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The Dental Corner 


Why do I get cavities on my teeth?

Over the last 10 years while practicing dentistry, I realized that a lot of confusion comes from our patients when it comes to the question “Why do I get cavities on my teeth?” 

“Is it from too much candy, soda, soft teeth, or a combination of all these reasons?”

The science on how we get cavities has been well studied and documented.  Cavities or decay on our teeth cause by bacteria byproducts. 

In a more simplified concept:


Sugar from our blood = bacteria food
Bacteria eats sugar and produces a byproduct = Acid content 
Acid produced by bacteria destroy our teeth and create a hole on our teeth = Cavity


When do I need to fix my cavities?

Let’s review the anatomy of the tooth before I answer the above question.

The tooth has 3 parts: Enamel, Dentin, and Nerve.

Tooth anatomy

Enamel is the hardest part of the tooth and also there are no pain receptors in the enamel.  Dentin is the soft part of the tooth and is also the alive part of the tooth. The nerve chamber is where the nerve and blood vessels bring in nutrients to keep the tooth alive.

When a cavity starts, it has to break through the enamel part.  Since this is the hard part of the tooth, it may take many years for the cavity to break through.  Usually at this state, the patient won’t feel anything due to lack of pain receptors in the enamel layer.

Eventually the cavity will get to dentin layer.  At this state, the cavity starts to change its color to brown or black due to the natural yellow color of the dentin layer.  Since dentin is the alive part of the tooth, the patient starts feeling sensitivity on the tooth with the cavity especially to sweet, sour, or cold food and drinks.

If the cavity is left untreated, it will end up reaching the nerve.  Once the cavity reaches the dentin it begins to grow very fast.  Since the dentin is the soft part of the tooth, the cavity can grown and hit the nerve in only a few short months.  Patients will experience extreme pain when the cavity hits the nerve.  Symptoms range from sensitivity to hot and cold drinks, sharp spontaneous pain, constant dull aching pain, to extreme pain, which gets worse when lying down.  Once this happens it is already too late to do a filling.

The best time to fix your cavity is when it is still in the enamel layer.  However, most patients only visit the dentist when they start feeling something hurt.  By the time cavity starts cause some discomfort, it is already in the soft part to the tooth.  At this point, we only have a few months to fix the cavity before a full blown toothache arrives.

So the best answer is to keep up with your 6-month appointment so the doctor can catch the cavities early; when a cavity is diagnosed, we need to fix it ASAP.

-Dr. Vinh Le


3 Common Oral Health Myths Busted!

Myth 1: Bleeding gums are normal.


 Busted: If you washed your hands and they bled, would you be concerned? Of course! The same goes for your gums. Bleeding is the first sign of infection. Gums bleed because plaque, which is full of disease-causing bacteria, is accumulating where a toothbrush cannot reach to remove it. This is why flossing daily is so important. It reaches these areas, about 35% of your tooth surface, that tooth brushing misses, no matter how well you brush. The longer the bacteria accumulates, the stronger it gets, which causes more than just bleeding and inflammation. This bacteria can cause your gums and bone that hold your teeth in place to break down, and they don’t grow back. Also, when plaque sits undisturbed it can harden, causing more irritation to your gums and providing a home to this virulent bacteria. At this point it is called calculus or tartar, which can only be removed by a dental hygienist. This is why regular dental appointments are more than just checking for cavities! Not great at flossing? Be honest with your dental hygienist about it. Your hygienist can show you other options such as interdental brushes, water flossers, or simply showing you the correct flossing technique. Once you begin flossing, your gums may continue to bleed for a while; this is your body’s immune response trying to fight the infection. So keep at it daily!

Myth 2: If Your teeth don’t hurt, they are healthy.

Busted: Many dental problems, such as chronic gum disease and cavities, don’t hurt in the beginning stages. It’s once they have progressed to a point where treatment is quite extensive, not to mention expensive, that you actually feel them. For instance, a cavity tends to only hurt once it has reached the center of the tooth where the nerves are located. At this point, a filling won’t simply take care of the problem. Most times you may need a root canal and a crown, if the tooth can be saved at all. This is why detecting problems early, with X-rays and regular dental visits, is so important. Dentists and dental hygienists are highly trained to know when you need X-rays. Dental X-rays are imperative to diagnose potential problems, to check for cavities, and to monitor your bone level holding your teeth in place, among other things. Without them your dentist and hygienist are working blindly. You wouldn’t want a broken arm to be set without an X-ray to determine the extent of the fracture, right? Same goes for your teeth.

