We get all kinds of questions as dentists, but one of the most common categories of questions people ask about is cavities. The questions vary, but to name a few:
- Why do you guys only treat cavities with fillings?
- When are they going to develop a way to fix cavities without drills?
- Is their a natural way to “heal” my cavities?
Patients are often surprised to hear us tell them that the answers to these questions are 1) We dont. We treat cavities with many different techniques 2) We already have it for small cavities. 3) Yes! we do it all the time. This Blog post is going to focus on how we heal small cavities.
What is a cavity and which ones can be healed?
Let’s start with a basic understanding of what a cavity is. At the most basic level a cavity is exactly what it sounds like – a hole in a tooth. The medical term for cavity is “caries” , and while I will refer to caries as cavities throughout this article (mostly) it is a little misleading. The distinction is important because early stage cavities (caries) don’t actually have a hole. In case you were wondering This video is a great summary of what causes cavities.
In this early stage the cavities are really just a weakening in the enamel of the tooth caused by loss of mineral. When we look in someones mouth these early cavities appear as chalky white spots along the gums, or as small irregularities only found in the enamel on Xrays. There is no actual hole in the tooth yet. If an X-ray shows a cavity that extends past the outer enamel and into the next deeper level of tooth, then the majority of the time these cavities have holes already formed and efforts to heal the cavities usually don’t work. If the cavity on the x-ray is limited to the enamel then it can be healed a larger percentage of the time……… but it doesn’t always work.
It used to be that, in an effort to catch problems when they were small, we fixed even these early cavities with fillings. However protocols developed over the last 10 years have proven effective in healing these early stage cavities.
How do we Heal Them?
At the center of our efforts to heal cavities is an age old, natural remedy: Fluoride. That stuff you find in your toothpaste and often in our water is a natural and effective weapon in the fight against dental cavities. It is not all there is to this battle though. The California Dental Association in conjunction with University of California at San Francisco (UCSF) has been a leader in publishing research surrounding the prevention and management of Cavities. They developed a protocol called CAMBRA (Caries Management By Risk Assessment)…….. Dentists aren’t very good at the catchy acronym game, but this protocol has some great information.
I’m not going to go into the whole protocol, but in summary it contains advice for patients who are showing evidence of developing cavities. These recommendations include diet (another blog post is pending surrounding this topic), home care including flossing and efforts to remineralize those weak spots in enamel. I recommend a simple protocol for most patients. It varies from individual to individual depending on their needs and problems but here are a few of the things we recommend. None of this is particularly complicated and may seem like common sense to some, but it works.
- Decrease frequency of eating and drinking carbohydrates. (In my experience nothing really works if we skip this step. )
- Floss and brush regularly. I recommend a Sonicare tooth brush.
- Use Fluoride tooth pastes and mouth rinses. For patients with early stage cavities we are trying to heal we usually prescribe a tooth paste with higher concentrations of Fluoride. ACT Mouth rinse, which can be purchased over the counter is great for rinsing after snacks and lunch. If you are concerned about the safety of fluoride I encourage you to read this well-written article on Fluoride: https://www.wired.com/2013/05/a-natural-history-of-fluoride/. Very little we do as dentists is natural. Fluoride is one of the most natural things we do for peoples’ teeth.
- I recommend Xylitol containing chewing gum for use during the day. Xylitol is a natural sugar that actually prevents the bacteria that cause all of the problems from growing. It has a small but worthwhile benefit. You must pick a gum that is 100% xylitol like Spry (available at whole foods, sprouts, and Natural Grocers) or Epic gum (available at www.epicdental.com). Current evidence indicates you must chew 100% xylitol gum at least 6 times a day to get any benefit.
How well does it work?
The simple answer: It depends. Even in the most compliant patient we see things get worse at times. Remember X-rays are not perfect and some of these cavities were already of the type that had a hole to begin with and weren’t going to heal. There are also other factors we didn’t discuss that effect a persons tendency towards cavities. Things like dry mouth caused by medications effect our bodies natural defense against cavities, and can sometimes thwart our efforts.
If you live or work in Arvada, CO and have a history of cavities and are tired of the ongoing pattern of drilling and filling please call us here at Sagewood Dental for a thorough evaluation and discussion of your options. Our Phone number is 303-463-8570 .
If you like this. Please Share it.