Have you ever wondered why you get cavities even though you brush and floss everyday? You are not alone. So many of my patients ask me this ALL THE TIME. I totally understand the frustration, especially when you follow all the recommendations and work so diligently to keep your teeth extra clean. To make things worse, you know someone (maybe a spouse), who does not practice good oral hygiene and somehow never gets cavities. Sigh.
Tooth decay, or dental caries (official dental term), is the most common chronic infectious disease in both children and adults. Yes, you heard this right! Tooth decay is a bacterial infection! Bacteria feed on sugar (including fermentable carbohydrates) and produce acids that eat through tooth enamel, causing a cavity or a hole in your tooth.
Here are 5 simple things you can do to prevent cavities:
1. BRUSH YOUR TEETH
Okay, so this is the most obvious thing to do. But make sure you brush regularly and properly. I would highly recommend investing in an electric toothbrush with a timer! Electric toothbrushes are so much more efficient at removing plaque (the white, sticky film that accumulates on your teeth), thus reducing bacteria and chance of getting cavities. I have a blog post dedicated to choosing the right electric toothbrush HERE.
2. FLOSS
Ha! Ok, so this is the second most obvious thing to do, but it is the only thing that will help you reduce cavities that can form between your teeth! (And prevent gum disease!) Also, make sure you know how to floss correctly. Improper flossing can damage your gums. When you floss, hold the floss taut with your thumbs and index fingers. Then, gently slide the floss up and down, rubbing it against both sides of each tooth (creating a C shape).
Now, not all flosses are created equal. My personal preference is a thicker, woven floss. Floss that is too thin will easily glide between your teeth, leaving a lot of plaque behind.
I know what some of you might be thinking. Can I use a waterpik as an alternative to flossing? Generally speaking, a waterpik is not considered to be a substitute for flossing. Sure, it can help remove food particles from your teeth and aid in reduction of bacteria even below the gumline. However, it does not remove plaque. With that said, brushing and using a waterpik is better than brushing alone.
3. EAT LESS SUGARY THINGS AND REDUCE ACIDIC DRINKS
I have so many patients, who tell me they don’t eat any candy, cookies, or any “sugary things” period. They only drink sugar free sodas or sugar free coffee. Ok, let’s start with “sugary things.” When I talk about “sugary things,” I mean any food that contains fermentable carbohydrates (carbs that are quickly broken down in the mouth into simple sugars). This isn’t just candy, or processed sugar. Starchy foods, such as pasta, bread, cereals, crackers, chips, etc can be as harmful to teeth as candy! Also, if you look at the nutritional facts labels, you will almost always find some added sugar.
Now, let’s talk about acidity. Even though sugar gets the bad rap, it is the acid that directly causes cavities. The pH at which cavities will start to develop is 5.5 or less. As a reference, the pH of pure water is 7. Sugar free soda is about 3.18, the pH level of our stomach acid is about 3.5. If you are sipping on a soda all day (even though it is sugar free), you are constantly bathing your teeth in acid. Acid demineralizes enamel (removes the calcium and phosphate ions) and opens the door for cavity forming bacteria to continue the infection into the dentin, or the second layer of the tooth.
There are some things you can do to offset the acidity in your mouth. One thing is to reduce the frequency of acid attacks (avoid grazing or sipping). After you consume coffee, soda or fermentable carbohydrates, it will take about 30 min for the pH of your mouth to get to normal. Rinse your mouth with water to help bring the pH up. Also, wait at least 30 min to brush your teeth, that way you will avoid removing some of the demineralized enamel with your toothbrush. Chew sugar-free gum to stimulate salivary glands. More saliva means more buffering capacity against the acids.
4. DRINK FLUORIDATED WATER
Drinking fluoridated water is probably the easiest way to fight cavities. Fluoride is a mineral that strengthens tooth enamel. Water also washes away leftover food and dilutes acids in your mouth. I recommend drinking tap water instead of bottled water. Bottled water usually does not contain fluoride and it may actually be acidic.
5. VISIT YOUR DENTIST REGULARLY
Regular dental visits are very important because they help to keep your teeth and gums healthy. There are two parts to a dental checkup – a doctor’s exam that may include x-rays and the dental cleaning. X-rays are necessary tools to check for cavities between your teeth. They can also show early signs of demineralization. Your dentist might have told you about a “weak” spot in your enamel. Technically, the “weak” spot is a cavity, but it might be too small to fill. If it is small enough, you might still be able to “re-mineralize it” or reverse it. Flossing and fluoride treatments may help. Your dentist might recommend some prescription and over-the-counter products (like MI paste) to help re-mineralize the small lesion. Once the lesion gets past halfway through the enamel then it will have to be drilled and filled.
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