It’s time for your 6 month dental checkup.  The last time you were in, you needed 3 cavities filled despite the fact that you brushed twice a day and even flossed most days.  “What can I do to keep from getting so many cavities?” you asked the dentist.  “Well, you’ve just got to do a better job of keeping your teeth clean and lay off the sweets.”  So for the last 6 months, you have brushed with a vengeance after every single meal.  You’ve become a flossing ninja.  Brownies and skittles have been replaced with broccoli and carrot sticks. You’re certain that things are going to be different this time…

this time you’ll join the ranks of the cavity free club.  You can’t wait for the dentist to come in and marvel at your flawless pearly whites- he may even ask you to be the spokesperson for his office!  But, after the normal pleasantries, you’re dismayed that he seems to be spending an awful lot of time staring at one of your x-rays.  And when the instrument sticks in the grooves of one of your molars, you know it means trouble.  You leave feeling depressed… a huge failure.  You dread going home and having to tell your husband that you need dental work……again.  And to make matters worse, he just got a clean checkup yesterday despite the fact that he brushes about twice a week and flosses once a year (the morning before his checkup).  How can this be????

Sound familiar?  It’s a situation that I encounter all too often.  Let me preface by saying that these cases are the exception rather than the rule.  For most people, proper diet and oral hygiene will control dental disease.  However, I encounter many patients who are doing all the right things and yet their dental health is still deteriorating.  Others seem to be using the wrong end of the toothbrush and never have any problems.  The reason for this became clear after reading a book by Kim Kustch called Balance that challenged most of what I’d been taught about tooth decay.  Most dentists were taught that tooth decay, or caries, is caused by a bacteria called Streptococcus Mutans that lives in the mouth.  When we consume sugar or carbohydrates, the bacteria feed on it and produce acid as a byproduct (yes, they are going “potty” on your teeth!) The acid eats holes in the teeth and cavities result.  The solution, we were taught, was simple- just remove the bacteria with good oral hygiene, don’t feed them sugars, and you’ll be free of decay.  The problem is that it’s just not that simple.  In fact, it’s incredibly complicated.

Research has since shown that dental plaque is composed of thousands of different bacteria and the interactions between them are so complex, they make the tax code look simple in comparison.   Each of us has a unique group of bacteria colonizing our mouth- some are capable of producing huge amounts of acid that lead to excessive tooth decay, some are prone to causing gum disease, and others are associated with good oral health.  Dental caries is a bacterial infection.  Furthermore, it is transmissible- family members can transmit the infection to one another so if you are very cavity prone, realize that your children or spouse may be at high risk too. 

So what can you do?  First, understand that dentists can drill and fill cavities all day long but, we’re only treating the result of the disease, not the disease itself- the decay will come back.  Treating the disease requires managing the bacteria and risk factors.  One of the most important things to minimize your risk of decay is to reduce the overall number of bacteria present by brushing 2 minutes, twice a day and flossing once a day.  However, it is impossible to sterilize your mouth.  So we also need to consider how to shift from harmful, cavity causing bacteria to healthy bacteria. 

Consider a neighborhood that’s been overrun with crime.  At one time, it may have been a very nice area with beautiful houses and friendly neighbors.  But, at some point, thugs moved into the area bringing crime and creating unpleasant living conditions.  The good members of the community began to leave and more crime filled the void.  The only way to make the area hospitable again is to clean house- round up the thugs, flatten the run down homes, and start over. This is basically what has to happen to the bad bacteria that have set up shop in the mouth.  Only after wiping them out and starting fresh can the mouth begin to repopulate with good bacteria.  In our office, we do this by first assessing a patient’s individual risk factors.  Also, we may use a series of antibacterial rinses made by Cari-free for a period of weeks or months that help restore a healthy balance in the mouth.  I began using them myself 2 years ago when I discovered several early stage cavities on my x-rays.  So far, they have remained inactive and have not required fillings.

Often it is wise for a whole family to undergo treatment together in order to minimize the risk of re-infecting one another.  Other risk factors such as dry mouth, medications, acid reflux, and ill-fitting dental restorations can also contribute to tooth decay.  Your dentist should be able to help you determine how to best minimize your risk factors.  Finally, diet is extremely important. Those acid producing, bad bacteria thrive in acidic and sugary environments. That means a steady diet of Sundrop and candy will guarantee you more cavities…….. you can’t outbrush a terrible diet!!! 

There is hope for those plagued with dental decay.  Treat the infection, minimize the risk factors, remove the bacteria, and don’t feed the ones that remain.  I hope you’ll like and share this post. If you have questions about this or other oral health topics, please ask on our website at

Dr. Nathan Cory Glenn, DDS

215 S. Jefferson Street,  Winchester, TN 37398

PHONE: 931-967-1933 • FAX: 931-967-5381