Most people know that eating lots of sugary foods and not brushing your teeth will increase somebody’s chance of getting cavities. Before we go into some strategies of how to avoid cavities, let’s go over briefly how they form. When we eat or drink something with sugars a layer of biofilm (plaque) forms over the teeth and are filled with bacteria that produce acids. These acids weaken the tooth and if not repaired by minerals in saliva then a cavity can form. So there is shifting emphasis on lowering the acid attacks in the mouth versus focusing only on brushing, flossing and fluoride. Here are some things to consider if you are struggling to stay cavity free.
1) Brushing and flossing after every meal will clean off the biofilm and greatly reduce the risk of damage. If you can’t brush and floss after every meal then at least twice daily. The best time to brush in the morning will be after eating breakfast. That way, you’re mouth will be basically free from acids until lunch. And in the evening brush and floss right before bed. If you have a snack after you brush at night, brush again! You don’t want the plaque to damage your teeth all night long!
2) Use an electric toothbrush. A good electric toothbrush spins or vibrates at high frequencies which can cleanse hard to reach areas more effectively then manual brushing. They also have timers built in so you can brush the recommended two minutes each time. There is a big price range between models and I know that it could be a big expense. But dental work can get expensive and the best treatment is no treatment at all. Consider a good toothbrush an investment in your oral health.
3) Mouth rinses and toothpastes can help lower the amount of cavity causing bacteria temporarily. Fluoride is present in many toothpastes and rinses which can help strengthen teeth. Of course I understand that some have problems with the potential toxicity of fluoride but since the discussion is how to reduce cavities fluoride is one way to help. Some of the chemical antibacterial additives are also potentially dangerous. Triclosan was supposed to be a fantastic antibacterial added to some toothpastes but now there are studies showing it’s endocrine disruptive effects amongst other health concerns. If you forgo fluoride toothpastes, try to get one with xylitol (birch tree source is supposed to be the best – non-GMO). Essential oils have antibacterial properties and are relatively safe. Fine baking soda/powder can help neutralize acids and are present in some natural toothpastes. There are many more herbal toothpastes which can be found in Google.
4) Regular visits to the dentist is certainly important. Plaque can harden and accumulate over time which can lead to weakening of tooth structure and early demineralized (weakened) tooth can be strengthened at the office. Without visiting a dentist it would be nearly impossible to locate and treat those areas on your own. Early detection of cavities gives you more options on how the treat them and will usually require more minimally invasive methods. Things like lasers, air abrasion systems, ozone gas treatment, remineralization techniques are several different methods a dentist can use to treat early cavities. But if you don’t visit the dentist regularly then these early cavities can turn into larger ones which may require crowns, root canals, or even extractions.
5) Avoiding frequent sugary snacks throughout the day. Every time you eat something with fermentable carbohydates (almost everything we eat!) there is a sharp increase in acid produced by bacteria. Saliva helps buffer the acid attack but if you have snacks frequently throughout the day, the constant attack from acid will eventually overcome the strength of enamel and cause permanent damage. I understand that from a metabolism standpoint frequent small meals is a good thing so make sure you brush or at least rinse after every meal or snack. A sugar free mint or gum can really help produce more saliva. Xylitol is a natural sugar alternative which is diabetic safe and has research supporting anti cavity effects. Some other artificial sweeteners may be harmful for you so be careful on long term use of the artificial sweeteners. So if you must snack, have a xylitol mint or candy after if you can’t brush.
6) If you suffer from dry mouth, you are missing the benefits of saliva buffering the acid attacks from eating. So people suffering from dry mouth from health conditions, medications or mouth breathing should make sure they are frequently sipping water or using sugar free mints throughout the day. You can always ask your doctor if there are any medications available which do not cause dry mouth. Visit your dentist if you suffer from dry mouth and need some help with options. I’ve seen some lozenges (xylimelts) that stick in your mouth overnight and can help stimulate saliva flow. If you can not get the saliva glands producing enough (radiation treatments can destroy salivary glands) then dental made trays can help. See below for more information on them.
