Cavities are one of our most common worldwide health problems. Everyone who has teeth is at risk of getting them, but the following factors can increase risk:

  • Tooth location. Decay most frequently occurs in your back teeth (molars and premolars). These teeth have lots of grooves, pits and crannies that are great for grinding food — but they can also collect food particles. As a result, they're harder to keep clean than your smoother and more accessible front teeth. Between your hard-to-reach back teeth, plaque can build and bacteria can thrive, producing the acid that destroys tooth enamel.
  • Certain foods and drinks. Some foods and drinks are more likely than others to cause decay. Foods that cling to your teeth for a long time, such as milk, ice cream, honey, table sugar, soda, raisins and other dried fruit, cake, cookies, hard candy, breath mints, dry cereal and chips, are more likely to cause decay than are foods that are easily washed away by saliva.
  • Frequent snacking or sipping. When you steadily snack or sip sodas, you give mouth bacteria more fuel to produce acids that attack your teeth and wear them down.
  • Bedtime infant feeding. Parents and caregivers are encouraged not to give babies bedtime bottles filled with milk, formula, juice or other sugar-containing liquids. These beverages will remain on teeth for hours while your baby sleeps, providing food for decay-causing bacteria. This damage is often called baby bottle tooth decay. Letting a toddler who's transitioning from a bottle wander around drinking from a "sippy" cup can cause similar damage.
  • Inadequate brushing. If you don't clean your teeth soon after eating and drinking, plaque forms quickly and the first stages of decay can begin.
  • Not getting enough fluoride. Fluoride is a naturally occurring mineral that helps avoid cavities — and can even reverse the earliest stages of tooth damage — by helping teeth repair themselves. Because of its benefits for teeth, fluoride is now added to many public water supplies. It's also a common ingredient in toothpaste and mouth rinses. If you drink bottled or filtered water that doesn't contain fluoride, you may miss out on its protective benefits. On the other hand, some bottled water may contain added fluoride. If your drinking water and tooth care products also contain fluoride, it's possible that babies and children could get too much. Talk to your dentist — and your child's dentist — about the total amount of fluoride you may be getting from your local water supply and other sources.
  • Younger or older age. In the United States, cavities are the most common chronic disease among children and teenagers. Older adults are also at higher risk as more of us keep our teeth as we age. Over time, teeth can wear down and gums may recede, making teeth more vulnerable to root decay. Tooth roots are naturally covered with a coating called cementum, but cementum is quickly lost when the root surface is exposed. The underlying dentin is softer than enamel and more susceptible to decay. Older adults also may use more medications that can reduce saliva flow, increasing the risk of tooth decay.
  • Dry mouth. Dry mouth is caused by a lack of saliva, which helps prevent tooth decay by washing away food and plaque from your teeth. Substances found in saliva also help counter the acid produced by decay-producing bacteria and can even help repair early tooth decay.
  • Worn fillings or dental devices. Over the years, dental fillings can weaken, begin to break down or develop rough edges. These developments can allow plaque to build up more easily and make it harder to remove. Fillings and dental devices can also leak or stop fitting well, allowing decay to begin underneath them.
  • Eating disorders. Anorexia and bulimia can lead to significant tooth erosion and cavities. Stomach acid from repeated purging (vomiting) washes over the teeth and begins dissolving the enamel. In addition, people with eating disorders may sip soda or other acidic drinks throughout the day, which also helps create a continual acid bath over the teeth. Eating disorders can also interfere with saliva production.
  • Heartburn. Gastroesophageal reflux disease (GERD), acid reflux and heartburn can cause stomach acid to flow into your mouth, wearing away the enamel of your teeth. If your dentist notices enamel loss and doesn't think this loss is caused by grinding your teeth, consult your physician to see if gastric reflux is the cause. Untreated reflux can cause significant tooth damage that is costly to correct.
  • Certain cancer treatments. Having radiation to your head or neck can increase your risk of cavities by reducing saliva production, which prevents cavity-producing bacteria from being washed away. Certain chemotherapy drugs also tend to cause dry mouth.
Apr. 28, 2011