Dental caries (tooth decay) are one of the most common chronic diseases of children and teenagers. While dental caries are rarely life threatening, they can lead to dental carious lesions (dental cavities) which can cause pain and discomfort in the mouth, and can lead to further oral health and systemic health issues. Hence, it is important to prevent cavities to maintain both a healthy mouth and body.

As we consume food, the tooth surface becomes covered with a sticky biofilm known as plaque which provides an ideal environment for bacteria (Streptococcus mutans) to adhere to. As bacterial cells break down the food in our mouths, they produce and release acid, causing the pH levels to lower in our mouths. Under normal conditions, the pH of our mouths is at a neutral 7; however, as bacteria releases acid in our mouths, our teeth are at risk when the pH levels drop below the critical pH of 5.5. Once the pH drops below the critical pH of 5.5, the enamel of our teeth start to demineralize.

The enamel is the outermost layer of the tooth, and it protects the softer dentin in the middle layer and pulp in the innermost layer of our teeth. Once the enamel is demineralized beyond repair, tooth decay can spread throughout the softer dentin, causing cavities to grow. According the the American Dental Association (ADA), signs of cavities include the following: 

• Pain in or around the mouth

• Sensitivity to hot or cold foods/drinks

• Bad breath

• White spots on teeth, and later dark spots on teeth

If cavities are left untreated, tooth decay can breach into the innermost layer–the pulp. The pulp contains the nerves and blood supply that keep our teeth alive, and if tooth decay spreads throughout the pulp, an infection will occur. According to the ADA, signs of a infection include the following:

• Swelling of the face or in the mouth

• Redness in or around the mouth

• Pain in the mouth

• A bad taste in your mouth

To help prevent cavities, the ADA recommends flossing once a day, brushing our teeth for two minutes, twice a day with ADA approved fluoride toothpastes, drinking fluoridated water, and visiting our dentists for regular checkups and cleanings. 

For brushing, toothbrushes should have soft bristles and should be replaced every three to four months. The ADA recommends brushing our teeth at a 45-degree angle to the gums as well as gently brushing back and forth in small strokes. Be sure to brush all the surfaces of the teeth and remember to brush the molars in the back. 

Children's oral hygiene is similar to that of adults, but the CDC does recommend a few differences, such as only using water to brush toddler teeth and using no more than a pea-size amount of fluoride toothpaste for young children. 

Fluoride is an important ingredient in toothpaste because it remineralizes the enamel of teeth and protects them from dental caries and cavities. As mentioned before, once enamel demineralizes past repair, dental cavities can form. This is why it is important to remineralize our teeth daily to prevent irreversible enamel damage. Since the mid 20th century, the U.S. government has fluoridated most community drinking water sources. This increase in fluoride supply has resulted in a decrease in cavities among all age groups. Moreover, drinking water does not only help flush food debris out of our mouths, but also helps remineralize enamel and prevent tooth decay.

Cavities can be painful and cause discomfort in the mouth. If untreated, oral infections can occur and cause both oral and systemic health issues. As a result, it is important to take preventative measures to maintain a healthy mouth as we continue to grow older.