Q: Why do I get cavities? I brush my teeth!

A:  Very often I see patients who are surprised that they have one or more cavities when they come in for their dental checkup.  The surprise comes because these people who go to the dentist regularly and brush their teeth every day. Sometimes that person hasn’t had a new cavity in many years. So why does a person get a cavity?

Well, the answer is multifaceted. A cavity in a tooth is formed by the combination a certain bacteria and an environment that causes the bacteria to be able to eat away at the tooth. To get rid of the bacteria, our first defense is brushing, as well as flossing. Cleaning the area in between the teeth is important because most adult cavities are formed in between the teeth, where they touch each other. Flossing or using some other dental device like a dental pick or proxy brush can clean this area of food and plaque. While brushing, concentrate on cleaning the area of the tooth that touches the gumline. Sometimes we get in a hurry and miss spots! I recommend that you spend a couple of minutes brushing. Divide your teeth up into four sections and spend 30 seconds on each section.

Getting rid of bacteria is the first thing to prevent tooth decay. Making your mouth a healthy environment is the second area of defense. What I mean by this is, number one, making sure that you do what you can to limit sugary foods. Sugar is food to bacteria. When they eat the sugar they release acid. Acid is what eats away at the tooth to cause a cavity. So limiting not only the amount of sugar, but the number of times each day you eat sugar is vital to preventing cavities. Remember that foods like bread, crackers, juice and fruit contain sugar! Secondly, having an adequate amount of saliva ensures that food can be washed down and swallowed while you eat. If you have an inadequate amount of saliva, mainly due to a medical condition or medications you want to be sure to supplement with a saliva substitute or special prescription medication to make up for it. Drinking more water can also help.

In closing, I must note that sometimes it seems like some people tend to get more cavities than others. Sometimes this is because there is a lot of dental work already existing. The problem may not necessarily be new decay, but rather failing dental restorations. Also some people have habits that will lead to tooth decay and they are not even aware of the problem. I had a patient once that had large cavities on the sides of her back teeth. After discussing what had changed she revealed that she had been falling asleep with a cough drop in her mouth right in that area every night for months. No amount of brushing and flossing will counteract that!

So be aware of your habits and make sure you are creating conditions for good dental health. Talk to your dentist and hygienist about better techniques you can use to keep your teeth decay free.