Simply, a cavity is a hole in a tooth.

What causes a cavity?

The mouth is full of bacteria (yuck). But don’t worry – some are very good bacteria, others are bad. Many of them have a favorite food: sugar (yum). And they produce acid (ugh). So when there are lots of sugars for the bacteria to munch on, they produce lots of acid. This slowly dissolves some of the tooth structure, or in fancy terms: decalcification (dee-cal-sih-fih-cay-shen). If enough of the tooth structure gets dissolved, it can lead to a hole. If the decay gets really deep, it can reach the pulp, or “nerve”, inside the tooth causing pain and possibly an infection.

My dentist wants to do a filling even though I don’t see a hole.

You may not be able to see the hole, but bacteria are really really small and if the tooth structure is dissolved enough, they can fill that space and make even more acid, increasing the size of the “cavity.” Based on x-rays we can sometime see how deep the decalcification is (and the real cavity is usually slightly worse than what an x-ray can see).

My dentist saw an “early cavity” and doesn’t think it needs a filling.

Sometimes if the tooth structure is not too damaged by the bacteria and their acid excretions, your dentist can “recalcify” or “remineralize” the area.

How?

In some cases, t can be as simple as avoiding sugar (not only candy, but high carbohydrate foods – see the Sugar Sugar page) and brushing with a fluoride tooth paste. There are also some prescription toothpastes and some other products that can help. Saliva (or spit, if you’re feeling less fancy) is amazing at fixing teeth if they are not fighting too many of those pesky bacteria acids.

Why do I get sooooooo many cavities?

I don’t know, I can’t see you, your records, or your history! But some common reasons are:

• High sugar diet (and remember sugars are not just in candy, they are in high carbohydrate foods!)
• Snacking on carbs – Exposing the teeth (and their bacteria buddies) to sugars frequently throughout the day – saliva can’t do its fighting if it can’t get the upper hand.
• Soda – even those that are not sugar filled are very acidic
• Heartburn (aka Acid Reflux) – rips those minerals right out of teeth.

Do I have genetically soft teeth?

Unfortunately the evidence doesn’t point to that being very common. There are some genetic malformations of teeth where they don’t form correctly, but usually they look different from the start.

We do know, however, that saliva mineral content varies from person to person, so there may be a genetic component to this. Also, adult teeth form during your childhood years – the crowns (the parts of the tooth you see) are formed many years before they show up in your mouth. With this in mind, it is always possible that an infancy/childhood illness, mineral deficiency, etc. could impact the formation of teeth.

So what should I do if I keep getting cavities?

You’re going to get sick of this…have a conversation with your dentist. They may be able to help you with the products you use, an evaluation of your diet vs. frequency of brushing, as well as your cleaning techniques. Sometimes simple changes, or fixing some habits can make a world of difference!