It’s a fairly simple question that most people assume they know the answer to, but if you stop to really think about it, do you actually know what a cavity is? Or how it forms? Most people understand there’s a link between eating sugar and getting cavities, which is true, but it’s not the full story.

What actually happens is this: Millions of bacteria live on the surfaces of your teeth in that sticky substance known as plaque. When you eat any type of sugar (this includes sucrose, lactose and fructose), the bacteria also feed on this sugar and produce an acid by-product. The acid then sits on your teeth and slowly eats away the protective hard enamel of your tooth, causing it to lose minerals. The more sugar the bacteria have to eat, the more acid they produce, causing the enamel to lose more and more minerals. Over time, these demineralized areas become visible as white spots on the enamel. This is an early sign of tooth decay. White spots have the potential to be stopped or reversed at this point by using minerals from saliva, fluoride, or other sources. However, if the demineralization continues, the decay gets worse and actual holes form in the enamel – aka cavities.

Once the cavity breaks through the enamel, it allows bacteria access into the dentin of the tooth. Dentin is the material that makes up the inside layer of your teeth, and because it is much softer than enamel, tooth decay spreads rapidly in it. At this point, to prevent further spread, a dentist must remove all the decay and place a filling in the tooth. If, however, it goes untreated, the decay will spread until it reaches the pulp of the tooth – the inner hollow core of the tooth, which contains the tooth’s nerve and blood supply. Once bacteria are allowed to enter the pulp, they will multiply inside the tooth and eventually cause the tooth to become abscessed or infected, leaving a root canal as the only treatment option to save the tooth.

But let’s not end on a sad note – there’s good news. By maintaining good oral hygiene, limiting your sugar intake at home, and visiting your dental office at least once a year for check-ups, these cavities can be caught at an early stage, before they become real problems. These simple steps will keep your mouth happy and healthy.

Dr. Jaimee Buchkowsky