Dental Cavities and "Mouth Chemistry"
The teeth are hard calcified objects which serve many useful purposes, including chewing food, supporting the jaws and giving form and stability to the lower third of the face. Teeth are made up of calcium and other minerals, and tooth enamel is the hardest substance in the body. Unlike bone, they do not heal when broken.
Due to their mineralized nature, teeth are susceptible to acid erosion and dental decay (also known as "dental caries"). Cavities form in teeth when bacteria digest the carbohydrates and sugars in our diet and create acid. This acid dissolves the minerals out of the teeth and breaks down the tooth structure creating holes or cavities.
Small areas of tooth decay require fillings. Historically, most fillings were made of silver-amalgam, but have now been mostly replaced with tooth-colored composite or resin fillings. Bonding composite fillings strengthens the weakened tooth and restores the natural color and appearance of the tooth.
Larger amounts of decay must be repaired using restorations such as onlays and crowns (also called "caps"). This is necessary due to the compromise in structural integrity that large amounts of decay or broken down tooth structure creates. If the decay reaches or damages the nerve in the center of the tooth, the tooth will either need to be removed or receive a root-canal procedure which removes the nerve and blood vessels in the middle of the tooth.
Dental Caries or tooth decay is a disease, and as such is more than just having "cavities". Caries is the process of how and why tooth decay happens. In short, it’s a bacterial infection, and filling cavities is just one step in treating the infection. Other steps require the proper management of oral bacteria and protecting the teeth against the destructive effects of acid.
The science of "mouth chemistry" is that teeth lose calcium at a pH of 5.5 or lower on the pH scale. Teeth that are "acid conditioned" become softer as minerals are removed from the teeth. This results in tooth erosion, decay and increased sensitivity.
Acidic conditions in the mouth occur from:
- bacteria which "eat" sugars and form organic acids,
- acidic foods and beverages,
- stomach acids – gastric acid-reflux.
Tooth decay happens when bacteria metabolize (eat) the food in your mouth and create organic acids around the teeth. This acid then removes calcium from the tooth, and if not arrested can produce a cavity or hole in the tooth.
Many foods and beverages lower the pH in the mouth causing the teeth to be bathed in acid. This acidic state is usually neutralized within 30-60 minutes due to the buffering and diluting effects of saliva. People with dry mouth (xerostomia) have problems neutralizing this acid state, causing an accelerated loss of minerals and more tooth decay. Many prescription and over-the-counter medications are known to have dry-mouth side effects. Extreme care must be taken to control mouth acidity and to not use sugar containing mints or gums to improve saliva flow.
When combined with aggressive tooth grinding, acid conditions in the mouth help create erosions (grooves) at the gum line on the sides of teeth, and the biting surfaces of teeth, exposing the softer sensitive dentin of the tooth.
Excessive tooth wear and damage from grinding can further damage weakened teeth, and can also shorten or collapse the jaws and face giving them and you an aged appearance. Teeth grinding obviously decreases the durability or life-expectancy of the teeth.
The good news is that just as calcium can be removed from teeth in acidic conditions, calcium in the saliva can be re-absorbed back into the teeth when the pH is neutral, making the tooth hard again. Topical fluoride also hardens tooth surfaces, making them more resistant to the effects of acid.
Take a Quiz to Find Out if You Are At Risk!