The scientific word for decay or cavity is dental caries. There are three main theories for causing dental caries. The acidogenic theory states that acid produced by bacteria dissolves the calcium softening the tooth. The proteolytic theory is where the bacteria destroy the tooth’s protein. The proteolysis-chelation theory where the bacteria breaks down the protein after the bacteria produce chelates, chemicals that bind to calcium. In reality, all three probably occur simultaneously. Bottom line: it is the bacteria that dissolves and destroys the tooth causing cavities. This is important to realize, since most people think it is food that causes decay. It is true, however, that food containing sugar (cariogenic food) feeds the bacteria that causes decay. And, people who consume a lot of sweet foods tend to get more decay.
When dentists see someone who has rampant caries, the concept of sugar frequency comes to mind. For example, if one sips on beverages containing sugar, such as coffee, tea or soda, over long periods of time, then they have a high sugar frequency. Another example is someone who eats hard candy and has some stuck on their teeth that dissolves over a long period of time. Still another example is someone who has a bowl of ice cream or yogurt or even a glass of milk (yes milk!) before going to bed. Dairy products are great for growing bacteria. Also, milk has lactic acid that can initiate the decay process. To avoid having a high sugar frequency, one should limit sugar-containing foods to meal times and brush and floss or use interdental cleaning aids at least once a day, preferably before bedtime.
Brushing using toothpaste with fluoride or even toothpaste with prescription strength fluoride (Prevident-5000 by Colgate, http://www.colgate.com/app/Colgate/US/OC/Products/FromTheDentist/PrevidentPrescription.cvsp) can help. One trick is to not rinse with water after brushing, just spit out the foam. By doing this, the fluoride will stay in contact with the surface of the teeth and make the outer layer less soluble in acid, the first step of caries formation.
The word that dentists use to refer to the bacteria that causes caries is plaque. Plaque is a gooey film of bacteria, also referred to as a biofilm, that coats the teeth. This same plaque causes periodontal disease. Consequently, when one cleans their teeth thoroughly, they will be preventing caries and periodontal disease.
To understand periodontal disease, I like to use the analogy of a splinter. If you had a piece of wood stuck in your hand and left it there, it would be a matter of time when the area would get infected. That is your immune system working trying to get rid of the splinter. What is happening is your immune system makes the infection that surrounds the splinter and destroys the tissue adjacent to the splinter. After enough destruction occurs, the splinter falls out and the area heals.
In our mouth, plaque coats our teeth and the bacteria in the plaque work their way under the gum making our teeth act like splinters. If left undisturbed, your immune system makes infection that slowly destroys the tissue holding your tooth, including the bone, around the teeth. Eventually, the tooth gets loose and falls out.
Prevention of periodontal disease involves cleaning our teeth thoroughly every day. This involves cleaning between the teeth and slightly under the gums.
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