The Latest in Dental Treatment and Prevention

Medicine (and Dentistry) has moved from a model of treatment to a model of prevention.  Cavities are no longer a mystery.  We have learned that brushing your teeth, flossing, fluoride, and cutting out sweets helps prevent cavities.  Have you ever asked, “why”?  Have you known people who brush and floss 5 times a day and still get cavities?  Know anyone who never brushes, eats candy like there is no tomorrow and gets NO cavities?  So unfair!!!

So let me tell you WHY!

A cavity occurs when acid breaks down your enamel (the hardest outside layer of your tooth) and forms a hole or “cavity”.  Where did the acid come from?  Bacteria convert carbohydrates (and their favorite is sugar) into acid.  When that acid sits in the same place long enough, it bores a hole through your enamel and into your tooth.

Brushing and flossing helps mechanically to move the acid and bacteria around so that the acid doesn’t sit in one area too long and cause a hole.

Fluoride helps in that it is like sunscreen.  Instead of preventing “sunburn” it helps prevent “acid burn” or cavities in your teeth.  The fluoride ion becomes incorporated into the enamel and become much more resistant to acid break down.  Fluoride is great!  But just as SPF 15 won’t help you in the Mohave Desert, Fluoride alone can’t keep all cavities from happening.

So why do some people do everything right and still get cavities and some people not care for their teeth and get no cavities?  It’s the bacteria!  Some people have a lot of the cavity causing bacteria and some people have very little.  The bacteria is transmissible so it is possible to get by sharing food, and sucking spit – I mean kissing. 

Can we do anything about the bacteria?

YES!  Xylitol exposure can help promote the good bacteria in your mouth and kick out the bacteria that causes decay.  It’s like a “probiotic”.



  suck on a 2g xylitol mint for 10 minutes

      chew 2g of xylitol gum for 10 minutes

  sip on coffee/tea containing 2g xylitol as sweetener for 10 minutes

  suck on a 2g xylitol mint for 10 minutes



Prevention is always first, but what are some of the latest treatments to cavities?

No numbing, no drilling, no filling, a liquid cavity stopper!

Recently, the FDA cleared Silver Diamine Fluoride for use in the United States.  Silver Diamine Fluoride has a long track record in other countries and has been proven to temporarily stop cavities. Silver Diamine Fluoride is a liquid that can be applied to the area of the cavity and let sit.  Often fluoride varnish is applied on top of the silver diamine fluoride or a fluoride releasing filling material – “glass ionomer” is applied in larger, easy to access cavities.  Silver diamine fluoride is not considered “definitive treatment” and PERMANENTLY STAINS THE DECAY BLACK.  The main use of silver diamine fluoride “SDF” is for patients that cannot undergo conventional dentistry – small children, elderly, severely phobic, or patients that are medically compromised. SDF is also an option for very small cavities that are not “big enough” to warrant a filling AND are not in an esthetically compromising position when the cavity turns black (a good option for between back molars).


So now you know about brushing, flossing, fluoride, xylitol, and silver diamine fluoride!