What Causes Cavities?


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Dental caries, or cavities, begin with a tiny hole in the tooth enamel. As time progresses, the hole becomes larger and more tooth structure becomes decayed. In the worst-case scenario, the decay progresses and attacks the nerve center of the tooth. But what causes cavities to form in the first place?

Tooth Decay

Your mouth is full of good and bad bacteria. The sugars and starches you eat are also food for the bad bacteria. Together they form a sticky, colorless film that adheres to teeth and gums, plaque. When it is not thoroughly cleaned away, plaque becomes hard and forms tartar, also known as calculus. Tartar is difficult to remove and can be a leading cause of cavities.

The acids produced by plaque attack tooth enamel. This causes the tiny hole which is the beginning of a cavity. If the plaque is not removed the acids will eat through the enamel and attack the next layer of the tooth which is the dentin.

Dentin is a softer layer and less resistant to the harmful acid so decay spreads faster. Additionally, this layer also contains tiny tubes that communicate with the pulp or nerve center of the tooth causing sensitivity.

The Death of a Tooth

If the decay is not stopped at this point, it will continue until the acid and bacteria attack the nerves and blood vessels of the tooth in the pulp. In most cases, the bacteria irritate the pulp and cause swelling. The pain can radiate from the tooth to the bone.

Infection from the bacteria can cause an abscess and the acids can also dissolve the bone around the tooth root. At this point, the tooth is essentially dead. The decayed nerves and blood vessels within the tooth now create the potential for more serious problems if the infection gets into the bloodstream.

Risk Factors for Cavities

The most obvious risk factor for cavities is poor oral hygiene if you do not brush and floss your teeth regularly and properly. Many people who have excellent oral hygiene habits still end up with a cavity or two. This can happen for several reasons:

  • Tooth location – The back teeth have pits and fissures where decay can develop easily. When the permanent molars erupt, your dentist may suggest putting sealants on your children’s molars and premolars to prevent decay.
  • Low fluoride – This mineral prevents tooth decay and has also been shown to reverse the early stages of tooth damage. Fluoride is a naturally occurring mineral.
  • Dry mouth – Lack of saliva can lead to cavities. Saliva acts as a cleaning agent by washing food and plaque away from teeth. There are substances in saliva which also counteract the acids produced by bacteria.
  • Acid reflux – Anytime stomach acid flows into your mouth, it is harmful to your teeth. The acids wear away the enamel exposing the dentin and making your teeth more susceptible to decay.

Other factors that can cause cavities include eating disorders involving purging (vomiting), old fillings or dental devices that no longer fit well, inadequate brushing, frequent snacking on high sugar foods or sipping on high sugar drinks. Age is also a factor. Younger children are more susceptible to cavities. Older adults often have teeth that are worn down or their gums may have receded exposing dentin to root decay. Certain medications also reduce saliva flow.

Regular checkups and dental cleanings are the best way to monitor the health of your teeth and prevent serious problems from developing. Dr. Nishan Halim and his team will help you achieve and maintain the best oral health. Contact us today to schedule your appointment.

Nishan Halim, DMD specializes in a comprehensive approach to dental care in his Capitol Hill, Washington DC neighborhood dental center. When treatment plans include specialty work, he coordinates every step with the practitioners you choose from his referral network. Contact Dr. Halim to schedule an appointment.

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