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Risk factors
By Mayo Clinic staffCavities are one of the most common worldwide health problems, and everyone who has teeth is at risk of getting them. But some factors increase the risk that you'll get a cavity or develop tooth decay. These risk factors include:
- Tooth location. Tooth decay most frequently occurs in the back teeth — the molars and premolars. These teeth have lots of grooves, pits and crannies. Although these grooves are great for helping chew food, they can also collect food particles. These back teeth are also harder to keep clean than your smoother and more accessible front teeth. As a result, plaque can build up between these back teeth and bacteria can thrive, producing acid that destroys the 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 it comes to your teeth, the amount of sugary snacks you eat is less important than when you eat them. If you frequently snack or sip sodas, acid has more time to attack your teeth and wear them down. This is also why parents are encouraged not to give babies bottles filled with milk, formula, juice or other sugar-containing liquids at bedtime. The beverage will remain on their teeth for hours and cause erosion — often called baby bottle tooth decay. If you're nursing or feeding an infant formula, talk to your baby's doctor about how to prevent early tooth decay. If you have a toddler who's transitioning from the bottle, don't let him or her wander around drinking from a "sippy" cup.
- Not brushing. If you don't clean your teeth after eating and drinking, plaque builds up, eroding your teeth.
- Bottled water. Adding fluoride to public water supplies has helped decrease tooth decay by offering protective minerals for tooth enamel. But today, many people drink bottled or filtered water that doesn't contain fluoride, and they may miss out on the protective benefits of fluoride. On the other hand, some bottled water may contain added fluoride, and if your drinking water also contains fluoride, babies and children could then get too much fluoride. Talk to your child's dentist about the amount of fluoride he or she may be getting and check ingredient labels on your bottled water.
- Older age. An increasing number of older adults still have their natural teeth. However, over time, teeth can wear down and the gums may recede, making teeth more vulnerable to tooth decay and cavities. Older adults also may use more medications that can reduce the saliva flow, increasing the risk of tooth decay.
- Receding gums. When your gums pull away from your teeth, plaque can form on the roots of your teeth. Tooth roots are naturally covered with a coating called cementum, but the cementum is quickly lost when the root surface is exposed. The underlying dentin is softer than enamel and can become decayed more easily, leading to root decay.
- Dry mouth. Dry mouth is caused by a lack of saliva. Saliva has an important role in preventing tooth decay. It washes away food and plaque from your teeth. Minerals found in saliva help repair early tooth decay. Saliva also limits bacterial growth and neutralizes damaging acids in your mouth.
- Weak or rough dental fillings. Over the years, dental fillings can become weak and begin to breakdown, or the edges can become rough. Either of these situations can allow plaque to build up more easily and make it harder to completely remove plaque.
- Eating disorders. Anorexia and bulimia can lead to significant tooth erosion and cavities. Stomach acid from vomiting, for instance, washes over the teeth and erodes the enamel. Eating disorders can also interfere with saliva production. In addition, some people with eating disorders may sip soda or other acidic drinks throughout the day, which creates a continual acid bath over the teeth.
- 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.
- Close contact. Some harmful, decay-causing bacteria in the mouth can be passed from one person to another by kissing or sharing eating utensils. Parents or even child care providers may pass along harmful bacteria to infants and children, for example.
- Certain cancer treatments. Having radiation to your head or neck areas can increase the risk of getting cavities by changing the saliva produced in the mouth, which allows more cavity-producing bacteria to thrive.
References
- Gonsalves W. Oral health. In: South-Paul JE, et al. Current Diagnosis & Treatment in Family Medicine. 2nd ed. New York, N.Y.: McGraw-Hill/Lange; 2007. http://www.accessmedicine.com/content.aspx?aID=3036775. Accessed March 9, 2009.
- Durso SC. Oral manifestations of disease. In: Fauci AS, et al. Harrison's Principles of Internal Medicine, 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2862909. Accessed March 9, 2009.
- Plaque: What it is and how to get rid of it. National Institute of Dental and Craniofacial Research. http://www.nidcr.nih.gov/NR/rdonlyres/0C900F9D-C582-4609-A62C-CF4AB53E84A0/0/Plaque_brochure.pdf. Accessed March 9, 2009.
- Seal out tooth decay. National Institute of Dental and Craniofacial Research. http://www.nidcr.nih.gov/OralHealth/Topics/ToothDecay/SealOutToothDecay.htm. Accessed March 9, 2009.
- Fact sheet: Tooth decay. Academy of General Dentistry. http://www.agd.org/public/OralHealthFacts/files/pdfgenerator.aspx?pdf=FS_ToothDecay.pdf&id=. Accessed March 9, 2009.
- Eating habits that can harm teeth. Journal of the American Dental Association. 2002;133:1739.
- The oral health of older Americans. Centers for Disease Control and Prevention. http://www.cdc.gov/OralHealth/publications/factsheets/adult_older.htm. Accessed March 12, 2009.
- Kagihara LE. Assessment, management, and prevention of early childhood caries. Journal of the American Academy of Nurse Practitioners. 2009;21:1.
- Caries. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec08/ch095/ch095b.html. Accessed March 8, 2009.
- Oral health: Preventing cavities, gum disease, and tooth loss. Centers for Disease Control and Prevention. http://www.cdc.gov/nccdphp/publications/aag/pdf/doh.pdf. Accessed March 9, 2009.
- Dental amalgam use and benefits. Centers for Disease Control and Prevention. http://www.cdc.gov/OralHealth/publications/factsheets/amalgam.htm. Accessed March 12, 2009.
