Facts and Myths About Tooth Decay

Marielaina Perrone DDS Cosmetic Dentistry
Tooth decay (also called dental cavities or dental caries) –  The destruction of the surfaces (dentin and/or enamel) of a tooth and infiltration of bacteria into tooth structure. Tooth decay results from the action of bacteria that live in plaque. Plaque is a sticky, whitish film formed by bacteria and food debris which adheres to the pellicle (a protein layer on the tooth surface). The plaque bacteria sticking to tooth enamel breakdown the sugar and starch from food particles in the mouth to produce acid.

Only Cake, Candy, and  Sugary Drinks Cause Tooth Decay.

Myth, but it’s almost a fact.

Guess what sugar is? You guessed it a carbohydrate. White rice, french fries, bagels, chips and fruits are all carbohydrates. The stickier the carb, like white rice, caramel, or fruit gummies, the longer they stay lodged between teeth and stuck in grooves. The truth is that the acid produced by the bacteria while breaking down carbohydrates is what causes tooth decay. The bacteria makes the acid when you eat anything with carbohydrates that stick and stay on your teeth. The resulting acid melts through the strong outer enamel and allows bacteria to enter into the inner layer (dentin). The bacteria are not visible to the eye, and the breakdown is slow and steady forming a hole, better known as a cavity. An important fact to know: It is not the amount of carbohydrates you consume that end up causing tooth decay, but the length of time your teeth are exposed. If you eat a high amount of carbohydrates for lunch, that’s one big exposure. But if you spend the day sipping sugary drinks, chewing on gummy bears, sucking on tic tacs, that continuous exposure is far more unhealthy for your teeth. Dentists have a saying, “sip all day and get tooth decay“.

All Dental Restorations Need to be Replaced Every Few Years.

Myth.

An amalgam or composite filling needs to be replaced only if it breaks down or a cavity forms around it, or if the tooth breaks or fractures. If none of those problems occur, you can keep the same filling for quite a long time. Most dental restorations do have a life expectancy but it depends on each individual. Tooth wear due to clenching or grinding, diet, and dental hygiene habits,  play a huge role in how long these restorations last, some last more than 50 years! Maintaining proper oral hygiene and maintenance  will help your dental restorations last longer.

Once You Get a Tooth Capped, the Tooth Can’t Decay.

Myth.

A Cap or a crown covers and protects underlying tooth structure. However, the area where the crown edge ends and tooth is not covered ( the margin), is where bacteria like to stick. It is the least smooth part of the tooth, and where bacteria can break the seal between the tooth and crown. Once the seal breaks, bacteria can move up and under the crown to slowly breakdown tooth and root structure. A dentist always checks margins around teeth to try to find breaks in margins, however, when breakdown occurs in between teeth it is harder to detect and  usually decays much further before it can be detected on an x-ray.

When You get a Root Canal, the Roots are Removed and the Tooth Can’t Decay.

Myth.

A root canal treatment does not remove roots, what is removed are the nerves, blood vessels, bacteria, and debris from inside of the roots. The dentist then fills and seals the roots with a rubbery filling and sealing paste. This prevents bacteria from re-entering a tooth. Once the root canal is completed, the tooth should heal, and usually be covered and protected with a crown to help prevent cracking. Tooth decay can happen, just as in any tooth.

Children are more prone to Tooth Decay than Adults.

Myth.

Advances in pediatric dentistry have allowed us to cut childhood tooth decay in half over the last 20 years. These advances include sealants, fluoridated water, dietary consultations, and preventive care. As we see advances in pediatric dentistry, and decreases in tooth decay a different population has had increases in tooth decay. Seniors have an increase in cavities due to an increase in advances in pharmacology, limited dexterity, insufficient professional cleanings, and dry mouth. Many medications have a side effect of causing dry mouth which increases the risk of tooth decay.

If You Have Tooth Decay, You Can Feel it.

Myth.

Tooth decay may or may not cause any symptoms. Everyone and each individual tooth varies in it’s pain threshold. The pain associated with tooth decay may be detected very early in some and when it is in a more advanced stage and is actually causing damage to the nerve in others. Allowing tooth decay to progress untreated can and will lead to much more expensive and extensive dental procedures, like root canals and oral surgery. That’s why regular dental examinations are so important. Teeth can only repair themselves when initial enamel breakdown is occurring, and the bacteria have not entered the dentin. Some enamel can repair with natural calcium remineralization and some can harden and repair with fluoride . Persistent bacteria will cause a cavity to forms which will continue to grow and progress into the tooth, eventually working its way into the dentin and then the nerve of the tooth.

Cavities Are More Likely Between Teeth.

Fact.

Any place in the mouth where you cannot reach and bacteria can hide is a place for tooth decay to form. That is why brushing, flossing, and using an antibacterial and fluoride rinse (such as Purple Listerine) are so important. They allow you to reach areas brushing alone cannot. Flossing is one of the few ways to get in between teeth and properly avoid tooth decay between teeth.

Chips and Cracks in Teeth Lead to Decay.

Fact.

Cracks and chips in teeth can create a hiding place for bacteria and make those areas more prone to tooth decay. Using a fluoride rinse can reduce the risk of tooth decay.

Sensitive Teeth Means You Have Decay.

Myth.

Tooth sensitivity could just mean you have hypersensitive teeth, or gum recession has exposed some root. You could also have a cracked or broken tooth or could need a root canal. There are many things, including tooth decay, that could lead to sensitive teeth. If your teeth are sensitive you should schedule a dental examination to make sure it is not something serious.

Cavities Are the Only Reason for Root Canals.

Myth.

Root Canal treatment is caused by a variety of things including tooth decay. Root canal treatment is needed if the nerve inside a tooth is damaged which can be a result of decay or trauma.  Trauma can result from accidents, grinding, clenching, biting into a very hard object (piercings, hard candy, etc.), ice chewing, etc.

You Don’t Need to Worry About Cavities in Baby Teeth.

Myth. 

Baby teeth are needed to hold the space for permanent teeth. Also, tooth decay in baby teeth can develop into serious pain, dental abscess and serious infection. On occasion the infection can spread to other parts of the body and has even caused death if left untreated.

Brushing, Flossing, and Rinsing and a Healthy Diet Is the Best Way to Prevent Cavities.

Fact. 

Definitely. Preventive dentistry is the key to staying cavity free. The bacteria must be removed from the teeth. Brush twice a day with a fluoridated toothpaste, and floss and rinse daily. Antimicrobial rinses target bacteria, reducing plaque, bad breath, and the severity of gingivitis. Rinses with fluoride make teeth more resistant to tooth decay. If bacteria are removed daily from every area of your tooth. Eat healthy foods, and limit exposure to carbohydrates.

Tooth Decay Conclusion

There are many misconceptions about what causes tooth decay and what doesn’t. The facts remain, A healthy diet, and proper oral hygiene will not only help you prevent tooth decay, but keep your whole body healthier.