Factors

If dental and oral hygiene are impeccable and there is no plaque accumulation around the teeth, then there will be no bacteria present that will lead to cavities. This is however an unlikely successful approach in preventing tooth decay because despite our best efforts, bacteria will always be present in our mouth.

There are several predisposing factors that can be held responsible. These are found in the environment surrounding teeth: beginning of course with the oral cavity, but also, in a broader sense, including the whole human body; an organism that strives constantly towards homeostasis, or a balance between its biology and the energy needed to maintain it.

Sugar and Saliva
Saliva is a natural tooth protector. Saliva acts as a neutralizer to acid, by simply diluting acids in the oral cavity with it’s alkaline pH thus restoring a neutral pH balance. The amount of time that teeth are exposed to acid is a factor that comes into play here. Saliva will take about twenty minutes to neutralize the acid in the mouth. If the sugar intake is spread over an extended period, for example drinking sweetened coffee or soft drinks over a span of several hours, or by consuming sugary items such as candies, pastries, cookies, dried fruit, mints or throat lozenges, then saliva will not have the opportunity to neutralize the acid in order to protect teeth. This extended exposure to acid in the mouth will lead to cavities.

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Actual case

There was one particular case where a patient who had been seen regularly every six months, maintaining a set of cavity-free teeth for years, had sucked on throat lozenges for 15 days during an illness. The result, which was a shock to everyone, was six new cavities.

In other words: if the consumption of sugar is limited to three meals a day without snacking then the likelihood of cavities will be less. If sugar is consumed more frequently throughout the day, there can be an increase in the risk for decay.

Salivary flow can be reduced by certain habits, such as smoking cigarettes, or stopped entirely when taking certain medications. In this case, you should seek an alternative to the medication or compensate for the missing saliva with appropriate remedies. Otherwise cavities can soon follow.

Lastly, balance, or homeostasis, of the human body is a factor to consider. Any acid or mineral imbalance will impact the tooth’s ability to defend itself. The tooth is a living organ with its own built-in defense mechanism. There is a flow of fluid that travels outwards from the center of the tooth via the dentinal tubules (microscopic channels). These can be compared, to some extent, to the pores of the skin.

This microcirculation of protective secretions provide some immunity to the tooth, and facilitates the addition of minerals to its surface. In the case of a general imbalance in the body, such as stress, lack of sleep, lack of exercise, disease, poor nutrition, or malabsorption, every tooth will be affected and the direction of microcirculation will be reversed. In these circumstances the teeth become more permeable, more porous to acids and vulnerable to invasion.

it is not only what we eat and how we brush our teeth that influences the formation of cavities

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Balance and the body

The teeth begin to function like sponges, storing substances in the immediate environment. Under these circumstances, the tubules are more easily penetrated by acid, leading to the demineralization of the teeth and leaving them more prone to cavities. This phenomenon was demonstrated by Ralph R. Steinman in 1971.* This means that it is not only what we eat and how we brush our teeth that influences the formation of cavities, but also conditions such as diet, sleep, exercise, and the absence of medication or drugs likely to disrupt the delicate balance of homeostasis. The body requires a favorable environment in order to maintain the circulation of fluids in the right direction, thereby supporting the defense mechanism of the tooth.

* Ralph R. Steinman and John Leonora, J DENT RES 1971 50:1536.