You are having your dental check-up and your dentist says, “You have a cavity.” You don’t want to hear it, and truly we don’t want to say it! What makes YOU be the one who always has cavities? In this portion of “Is Your Dentist a Hitman?”, we will talk about the next area we assess at your examination, the part dentists are “famous” for treating, the teeth.

Biomechanical (or “What Causes Cavities”)

To determine how likely you are to get cavities, we may ask you the following questions on your dental history or while you are in our office, and your answers matched with our examination findings will point to a level of risk.

  • Have you had any cavities in the past three years? If you have, you are at risk for developing more cavities. Why? You may have changed your diet, changed your oral hygiene habits, changed your medications, any of which can change either the type of bacteria in your mouth or create an environment where bacteria can more easily grow.
  • Does the amount of saliva in your mouth seem too little, or do you have difficulty swallowing food? Saliva production decreases as a side effect of medication, cancer treatments, mouthbreathing, etc, and inadequate saliva can make swallowing food more difficult as well, increasing danger of choking while eating.
  • Do you feel or notice any holes (i.e. pitting or craters) on the biting surface of your teeth? A hole can be a cavity, but it can also be acid erosion related to gastric reflux, bulimia, burping, or repeated vomiting during cancer treatments. This pitting makes the remaining tooth weaker and easier for bacteria to penetrate, causing cavities.
  • Any teeth sensitive to hot, cold, sweets, or do you avoid brushing any part of your mouth? Missing or breaking fillings can make teeth sensitive, but often times cavities don’t actually cause pain. However, if the roots of your teeth are exposed from recession of the gums, the roots are more likely to decay and be sensitive when this happens.
  • Do you have grooves or notches on your teeth near the gumline? Grooves or notches are related to uneven chewing pressure or very acidic foods and drinks, and these notched areas are also much more likely to get cavities.
  • Have you ever broken teeth, chipped teeth, or had a toothache or cracked filling? Injury aside, teeth will only break when they are weakened by large fillings, teeth grinding, or chewing with an unbalanced bite. Anything that can break a tooth can also increase the chances of getting cavities.
  • Do you frequently get food caught between any of your teeth? If food is stuck between teeth and not removed, the outer surface of the tooth becomes weaker and more easily broken down by bacteria causing cavities. Often poorly-fitting filling material can make this situation even worse.

If you’ve never had cavities or it has been many years since you’ve had a cavity, if your teeth aren’t worn or chipped, and if your teeth are even and straight and your bite is comfortable, you are less likely to get cavities in the future. However, if you’ve had cavities recently, if you suffer the effects of erosion or abrasion, if your diet or home care habits have changed, you will be at greater risk for future problems. Your cavity risk level will cause us to recommend a variety of solutions based on your needs; however, the old adage of brush 2X/day and floss daily goes a long way to keep your teeth healthy. Ask us to assess your cavity risk at your next appointment so you can have the strongest possible smile.

Dr. Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario. If you have dental questions, you can call her at 613-271-7091 or visit her at drandreastevens.com Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer.