Why you keep getting cavities.
It’s more than brushing and flossing.
One of the most frequent questions that I hear from the dental chair is, “But why do I keep getting cavities?”
There are a lot of rote answers to this question and most involve passing the blame onto patients. It must be that you aren’t brushing and flossing.
Let’s get honest; brushing and flossing is important. Impeccable oral hygiene makes you look nice, creates a healthier mouth and it does help prevent cavities; but it isn’t EVERYTHING.
I have encountered plenty of patients who have never flossed in their life and are cavity free.
DUN DUN DUN! I know. Mind blown. The dental universe weeps.
So, let’s dive deeper to really figure out why you keep getting cavities.
1) SUGAR!
If you still read books (what are those) and are looking for a good (albeit super nerdy) read you should pick up The Dental Diet by Steven Lin. Even after years of dental school and many more of dental practice, I learned a good bit. We spend far too little time looking at the link between diet and our oral health. I discovered here that getting cavities is a new problem. (WHAT!) Yup. We didn’t start seeing widespread dental disease the way we know it until the Industrial Revolution when we started processing more of our food and processing sugar. NOW, sugar is in everything.
We’re all guilty of sugar consumption. I confess that dentists are some of the worst sugar consumers I know. Maybe we all believe we can fix it or we know how to brush our teeth properly so we are immune, but alas, we are human too. So, we are all in desperate need of a diet and lifestyle makeover if we truly want to mitigate cavity risk. The occasional gnosh isn’t the issue; it is the pervasive sugar content in all of our foods.
If you dive far into this book it goes over a comprehensive list of dietary changes and promotes a raw/paleo kind of diet and also reviews numerous vitamin and mineral deficiencies inherent in our current way of functioning. Take for example, vitamin D. Vitamin D is necessary for proper repair of bones and teeth. However, vitamin D cannot function well on its own. It is linked to vitamin K2. Vitamin K2 tells your body where to send vitamin D. So guess what? If you are vitamin K2 deficient, you are not utilizing your vitamin D well and will probably have “softer” teeth.
The easiest way to make a dietary change is not all at once. We know how those sort of fads in our lives go. We stick to it for a couple weeks and then slip back into old habits. What I started doing was carefully looking at labels at the grocery store before I bought anything. A lot of yogurts on the shelf have up to 15g of sugar! The American Heart Association recommends for men not to exceed 36g/day and for women not to exceed 25g/day. So ladies, after 1 yogurt you’re essentially done? I also recommend sticking to the perimeters of the grocery store. All of the fresh stuff is never down the aisles. If you stick to fresher items, your sugar content – and cavity risk – will decrease.
2) PH: if its acidic it will erode
Most people have plenty of nice, basic spit. I don’t mean basic as a being basic here. I mean it has a pH of about 7. This keeps your mouth nice and neutral. We like neutral parties. When you are eating, your spit changes and drops to a “critical” pH of 5.5. During this time your teeth are susceptible to acidic damage. So, we want to keep everything as neutral as possible as much of the time as possible. How do you do that?
Snack less and be mindful about what you’re snacking on. Every time you put something in your mouth that isn’t water, the pH drops. So, every time you snack you could form a cavity. I don’t want you to feel paranoid about eating and give you a complex, but I do want you to become a conscientious consumer. What you are eating matters too! I give full license for you to snack on fresh fruit and vegetables, cheese and nuts as long as you don’t have allergies to any of those. These foods either have characteristics that make them less cavity inducing or actually help to repair your teeth. If you are chowing down on Cheez-its or fruit leather, I’m sorry, you are asking for it. Avoid anything that is too sticky, sugary and processed.
I hope that it also goes without saying that anything other than water, yes really, that means seltzer drinks too, count as a damaging drink to your teeth and fall in this same category. Not only do they drop you below your critical pH levels, but they take you far beyond that. Soda adds in extra acidity and cavity forming power with a pH of 2-3! Stick to water between meals. Drink our sugary beverages WITH your meals. They will do far less damage.
3) Spit Happens, Or Doesn’t
Your spit is super important. What is the function of spit? Well, it acts as a lubricant so your mouth can move around comfortably and it helps with that pH we just discussed. You can help keep your spit flowing nicely by staying well hydrated. It’s mostly water after all with just a few enzymes thrown in for good digestion!
Acidic spit. This sounds like some bizarre evolutionary animal defense mechanism, right? Unfortunately, it happens. And when it does, it’s not good. We can do simple tests to check your salivary pH which is just naturally produced by your body. You may actually be just more prone to cavities if your mouth pH is below 7. This naturally happens during pregnancy at 26 weeks. If this is the category you fall in there are still helpful techniques to mitigate your risk, but we would have to sit and have a chat about that.
Dry Mouth. There are lots of reasons to develop dry mouth, but most commonly it is because of medication. Other possibilities include a systemic disease or marijuana/drug use. Regardless of the reason, dry mouth means doom! Without any kind of pH buffer your teeth are just primed bait and have no defense against acidic injury. Again, if you have this, let your dentist know ASAP.
Alright, so there is a lot of information here to sift through as to why cavities might be forming. If you can relate to any of the above, talk to your dentist! And if they only tell you to keep brushing and flossing, push them for more information. Or, just schedule an appointment with me and we can nerd out about spit pH till the cows come home. Until then, here is a list of takeaway items and simple actions to help prevent forming cavities:
Brush and floss (I had to say it! Haha)
Be a conscientious consumer and start looking for hidden sugar content, even in “healthy” foods
Snack less often, and if you have to, snack on fresh foods, nuts or cheese
Talk to your dentist about procedures or treatments for acidic spit or dry mouth
Stay hydrated
Avoid recreational drug use