How to stop or even reverse cavities?

Question

This is not a question that requires any knowledge of dentistry. All I ask for is your personal experience.

What do you in case of a cavity and don't want to go dentist because you fear the side effects of drilling?

Answer 1

I can speak from personal experience, and from experience working as a physical chemist peripherally associated with a group researching dental care.

My personal experience is that I have a few lesions that my various dentists over the last couple of decades have decided not to fill because they are not serious and not getting any worse. So a dentist will not necessarily reach for their drill at every opportunity.

My research experience is that at least in vitro enamel can remineralise, but you are talking about incremental improvements and nothing approaching total repair of a cavity. Any major cavity will not repair itself.

It is impossible for you to assess the damage to your teeth because you have neither the skills nor the equipment required. Your dentist has both, and you should respect their judgement. Your dentist should probably not have been impatient with your questions, but bear in mind that by questioning him you are implying he does not know what he is talking about and even the most saintly of dentists will get fed up with this eventually.

Answer 2

There are really two different questions posed here:

1. How to stop or even reverse cavities?

This is currently only partially possible in the sense of slowing down the further spread and development of caries.
Eliminate acids and sugars from your diet, that includes starches and other cariogenic carbohydrates. Practice impeccable oral hygiene with lots of fluoride toothpaste, interdental cleanig with mouth washes, tooth picks and floss. Drink lots of green tea and milk. All of this – and more, if believe what's floating around the net popularly and mostly falsely – has very limited effects and cannot fully replace a visit to the dentist under any normal circumstances.

Cavities cannot be "reversed", that is rebuilt and filled up to a fully working intact tooth. Not with miracle supplements, exotic foods and not even by a dentist, except that a dentist might have suitable substances to fill the cavity.

That answers hypothetically a question with unrealistic goals.

And the real question:

2. What do you in case of a cavity and don't want to go dentist because you fear the side effects of drilling?

_{First thing is of course something of the past in this case: try to prevent the cavity from forming in the first place. this is called prophylaxis and includes the usual: limit carbohydrate contact with teeth, practice oral hygiene and visit a dentist, not to let her drill anything, but to remove calculus and get protective lacquer layers. But as this is apparently too late in a case with developed cavities:}

Someone with a cavity who does not want to go to a dentist because of the fear of drilling has to go to the dentist and let her drill and fill. The biggest problem in the scenario presented is not the procedure itself but the anxious anticipation that prevents a necessary and very, very probably best option.

The secret of success is mentioning the anxiety involved and then requesting at least one of the following or even two drugs at once. Most of the time the request will be preempted by an offer:

1. a large dose of local anaesthetic – for example Lidocaine – that will prevent any pain from being registered in the brain
2. an adequate dose of a one-time anxiety reliever or even a sedative that will make your brain not only dull to the pain but utterly uninterested in the effects for a while that is long enough until the procedure is over

Dentists can also prescribe medications such as antibiotics, sedatives, and any other drugs used in patient management.
_{Wikipedia: Dentistry#Dental treatment}

Current methods of sedation in dental patients - a systematic review of the literature Med Oral Patol Oral Cir Bucal. 2016 Sep; 21(5): e579–e586. Published online 2016 Jul 31. doi:10.4317/medoral.20981

WebMD: Sedation Dentistry: Can You Really Relax in the Dentist's Chair?
MouthHealthy, ADA, Anesthesia and Sedation
ADA Guidelines for the Use of Sedation and General Anesthesia by Dentists 2016
SedationDentstry4U
Inform yourself before requesting any of that and do not fixate on a specific combination, but discuss this with your dentist.

Answer 3

As I understand it, the current consensus among dentists and scientists is that cavities which have reached the dentin layer are too big to heal using any existing technology, but that carious legions (areas of the tooth that have begun to erode through demineralization) can be remineralized with a lot of methods. Your own saliva contains calcium which regularly remineralizes teeth when conditions are right (mostly that pH is high enough). Almost all toothpastes help remineralize by containing some combination of calcium, phosphorous and/or fluoride.

As has been mentioned by other responses, there is some promising research on repairing teeth with substances like AD drug tidesglusib. None of these treatments, to my knowledge, are ready for non-experimental use.

The reason this problem is so tough is that tooth enamel is not a living structure like much of your bone is. It does not contain any living cells. The pulp in your teeth is alive, and can manufacture a small amount of protective dentin (the intermediate layer) to repair damage from the inside, but hasn't been shown to repair the enamel. Once bacteria have reached the dentin by wearing a cavity all the way through your enamel, there is no easy way to kill that bacteria so it is assumed that it will continue to thrive in the cavity until it reaches the pulp and ultimately destroys the tooth. Fillings are created by removing all the weakened and infected enamel and replacing it with an artificial material to protect the rest of the tooth.

Wikipedia provides references for most of this: https://en.wikipedia.org/wiki/Tooth_decay

And here is the information about tidesglusib, which is expected to begin human trials in 2019: https://epatientfinder.com/human-trials-regrowing-teeth-expected-start-2019/

In answer to your second question, the best thing to do to start out is to get a dental x-ray. This will show you how deep the cavity has penetrated and you may well be able to stop its progress by stepping up your dental care and nutrition, making a filling unnecessary.

Answer 4

There were two questions here, but I'm only going to respond to the one in the headline "How to stop or even reverse cavities?" with one possibly helpful ingredient of the puzzle.

Besides the regular brushing advice that dentists have been giving for decades, a more recent discovery is the benefits of xylitol on oral health. Studies have shown that oral products with xylitol in them have been "observed to be effective in preventing caries" (cavities). These oral products include xylitol chewing gum, xylitol gummy bear snacks, xylitol mouth rinse, and xylitol toothpaste.

According to a medical article published in 2014, on https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232036/ it says regarding xylitol:

"The predominant modality for xylitol delivery has been chewing gum. Chewing gum accelerates the processes of rinsing away acid and uptake of beneficial calcium phosphate molecules to remineralize tooth enamel."

It also says:

"A study among Montreal children showed that children who chewed xylitol gum had significantly lower caries progression after 24 months than those who did not use gum. These children exhibited a significantly higher number of reversals of carious lesions than the control group, suggesting that remineralization has occurred."

It also talks about xylitol syrup:

"Twice-daily administration of xylitol oral syrup at a total daily dose of 8 g was observed to be effective in preventing caries."

Regarding xylitol toothpaste, it says:

"Toothpaste with xylitol led to a decrease in S. mutans colonies in saliva, the amount of secreted saliva, and the increase of pH value. It has a positive effect on the quality of the oral environment and it would be useful introducing it into prophylactic programmes."

The study concludes that:

"...more research is needed on the mechanisms of action of xylitol..."

and

"While these issues of xylitol still need to be expanded, the benefits it offers are literally worth salivating over."

Please read the full article for all the details.

An additional medical article from https://www.ncbi.nlm.nih.gov/pubmed/14700079 notes that they did a study where samples were soaked in xylitol solution, and says that:

"These results indicate that xylitol can induce remineralization of deeper layers of demineralized enamel by facilitating Ca2+ movement and accessibility."

Xylitol is a sugar substitute, with 40% less calories and 75% less carbohydrates (than sugar), that naturally occurs in fruits and vegetables, which doesn't have the negative side effects reported from many artificial sweeteners.

Xylitol chewing gum, mints, mouth rinse can be found at many stores but are especially prevalent in many health food stores.

This answer wasn't meant to replace any recommendations from a dentist, and was only intended to point out some newer things to possibly supplement your usual oral care. You should probably consult a dentist, if you think you have a cavity.