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Cavities/Dental Caries are caused by high levels of bacteria in the mouth. Oral bacteria, or plaque as it is known, multiplies and organizes and attaches to various areas of the mouth. When the plaque attaches to the little grooves on the top and sides of your teeth, cavities occur. The plaque that attaches around your gum organizes into specific colonies called biofilms. The plaque around the gumline causes gum infections called periodontal disease.
Dental Caries risk is related to:
- Susceptibility of the host. Susceptibility factors include:
- Grooves in teeth
- Genetic hardness of the teeth
- Rough, jagged old restorations that “catch” germs
- The amount of sugar in the host’s diet
- The host’s oral hygiene profile. The more bacteria removed, the less the risk of dental caries.
High risk dental caries patients are people that have most teeth “filled” and often have cavities diagnosed when they go to the dentist. We recommend that our high risk dental caries patients undergo our Caries Management Program.
The CMP/Caries Management Program is a scientific, medical-based system for controlling dental caries, similar to controlling a medical ailment such as diabetes. We recommend patients at high risk for dental caries take a Caries Risk Test.
The Caries Risk Test involves taking a saliva sample and culturing it in a special medium. We look for the number of colonies with the Streptococcus Mutan and Lactobacillus bacteria. These germs are associated with dental caries. If we find medium to high levels of these germs, we will design a custom program with a goal of lowering the levels of oral bacteria.
 Factors that perpetuate dental caries include:
- Medical conditions - Drugs that dry the mouth put you at a high risk for caries. Saliva has anti-bacterial properties. Medications or medical conditions that lower saliva (dry mouth) contribute to increasing the risk of dental caries as diabetes, immune disorders and smoking.
- Diet - Sugar, sugar in foods, sticky, fructose sugars, and most diet and regular sodas (food that have acids in them that dissolve crystal structures like enamel and porcelain).
Oral hygiene abilities and habits
Oral bacteria organizes into sophisticated colonies called plaque and or biofilms. These plaque biofilms reproduce every 24 hours and reorganize into pathologenic colonies every 10 days. Studies indicate the best method of controlling plaque is through mechanical action.
Modern toothbrush designs enable the successful removal of plaque at the tongue, cheek and biting surfaces of the teeth. Most electric toothbrushes are moderately more effective than conventional toothbrushes because of the use of timing devices.
Brushing must be done at least two times per day (a.m. and before bedtime) and should be performed for a minimum of 90 seconds each time.
The surfaces between the teeth and under the gumline are the areas that attract the greatest amount of plaque. Interdental (in between) cleaning devices include: floss, interdental brushes (Interclean, Braun/Oral B, Proxi-Tip, AIT Dental), oral irrigating devices (Waterpiks) and wooden sticks.
Plaque retention and its associated bacterial presence can also be affected by irregular alignment of teeth, missing teeth, incomplete eruption of teeth, old or defective restorations, tooth surface irregularities, and untreated decay.
Genetic Factors
 Dental caries as well as periodontal disease are affected by complex genetic factors. Differences in the type, the amount, the adhesiveness and reproducibility of bacteria can be subject to genetic influences. The ability of plaque to penetrate tooth structure and cause cavities can be related to genetics.
The study of saliva and gene engineering will be pathways to newer therapies such as reversing cavities, reversing periodontal destruction and improving patient resistance to disease.
Other factors affecting dental caries include recreational drug use.
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