The Cavity PUZZLE

By Dr. William Plumb, DDS, Plumb Dental

Recently, a patient came into my office and was diagnosed with cavities on several of her teeth. One was so severe that she ended up losing the tooth. It had been less than a year since her last visit, and she practiced great oral hygiene and had not proven to be cavityprone in the past.

At first, I couldn’t understand or explain why this happened. We walked through her nightly routine, which included brushing with a mechanical toothbrush and flossing on most nights. Nothing in her diet had changed. She confirmed that her prescription medication was the same as last year, and she was still using a CPAP machine.

When I questioned further about over-thecounter medicines or supplements, she remembered that she had been having trouble sleeping and had started using melatonin regularly. The melatonin she used came in gummy form, with added sugar for flavor. Although she spent adequate time cleaning her teeth, she would pop a couple of pieces of what essentially was candy into her mouth right before hitting the pillow. The oral bacteria were then able to work on that sugar the whole night, metabolizing it into acid that ate away tooth structure, causing decay.

I was happy we were able to identify the problem; it will make her future dental work much more predictable. But I would prefer that it had never occurred in the first place.

Diet and nutrition play a critical role in oral health. Unfortunately, nearly everything we consume has sugar. It’s important that if we’re not in the position to brush our teeth right after we eat that we at least rinse our mouths out with water. This practice helps remove some debris and balances the pH.

What we fail to recognize sometimes is that many of the supplements and medicines we take over the counter also contain sugar. Cough drops, cough syrup, and vitamin gummies are huge culprits. If taking these medicines or supplements before bed, I recommend doing so prior to brushing and flossing. Look for products that are labeled “sugarfree,” especially if they dissolve slowly in your mouth over time. And remember that the most important time to have a really clean mouth is during the night when conditions are more conducive for pathological bacteria to flourish.

About the Author

Dr. William Plumb, DDS, Plumb Dental

Dr William Plumb graduated from the State University of New York School of Dentistry in 2006. He opened Plumb Dental in St George, Utah, in 2009. He has received extensive continuing education in cosmetic dentistry as well as oral surgery and implantology. Dr. Plumb loves living in southern Utah with his wife Kari and their four children.