Myth 3: Oral health doesn’t affect overall health.

Busted: Your mouth is connected to your body! In fact, many diseases can show their first symptoms in your mouth. This includes some autoimmune diseases and even HIV. Further, you are swallowing the bacteria in your mouth every day, all day. If you have gum disease, this bacteria can be harming more than just your mouth. Bacteria can enter your bloodstream and affect other organs in your body. Research is emerging every day showing links of bacteria from the mouth contributing to heart disease and stroke risk to rheumatoid arthritis, pre-term and low birth weight babies, even Alzheimer’s disease and the ability to control blood sugar levels in diabetes. Infection in your mouth = problems for your whole body, so take care of your mouth!

Lacey  McAvoy, RDH

Brushing Before or After Food And Drinks

Little girl brushing her teeth

   Have you ever been told to brush your teeth before you eat? Probably not, but according to a recent article it is suggested that it would be better for your teeth (Nathan J). One of the biggest reasons to brush before you eat would be to avoid enamel or dentin erosion. When you eat most foods, or drink beverages like coffee, soda, or juice the pH of your mouth becomes more acidic. The more acidic your mouth is, the “softer” you tooth surface, the more likely tooth erosion happens when you brush. Brushing before you eat removes the plaque and biofilm that is made up of bacteria waiting to be feed by the food you eat. Once that bacteria starts to metabolize the food in your mouth, the acidity of your mouth is increased (Pradhan D, Jain D, Gulati A) leading to “softer” tooth surface.

   One reason that most people might not want to brush before they eat is the taste of food from brushing with toothpaste. Brushing without toothpaste could be an option for some, although I would recommend using fluoride mouth rinse not only to keep fluoride in your oral hygiene routine but to aid in removal of food particles. If brushing before you eat doesn’t sound like something you would want to try, waiting at least 1.5 hours after you eat or drink before brushing your teeth can help minimize tooth wear (Nathan J). I believe that for those with gum recession, worn enamel such a toothbrush abrasion, or even those who have tooth sensitivity, brushing before you eat might really be beneficial.

  1. Nathan J. Toothbrushing in Relation to Food Consumption. Access. 2015;29(8):18-19,33.

  2. Pradhan D, Jain D, Gulati A, et al. Effect of the presence of dental plaque on oral sugar clearance and salivary pH: an in vivo study. J. Contemp Dent Pract. 2012;13(6);753-5.

Tasha Melendez, RDH

Reduce Tooth Loss With A Little Floss!

Dental Floss

    The Holidays are over and it’s time to start the new year! With all the New Year’s resolutions that we demand of ourselves, one resolution that we should include is to develop healthy habits. This New Year resolution or goal doesn’t have to be a big goal. You can just start with something small including with your oral health. Developing small habits to keep your teeth and gums healthy will benefit your overall health in a big way. Flossing is a habit that everyone should and needs to partake on. I know that as a health care provider, we can not stress this enough and I’m sure as a patient, you already heard of flossing enough. I find that most patient’s that do not floss is not because they don’t know how or don’t know what floss is, but it’s really because they haven’t made it a habit long enough to make it part of their daily hygiene routine. Yes, in the beginning, including flossing into your routine will be a little difficult but if you take these baby steps, it will get much easier. 
    Tips of making flossing part of your oral hygiene routine would be to floss first then brush your teeth. The tooth brush can not reach in certain areas so whether you floss before or after, it really doesn’t matter just as long as you do it.If you floss twice a day, three times a day, or every other day, make it a goal to add another day into your flossing schedule until it becomes a daily habit.Another tip, is to carry floss with you. Everyone is always on the go these days, so on your down time, for instance while waiting at a stop light, take out your floss. I know, its not the ideal place to floss but most peoples’ excuse of not flossing is because they were in a hurry or too tired to floss, so hey floss when you can as long as you’re doing it. Of course, if flossing seems difficult to do, they are other tools that we can use like proxy brushes to clean between teeth and gums to keep your mouth healthy. Developing this habit will not only keep you from developing periodontal disease or cavities, but it can also prevent your body from getting other diseases such as heart disease. Your body will thank you and your love ones will thank you too. Happy New Year and remember, “reduce tooth loss with a little floss.” 
Claudia Cisneros, RDH