WHAT CAUSES CAVITIES?
When I ask
patients with cavity problems to guess the origin of their problem, I
occasionally get answers like these:
“It was some medicine I took as a
child.”
“My teeth were fine until I had my
children. They sucked all the calcium
out of my teeth when I was pregnant. Then my teeth got weak and decayed.”
“My parents had dentures. I guess I inherited bad teeth.
“It must be from not brushing my
teeth right.”
Let us look
together and see how decay really gets started, then go on to investigate how
we may prevent it!
What is decay?
Teeth are
made of minerals, and are the hardest organs of the body- much harder than
bone! Decay is a process whereby the
hard enamel outside of a tooth is dissolved by acid. Once decay gets through the enamel, the same
acid dissolution progresses very quickly in the inner dentin of the tooth. If the patient does not get the cavity filled,
decay invade the tooth root (containing nerves) and a toothache results.
So where does this acid come from?
It can come
from a couple of sources. The most
common is from bacteria living inside our mouths. Many of these sugars utilize for energy, and
produce lactic acid as a by-product. It is primarily this acid which acts to
dissolve teeth. Bacteria can turn dietary
sugars into lactic acid in only 20 minutes. Unless the mouth is rinsed or
cleaned, this acid hangs around to dissolve teeth for a whole hour! So you can see that a child who ingests candy
most of the day will have an acid mouth all day, an inevitably have move than a
few cavities! An adult who sips
sweetened coffee most of the workday will likely suffer from the same fate.
But adults
frequently get acid more directly- by drinking soda pop! Few people realize what strong acids
carbonated beverages really are! Carbonated drinks are such potent acids that they can dissolve teeth
directly whether the soda is “diet” or has sugar in it. I would estimate that 75% of adult decay I
see is the direct result of excessive soda drinking. And as if that were not enough, too many
sodas can contribute to stomach ulcers and even osteoporosis.
Excessive daily soda
pop intake caused characteristic tooth decay around gums.
Other sources of acid we sometimes
encounter
Chronic
vomiting, as seen in bulimia and some other disorders, can erode teeth and also
cause cavities.
We have
noted lately many cases of gastric reflux, where small quantities of stomach
acid enter the mouth. This causes rampant
destruction in your mouth, and should be controlled by prescriptions or
surgery!
Don’t some medical conditions
expedite decay?
Yes.
Although not directly a cause of decay, any condition which dries the mouth can
make your teeth more susceptible to it. Examples are doses of radiation to the
head, using certain antidepressants, and antihistamines. We find that people
that are mouth breathers are prone to more decay than those who can breathe
normally through their nose.
Fluoride- our two-edged sword in
fighting decay
Even should
physicians be unable to treat the above medical conditions, we still are able
to stop decay- provided we have patient cooperation and fluoride.
Fluoride
actually works two ways. It has a toxic
effect on decay causing bacteria. It also hardens tooth enamel and makes it
more resistant to acid attack. Interestingly, fluoride strengthens bone in the same way it strengthens
teeth. Physicians sometimes use fluoride
supplement to treat osteoporosis.
For adults
with decay problems, we often prescribe a fluoride gel to brush on the teeth at
night just before bed, and a fluoride mouth rinse in the morning. For really tough cases, including patients
who have uncontrolled gastric reflux, we make custom trays to wear with
fluoride at night. With this heavy-duty
preventive treatment, few patients get cavities!
Kim Henry, D.M.D. |
