What is Caries and what causes it?

    I wanted to write a Blog post that would be helpful explaining what causes cavities. A cavity is one way of describing a hole or cavitation that forms in your tooth. Do all the dark stained areas on your teeth need to be drilled out and filled? Not in my opinion. Is a dark area a concern? Yes and it should be monitored regularly by me to see if it is progressing into something that does need to be treated. The treatment is usually removing the dark area and replacing it with a tooth colored material (a filling), or in some cases if the decay or deteriorated dark area is large enough an indirect restoration would be fabricated and bonded to the tooth. This is called an inlay or onlay a crown or a veneer. But what causes the decay? well lets consult the ADA website.

Caries Risk Assessment and Management From ADA website

• Dental caries is defined as a “biofilm-mediated, sugar-driven, multifactorial, dynamic disease that results in the phasic demineralization and remineralization of dental hard tissues.”
• The formerly practiced paradigm of “drill and fill,” that is drilling out pits and fissures or surgically removing decayed and diseased tissue and placing permanent restorations, does not address the full continuum of the caries disease process, including microbial activity and the balance between enamel remineralization and demineralization.
• Systematic methods of caries detection, classification, and risk assessment, as well as prevention/risk management strategies, can help to reduce patient risk of developing advanced disease and may even arrest the disease process.

There is a lot that can be done to prevent caries from forming and that has a lot to do with home care. Home care is brushing, flossing and following all the recommendations from your dentist. In the office we place sealants on any tooth that has deep grooves and might be more prone to caries progression. Usually this is done for kids but can be performed on adults as well. It is recommended that you have two professional cleanings in my office a year, meaning you let me get clean with my light and magnification so the areas you miss do not go for too long. when those areas go too long there are consequences. One of those consequences can be caries or holes in your teeth. This is due to acid production and a net demineralization.

Patients, especially those at high risk of caries development, should be instructed to reduce the amount and frequency of carbohydrate consumption. Patients should limit sugary snacks between meals and eat a healthy diet that limits added sugars and high-acid foods that can affect mineralization of enamel. Encourage patients to chew sugar-free gum with xylitol, which can promote salivary flow, remineralization, and cannot be metabolized by cariogenic bacteria. All patients should be educated in optimal oral hygiene practices, including brushing with fluoride toothpaste twice a day and cleaning between teeth daily. Although some caries prevention recommendations include use of topical antimicrobials (e.g., chlorhexidine rinse) in patients 6 years of age and older who are at high risk of caries. ADA website