I brush everyday, why do I still get cavities? - North Dallas Moms

Trust me nothing is more deflating than going to the dentist and being told you have yet another cavity. You have been diligently brushing and taking care of your teeth yet it seems like every time you go in for a check up it’s always bad news. If this sounds familiar, you aren’t alone! Even though I am a dentist, I have a mouth full of dentistry and this was my experience for years.

Don’t get me wrong, excellent home care and routine dental check ups are an absolute must to preventing dental disease but there is more to the story. Dentists have historically been terrible at explaining and educating patients. Growing up my dentist would walk in, say you have 3 cavities and walk out. The good news is that we are in the middle of a paradigm shift in our profession, the new generation of dentists are prioritizing education and prevention. 

“Wait, what exactly is a cavity?”

A cavity is a hole in your tooth that’s caused by bacteria. Our mouth is part of our digestive system so like our gut, our mouth is filled with bacteria. Some of these bacteria will spend all day trying to break down our teeth. Our teeth are made of different layers and the outer layer, our enamel, is actually one of the strongest materials in the body. Unfortunately that enamel isn’t invincible, its arch nemesis is acid. Acid can be from food and drinks or it can be from the “poop” of the bacteria.  

“Did you say bacteria poop?”

We can classify mouth bacteria as either “teeth bacteria” and “gum bacteria” because they either live out in the open on our teeth or they like to hide under our gums. Teeth bacteria love to eat the leftover foods in our mouth after we are done eating a meal. Foods they especially love are carbs and sugary drinks like chips, crackers, granola bars, candy, sweet tea, sodas etc. When a tooth bacteria eats sugary foods they digest it and “poop” out an acidic by-product. That acid is what slowly breaks down our teeth and makes a hole. 

“Who cares if I have a cavity, it doesn’t hurt right?”

When cavities are small, they don’t hurt and are barely noticeable. In fact they are one of the sneakiest diseases in our body because you as a patient will never know you have a hole in your tooth until the situation gets very serious. Our teeth have a nerve inside them and when a cavity gets big enough it will reach the nerve and cause it to get very sick. That’s when patients experience excruciating pain, swelling, infections etc. 

“Are you saying I can’t have candy or soda?”

I have the world’s biggest sweet tooth so I would never tell you to cut out snacks. Here is my advice, focus on reducing your intake and your frequency. If I give you a gallon of soda and you chug it in 5 minutes, you will not feel very good but your teeth won’t be affected much. On the other hand, if I give you a bottle of Gatorade and you sip on that every few minutes for 2 hours during a football game, that’s worse for your teeth. You are washing sugar and acid over your teeth every few minutes and giving the bacteria a ton of ammo to hurt your teeth. Focus on reducing frequency first and then work on lowering your quantity. 

“So do I need a filling?”

With the level of sugar that’s present in our diet these days, there is a high chance you will eventually get a cavity in your lifetime. Don’t feel bad! Remember cavities can take months or years to form and get bigger. Small cavities that are in the hard shell of your teeth are often monitored by your dentist, not all cavities need treatment. Small cavities can be slowed down with good home care and fluoride treatments during dental visits. At our office we educate patients on the severity of their cavities and whether we will work on slowing it down or treating it. Once a cavity gets into the inner layer of your tooth it can spread quickly to the nerve so it needs to be cleaned out, disinfected and rebuilt. Our goal is to treat teeth BEFORE they start to hurt. If your tooth is hurting that’s not a good sign, usually it means your cavity has gotten so big that it’s causing your tooth nerve to act up. Catching cavities early means easier and cheaper treatment. Waiting until it hurts could mean expensive and invasive procedures to save the teeth. At our office we use high-def digital x-rays to screen for cavities and check their severity. We focus on educating our patients on the disease process and come up with a game plan for how we can treat the disease and prevent pain.

Tips for Kids

  • Have planned meals/snacks instead of snacking all day. Goldfish crackers being stuck to the grooves of our teeth can be a buffet for the bacteria in our mouth
  • If they want a sugary snack or juice, it’s best to eat that with your main meals
  • When kids play sports in the summer, make sure you reduce the frequency of the  Gatorade/Powerade. Maybe do water during smaller breaks and offer the Gatorade at halftime or at the end of the game so they can finish it in one go. 
  • Avoid letting kids go to sleep with a milk bottle. Try to build a habit of brushing their teeth with a small amount of fluoridated toothpaste before bed

Tips for Preventing Cavities

  1. Brushing at night before sleeping is the most important because your mouth bacteria will snack on leftover food all night
  2. Using an electric brush is a MUST, it cleans much more thoroughly than traditional brushes
  3. Applying a fluoride varnish every 6 months gives your teeth an added boost to slow down cavities
  4. Flossing helps to remove the food and bacteria that your brushing might miss

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