Preventing a tooth cavity involves a combination of understanding the possible risk factors and avoiding it in conjunction with undertaking the necessary preventative measures. Early treatment of tooth decay can often prevent the formation of cavities.
Causes and Risk Factors
Foods and Dietary Habits
- Diet rich in carbohydrates (sugar and starch). This may be related to poor dietary habits or sugar cravings (sweet tooth) which may be more common in states like pregnancy.
- Acidic foods and drinks, such as cola. In addition, regular cola is high in sugar.
- Prolonged contact of teeth with milk or fruit juice, as with babies put to sleep with a bottle of milk or fruit juice in their mouth.
Mouth and Teeth Problems
- Presence of acid-producing bacteria in the mouth. Streptococcus mutans is the most common bacteria causing tooth decay and cavities. Decay-causing bacteria may be passed by parents to their children through kissing or sharing eating utensils.
- Defect in the tooth surface – uneven surfaces, pits and fissures encourage accumulation of plaque. Molars and premolars (the back teeth) are more prone to cavities as a result of more pits and grooves which help to retain food particles and also because they are less accessible while cleaning.
- Decay around the edges of old cavity fillings can further produce cavities, especially in older people.
- Gum recession can increase the risk of cavities by exposing the roots of the teeth. Elderly people are more prone to cavities caused by gum recession.
- Poor dental and oral hygiene. Low fluoride intake. Brushing too hard can also erode enamel.
Systemic Disorders and Drugs
- Diminished saliva in the mouth – drugs (such as cold medicines, some antihypertensive and anti-Parkinson’s drugs) or disorders (such as Sjogren’s syndrome) cause xerostomia or dry mouth, which is a predisposing factor for cavity formation since saliva helps to prevent tooth decay.
- Eating disorders, such as bulimia and anorexia can lead to tooth erosion and cavities, mainly due to stomach acid from vomiting wearing away the enamel of the teeth.
- Gastroesophageal reflux disease (GERD) and acid reflux can also cause erosion of the enamel due to acid regurgitation (acid reflux) into the mouth.
Diagnosis of a Tooth Cavity
- A tooth cavity in the early stages may be detected during a regular dental check-up. There may not be any pain at all but the area may feel soft when probed with an instrument.
- X-rays can detect a cavity before it becomes obvious to the eye.
- Toothache, especially after taking hot, cold or sweet food or drink, may indicate tooth decay and cavity formation.
- Obvious pits or holes in the tooth may be easily visible.
Treatment of Cavities
Treatment will depend on the extent of the cavity.
- In very early stages of tooth decay, use of fluoride-containing mouthwash in the correct prescription strength may help heal cavities in the enamel.
- Chlorhexidine gluconate mouthwash to decrease decay-causing bacteria.
- Pain relievers such as acetaminophen, ibuprofen and aspirin may help to reduce pain and inflammation. Aspirin should not be given to anyone below 20 years because of the risk of Reye’s syndrome, a potentially life-threatening condition.
- Cavities caused by mild tooth decay may need drilling to remove the decayed portion of the tooth, followed by filling of the cavity. Different types of fillings are used, composed of silver alloy, gold, porcelain, or a composite resin. If the area of decay is large with extensive cavity formation and destruction of the tooth, a crown (or cap) is fitted over the tooth, which may be made of gold, porcelain, or porcelain fused with metal.
- Root canal treatment may also be done in case of large cavities where the pulp is infected. The pulp is removed from the center of the tooth and the pulp cavity filled. A crown will need to be fitted over the tooth after a root canal treatment.
- Dental extraction (tooth removal) may become necessary as a last resort. The tooth may be replaced with a bridge or an implant after the relevant dental procedures.
Prevention of Cavities
- Eat a healthy, balanced diet that is low in refined carbohydrates, particularly sugar.
- Fresh food and vegetables help to remove trapped food particles between the teeth.
- Unsweetened tea or coffee and sugar-free gum may help to wash away food particles and thus prevent cavity formation. In addition, sugar-free gum increases the production and secretion of saliva which has antibacterial properties.
- Good dental hygiene involves brushing the teeth regularly twice a day and flossing daily. Use a mouth wash to rinse after eating. Both the toothpaste and mouthwash should contain fluoride.
- Regular dental check-ups – ideally every 6 months, or at least once a year.
- Fluoridation of public water supplies.
- Sealants applied to pits and fissures that are normally hard to reach, particularly on the back teeth, act as protective covering on the teeth. Bacteria in these grooves cannot produce acid because food particles do not lodge in the covered pit or fissure. Sealants may remain intact for up to 10 years, although they may need replacement earlier. Sealants may be used in both adults and children. The Center for Disease Control and Prevention recommends its use in all school-age children.