7) If you’re doing great homecare and visit the dentist at recommended intervals but still getting cavities, you may be suffering from acid reflux. Frequent vomiting is another source of excessive acid attacks. If you have frequent heartburn and/or chest pain after eating or when lying down, it could be a symptom of reflux. Strange bitter tastes or frequent sore throats can be other signs. If you think you may be suffering from reflux you should definitely go see your doctor. There are traditional and alternative methods of treating reflux but the best thing is to get professional help and get it under control. Otherwise, you’ll have an extremely difficult time keeping your teeth healthy. Sometimes acid erosion won’t lead to cavities but can still eat away the enamel and severely damage the teeth. If you think you are suffering from acid reflux then make sure you get checked. I’ve seen reports that chronic reflux can be risk factor for esophageal cancer.
8) Avoid sodas! Almost all sodas have sugar and even the sugar free versions can contain acids. If you have many acid producing bacteria in your mouth, having sodas is like throwing gasoline onto a fire. Fruit juices often have added sugar which also makes them potentially harmful. One way to minimize the effects of these drinks is to use a straw. Best best would be to stick with water since most of us aren’t drinking enough daily water anyways and unsweetened teas are also safe although they can stain teeth. As mentioned before, if you do have sodas then either rinse your mouth after or have a xylitol candy after.
9) Oil pulling is something that’s getting more popular in the US. Swishing with coconut or sesame oil for 20 minutes a day is the standard recommendation but there are some studies that show it’s effectiveness. There are even some oil pulling rinses on the market now that you can find online or at health food stores. There could be other health benefits too so if you’re suffering from frequent cavities I’d certainly explore this option. I’ve seen some patients with pretty incredible results from oil pulling in terms of dental health.
10) Your dentist can make custom trays so that you can use special gels for a few hours every evening to help strengthen teeth. These are basically teeth whitening trays so instead of using whitening agents, you can substitute xylitol based gels. Of course you can use fluoride gels too but it would be hard not to ingest some if you’re wearing trays for extended periods of time. Carifree makes a nice gel that you can use inside trays.
11) Remineralization techniques can help strengthen the areas weakened by acid. There is a product called Icon that can treat early cavities between teeth without drilling. Some dentists will use in office fluoride treatments. For those very susceptible to cavities I like using ozone trays with calcium phosphate remineralization. There are several methods so ask your dentist about what preventive techniques they can offer.
12) Chronic use of strong pain medications will very likely lead to very damaged teeth. These medications usually cause extreme dry mouth and block out any sensitivity or pain associated with cavities. So as teeth start to rot and decay, the pain meds block out most sensation. So it’s very common to see teeth with extreme damage requiring extractions and dentures. If you have extreme pain requiring heavy dosages of pain meds for long periods of time, then make sure you visit your dentist frequently. Use as many methods listed above as you can to slow down decay. And explore other alternatives such as acupuncture, regular chiropractic care, yoga, meditation and any other technique that may help reduce the amount of pain medications necessary. And pain med can lead to clenching and grinding which further damages the teeth.
13) If you clench and grind your teeth, go to your dentist to find ways to protect your teeth. Chronic clenching and grinding of teeth lead to damage in the enamel which can make your teeth more susceptible to getting cavities and can cause older fillings/crowns to fail prematurely. A nightguard can help protect the teeth but sometimes orthodontics or splint therapies can help. By improving the bite to proper function, sometimes clenching and grinding disappear or decreases. Clenching and grinding can lead to premature gum recession which exposes a much weaker area of the tooth called cementum. These areas are also much more susceptible to decay and often called root decay. it’s difficult to fix root decay long term and again, the best treatment is prevention.
14) CPAP use can really cause dry mouth for obvious reasons. If you find that you can stop cavities from forming and you use a CPAP, use the humidifier and adjust the settings to raise the moisture. If you are an open mouth breather with the cpap, then maybe a chin strap can help keep the mouth closed. And maybe the use of xylimelts can help stimulate saliva while you sleep. It can also be helpful to keep a bottle of water next to your bed in case you wake up and your mouth is dry. Also, make sure your mask is not leaking, that can cause the dry mouth also.
Many people have several high risk factors which will increase the chance of cavities. If so, all one can do is try to minimize the effect of each risk factor by looking at alternative treatments of each factor. It’s tough to tackle this problem by yourself so make sure you get help from your dentist and doctors. At Dr. Tony Kim’s Honolulu holistic dental office, we try to focus on safer ways to help with cavities. Contact us through the website or call us for a free consultation.