I have patients who routinely get new cavities and it is frustrating for both them and for me. These patients might show up routinely for cleanings and brush and floss their teeth, but it seems like they cannot stop getting cavities. For my patients who routinely get cavities, not only does it affect their pocket books as it can become costly, but it also limits my recommendations for elective dental treatments such as veneers or braces. While many of my patients are not interested in cosmetic dental treatment, to those who are interested in it, this can be a burden. To understand this better, I think it is important to look at the three parts of cavities: the bacteria which causes the cavities, the habits that fuel the cavities, and the treatment options to help prevent cavities.
A multitude of different types of bacteria cause cavities. Researchers who study cavities and the bacteria involved more or less discover a new species of bacteria every three months. This is important because it means that we cannot easily create a vaccine to prevent cavities, nor does a certain antibiotic kill this bacteria. This is also important because it means that the interaction between the different species of bacteria causes many of the problems. One type of bacteria might be best for creating the acid that breaks down the teeth whereas another might create the plaque necessary to protect the bacteria from saliva and other ways our body. What I find though is that bacteria that causes cavities is generally transmitted from person to person much the flu can be passed from person to person. For example, if a mom suffers with many cavities throughout her life and never has the cavities under control, it is more likely for her child to get that same bacteria in their mouth and suffer with cavities as well. While it is hard to control the type of bacteria in the mouth, it is an important part to consider.
The next part of cavities is what habits are being done that might cause cavities. Processed simple starches like those found in sweets are the fuel that the bacteria use to destroy teeth. Soda also has a double whammy as not only is it high in sugar but is also acidic which weakens the teeth. Also after exposure to sugar, the acid levels of the mouth drop for around 20 to 30 minutes and stay at the danger zone where teeth break down. If this happens once or twice a day it is not a big deal, but if a person continually snacks or drinks soda, then the mouth will always be acidic and teeth will break down. While cutting down on sugar might seem intuitive, it can be challenging as sugar is in everything these days as it is cheap and tastes good.
The final part of the equation is what extra things can be done when a person suffers from cavities routinely. First and foremost, I recommend that these patients come in every 3 months for cleanings. The reason is that a professional cleaning can remove harmful plaque that tends to cause the decay. Second, I recommend prescription strength toothpaste and mouthwash as well as weekly whitening with an at home whitening system. The mouthwash and whitening help kill the bacteria in the mouth while the toothpaste will help heal the teeth. Lastly, I will recommend that a patient has silver diamine fluoride or SDF applied to the teeth on a regular basis. SDF has been used for decades in Japan, and it was recently approved here in the US. SDF kills cavities at the beginning signs of issues. The only issue with SDF is that it turns any affected area dark black as the silver ions are what kills the cavity and helps prevent new infection from coming back. In the majority of patients it does not matter as these cavities are in the back and near the gum line; however, it is an important point to consider. If SDF does stain a tooth that is in the smile line, the black area can be fixed with a white filling.
Cavities are an infection but one that can be treated and prevented. The wonderful part of being a dentist is seeing patients who have suffered with cavities for their entire life but with new habits and better techniques for keeping the mouth clean, they have been able to go multiple cleanings with no new issues. They no longer fear having a cleaning done and it is a good relationship. If you suffer with cavities routinely and want better solutions, call us at 504-392-5104 and we will help you out.