Office of Dr. Nick Nguyen, DDS, APC

Dental Health Articles

How Prone Are You To Developing Dental Cavities? (Part II)

By Nick K. Nguyen, DDS, APC

In the last issue, we discussed in detail how cavities are formed and the multiple factors which may influence an individual's susceptibility to cavity development. In this segment, we will focus on how to prevent cavity formation and how to reverse it. For a copy of Part 1, please refer to

As discussed previously, consumption of starches (especially simple sugars) causes certain mouth bacteria to secrete acid, lowering oral pH. This may cause the tooth to lose calcium and phosphate, a process called demineralization. A demineralized tooth may eventually form a cavity. In contrary, re-mineralization involves neutralizing oral pH and restoring calcium and phosphate back into the tooth. This process can be enhanced with the application of fluoride.

In part 1, we discussed factors which may increase a person's cavity risk. This included but is not limited to individuals with dry mouth, soft teeth, bad oral hygiene, high bacteria counts, high sugar intake, and/ or acidic saliva. With the guidance of their dental office, such individuals should determine their unique cavity risk and develop an interventional treatment plan that may halt demineralization and favor re-mineralization. This begins with reviewing the medical history, improving brushing, flossing techniques, and modifying diet (including sugar intake). If necessary, a person's cavity risk may include measuring saliva production and pH levels, bacteria strains and counts especially if the individual is at high cavity risk. It is important to note that individuals with dry mouth may result from taking certain medications, stress, depression, drug use, radiation therapy, HIV, or Sjogren's syndrome.

When a person's unique cavity risk is determined, there are many different home treatments a person can consider besides using better brushing and flossing techniques. If the problem is bacteria, chlorhexidine and xylitol should be considered as they have been shown to significantly reduce bacteria levels. Chlorhexidine is a mouth rinse that can be prescribed by a dentist. Xylitol is a naturally occurring sugar that cannot be fermented by oral bacteria. Xylitol can be found in granular form to replace table sugar and can be found in candy, mouth sprays, toothpastes and mouth gels.

Fluoride can also be considered and it has been long known to inhibit plaque bacteria and enhance re-mineralization. It comes in over the counter and prescription toothpastes, prescription tablets, and mouth rinses. The strength a person requires will depend on their cavity risk.

Other solutions include using calcium and phosphate paste, and baking soda products. Calcium and phosphate pastes have been shown to effectively re-mineralize teeth. And for individuals with acidic levels in their saliva, baking soda products such as toothpaste and gum can be considered.

If is very important to know that to optimize the efficacy of the above products and to avoid negative outcomes, the amounts, duration, combinations, and frequencies in using one or more of these products must be discussed with each individual's dental office. For example, a person who uses chlorhexidine and fluoride should take them at least 30 minutes apart or else they will be less effective. Taking too much fluoride may lead to fluorosis. Excessive use of xylitol may cause diarrhea. It is both exciting and a relief that we now have so much knowledge about how cavities are formed. This has allowed us to develop specific, minimal intervention treatment/prevention modalities. In doing so, we hope to greatly reduce this epidemic of cavities and minimize on the old-fashioned modality of drill-and-fill dentistry.


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