The Specialist

Why you have so many cavities

Cavities, like periodontal diseases, are rampant in The Bahamas. A PAHO (Pan American Health organization) study completed in 2000, examined the oral health status of school-aged children in The Bahamas. The survey then gave us a glimpse of the seriousness of this public health crisis. It concluded that cavity prevalence, between the ages five and 15 years, is over 60 percent. Since that time, with the onslaught of sugar in so many of our diets, coupled with my clinical observations over the past 30 years of practice, I would say it is far worse today.

Due to the effective use of water fluoridation programs and fluoride toothpaste, cavities (scientific name is caries) in many countries like Western Europe and North America have decreased by 90 percent.

In The Bahamas, the fluoride level in our tap water varies from too low to too high, depending on which Family Island water is measured. As a result, we experience two extremes – on one hand we see rampant cavities in most areas where fluoride is non-existent and on the other hand, we see enamel fluorosis, the result of too much fluoride in the water. Additionally, the many bottled drinking waters on the market today in The Bahamas are also non-fluoridated.

Enamel fluorosis

Enamel fluorosis is a defect of tooth enamel caused by too much fluoride intake during the first eight years of life. It is an unusual staining and hardening of your teeth. Although fluorosis can be cosmetically treated, the damage to the enamel is permanent.

Have you noticed, as you age you are still getting cavities?

The challenge with many cavities in adults is that they often occur in difficult-to-reach areas. Some of these areas are in between the teeth, on the root surfaces under the gum line and under prosthetic crowns. Believe me, your dentist is not pleased treating these areas because they are very difficult to reach.

Cause of cavities

As babies and adolescents, our saliva has a neutral pH or is slightly alkaline. This is a measure of the acidity or alkalinity of a solution. When the reading is below seven, it is acidic and when above, it is alkaline. An acidic environment causes an erosion of your teeth. As we age, it is likely that our saliva becomes more acidic for the following reasons:

• We are more likely to take several medications. One of the side effects of many medications is that they cause your salivary glands to not work to satisfaction. As a result, our mouth becomes dry.

• Our salivary glands tend to not function as well as when we were babies. Remember seeing or experiencing the enormous amount of saliva that drains from a baby’s mouth. That is God’s way of protecting the little darlings by self-cleaning and self-medicating their mouths.

• Dry mouth is an acidic mouth and an acidic mouth causes erosion of your enamel and more disease. Bacteria flourish in this environment.

• The sugar and carbohydrates you consume causes your pH levels to become more acidic thereby causing more cavities.

What you should do

Speak to your medical doctor about the many medications you take. Perhaps it’s time that they would consider withdrawing one or more of them while using an alternative medication or even better, institute a proper exercise and nutritional approach to improve your health status.

• Reduce the sugar in your diet. Sugar comes in many forms. Processed food has sugar. We love candies, cakes, puddings, chocolates, etc. Sugar increases the incidence of decay.

• Measure the acid level in your mouth. You may use a special test paper. The acid-detecting paper is placed in the mouth until it gets wet. It then changes color and is compared to a color chart to determine your pH (acid level). A good reading should be seven, which is neutral.

New approaches to
managing your pH level

Have you ever heard of xylitol? Xylitol is a sugar that has been known to neutralize the pH level. By doing so, it remineralizes decaying tooth structure. This means it actually begins to reverse the decaying process making your teeth harder and less susceptible to cavities.

If you don’t produce enough saliva, you can buy a rinse that stimulates your glands. A simple home remedy is to use baking soda rinses. The pH is higher than 7.0, and will neutralize acids very fast. Take a tablespoon of baking soda, mix with eight ounces of water, and just rinse with a mouthful of it and spit out; do this two-to-three times per day.

Also, you may eat more raw vegetables, which reduces the acids in your mouth, helps with digestion and has important nutritional benefits.

Therefore, despite the challenges that come with aging, there are home remedies that are effective. Visit your dentist for professional help today.

Next issue: How your dry mouth is killing your teeth

• Dr. Kendal V. O. Major is founder and CEO of Center for Specialized Dentistry, a comprehensive family dental practice operating in New Providence and Grand Bahama. He is the first Bahamian specialist in gum diseases and dental implants since 1989. He is also a certified Fastbraces provider. His practice is located at 89 Collins Avenue; he can be reached at telephone (242) 325-5165 or

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