “12 year molars” – come in when a child is between 11 and 14 years old.
Take your child to the dentist for regular check-ups
Visit a dentist regularly for cleanings and an examination. During the visit the dentist or hygienist will:
- Remove dental plaque
- Check for any areas of early tooth decay
- Show you and your child how to thoroughly clean the teeth
- Apply a fluoride gel or varnish, if necessary
- Schedule your next regular check-up
Getting rid of cavities at home
Many home treatments are based off of a studyTrusted Source from the 1930s that suggested that cavities are caused by lack of vitamin D in the diet. In this study, kids who added vitamin D to their diets showed a reduction in cavities. However, those who added vitamin D while also removing grain products from their diets had the best results. This is possibly because grains can stick to the teeth.
Not getting enough vitamin D may make teeth more susceptible to cavities, but we now understand that this is only a part of the puzzle. Other risk factors for cavities include:
- dry mouth or having a medical condition that reduces the amount of saliva in the mouth
- eating foods that cling to teeth, like candy and sticky foods
- frequent snacking on sugary foods or drinks, like soda, cereals, and ice cream
- heartburn (due to acid)
- inadequate cleaning of teeth
- bedtime infant feeding
Once a cavity has penetrated the dentin, you won’t be able to get rid of it at home. The following home remedies might help prevent cavities or treat “pre-cavities” by remineralizing weakened areas of your enamel before a cavity develops:
1. Sugar-free gum
Chewing sugar-free gum after meals has been shown in clinical trials to help remineralize enamel. Gum containing xylitol has been researched extensively for its ability to stimulate saliva flow, raise the pH of plaque, and reduce S. mutans, but long-term studies are needed.
Sugar-free gum containing a compound called casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has been shown to reduce S. mutans even more than xylitol-containing chewing gum. You can find this type of gum in stores.
2. Vitamin D
Vitamin D is important to help absorb calcium and phosphate from the food you eat. StudiesTrusted Source show an inverse relationship between eating foods high in vitamin D and calcium, like yogurt, and cavities in young children. You can get vitamin D from dairy products, like milk and yogurt. You can also get vitamin D from the sun.
More recent research has challenged how vitamin D can affect dental health.
3. Brush with fluoride toothpaste
Fluoride plays an important role in preventing cavities and remineralizing enamel. Extensive researchTrusted Source has been done to show that regularly brushing your teeth with a fluoride toothpaste prevents cavities.
Most studies have been conducted either in children or adolescents, so more research is needed in adults and the elderly.
4. Cut out sugary foods
This is the cavity remedy that no one likes to hear — stop eating so much sugar. The World Health OrganizationTrusted Source says that eating sugar is the most important risk factor for cavities. They recommend reducing your sugar intake to less than 10 percent of your total caloric intake for the day.
If you’re going to eat sugar, try not to snack on sugary foods throughout the day. Once the sugar is gone, your enamel has a chance to remineralize. But if you are constantly eating sugar, your teeth don’t get the chance to remineralize.
5. Oil pulling
Oil pulling is an ancient practice that involves swishing around an oil, like sesame or coconut, in your mouth for about 20 minutes, then spitting it out. Claims that oil pulling “removes toxins” from the body aren’t backed up by evidence. But a small, triple-blind, placebo-controlled clinical trial showed that oil pulling with sesame oil reduces plaque, gingivitis, and the number of bacteria in the mouth just as effectively as chlorhexidine mouthwash. Larger studies are needed to confirm these effects.
How can I tell if I have a cavity?
Cavities usually appear as a pale or dark spot initially and gradually turn a yellow, brown, or black colour. It’s a good idea to regularly examine your mouth to detect any discolouration. However, if a cavity is located between two teeth or on the back surface of a tooth, you might never see it at all.
That’s one of the reasons dentists recommend regular checkups – so that cavities can be detected in their early stages, before they cause more serious problems. Your dentist will determine whether you have a cavity by examining your teeth thoroughly, probing for softness, and performing radiographs.
Early tooth decay isn’t painful, which means that without regular checkups you probably won’t even know you have a cavity until it starts to penetrate deeper into the tooth. When this happens, you may find your teeth become more sensitive to heat, cold, or pressure.
When the decay reaches the central pulp cavity of the tooth, where the most nerve endings are, you will start to experience persistent and sometimes quite intense pain. At this point, you are also at risk of developing a dental abscess.
How soon do I need to see a dentist if I suspect I have a cavity?
As soon as you possibly can. The sooner you see a dentist, the greater the chance that the tooth decay can be stopped in its tracks before it starts to cause pain and without the need for serious (and expensive!) intervention.
If you catch it really early, you might even get away with a simple fluoride treatment to restore the enamel. But if you are already experiencing sensitivity or pain, you will probably need more extensive treatment.
The longer you leave it, the more damage will occur, the more pain you’ll experience, and the bigger the bill you’ll be up for at the end.