Tooth Decay Care

Barbara Tritz
· July 6, 2021 ·

10 minutes

Cavity after cavity, and you’re brushing, and flossing, you swear! I believe you. It is time to find the source, or more decay is inevitable.  Here’s a game plan for tooth decay care and prevention.

Tooth decay is a result of host resistance, the food we eat, bad microbes being out of balance, and mouth breathing.  We need to look at all four components of the decay process. 

But you’ve got cavities, you’re overwhelmed, and you just want to know what to do. I get it! Here’s a suggested check list. We’re going to go over the why of everything, plus tools to help you out below, but this gives you a place to start from. (Something not going to work? You do what works best for you.)

TO DO List: 

  1. Get out of pain. Do any fillings that are a danger to health. Deep decay must be removed and restored. 
  2. Icon no-drill fillings are great for smaller decay- Icon. DMG – High quality dental materials for dentists and dental technicians (
  3. See your primary care doc for blood work, food sensitivities, and stool testing – this should happen at the same time as any dental work.
  4. Nutritional evaluation would be great – find the missing vitamins/minerals, and sugars hidden in your diet. 
  5. Myofunctional therapy to ensure proper lip seal and tongue rest posture. 
  6. Myo Munchee to stimulate saliva and so much more. We can put a remineralizing product in the trays although saliva is the best, most natural we have. 
  7. Frequent recare- I would suggest every 2-3 months rather than the six month suggested recare schedule. 
  8. Do salivary diagnostics so we know where we are starting from and thus where we need to go- Finding if there is fungal or viral components would also help the primary care doc.  

Host Susceptibility

Like I said at the beginning, tooth decay is a combination of things, one being how susceptible you are to it. Most dental offices never suggest working with your primary care physician, but this step is critical to finding the real, root cause of the dental breakdown. Teeth are normally resistant to the acids in the mouth and can heal themselves if given the proper tools and nutrition.

Something within the body is creating the environment that is allowing the teeth to literally dissolve. 

For host susceptibility: see your primary care doctor and do blood work, stool sample, and allergy testing for foods. They need to look at gut health as well as vitamin D3 levels. Something is “off” somewhere and sleuthing out the root cause is vital. Look into possible connections to lurking diabetes, leaky gut, celiac and wheat sensitivities as well as vitamin deficiencies. The test results will help lead your doctor to further testing and answers.  Tooth decay really starts in the gut. What you see in the mouth is just the tip of the proverbial iceberg. Bigger issues are happening underneath the surface.

The Food We Eat

Some biology: the fluid flow within the tooth runs from the pulp chamber (where the nerves and blood supply live) to the outer edge of the enamel.  This fluid flows like a lymph system and feeds and nourishes the tooth constantly.

When this fluid flow is halted by sugar or gut dysbiosis/leaky gut, the bacteria and acids from the mouth flow into the tubules and enter the tooth, demineralizing it. (Rather like driving the wrong way on a one-way street!)  Sugar stops the dentinal tubule flow and causes the acids in the mouth to travel up the tooth tubules. That is where decay starts.  Ralph Steinman & John Leonora’s research into causes of tooth decay (  (Research directly here, but behind a paywall, unfortunately!)

Find a functional nutritionist and sleuth out any diet issues, including hidden sugars, and any possible nutritional deficiencies.

Evaluate and consider increasing your intake of fat-soluble vitamins- A, D3, K2, and E. Be sure to compliment their consumptions with fats in order to best break them down and get them into your body! Cook your kale in some good butter, drizzle your carrots with olive oil, or eat a steak with some nice marbling and have your veggies on the side! Fat-soluble vitamins feed the odontoblasts- the healing cells within the tooth.  No vitamins or fats- no nourishment for the odontoblasts. 

Everything we eat is either feeding disease or fighting it. Microbial dysbiosis is the root cause of almost all diseases. 

Bad Microbes Being Out of Balance

Our mouths make plaque every day. There is good, healthy plaque which protects our teeth by buffering acids and remineralizing the teeth with nutrients from our saliva. Plaque is healthy and needs to be there until it becomes unhealthy.  When the microbiome ecology is out of whack then the good bugs are outnumbered by the bad bugs. The bad guys take over. The bad bugs like an acidic environment and feed on the simple carbohydrates and sugars we eat. 

The pH of the mouth is critical to keeping the good bugs healthy. The good bugs like a neutral environment. This neutral pH will help keep the bad bugs in check. 

Eating foods with prebiotics like apples, bananas, seaweed, garlic, and oats feeds the good guys, keeping the mouth neutral and the bugs healthy. 

Mouth Breathing 

As I tell my patients, the nose is for breathing and the mouth is for eating. 

Nasal breathing is a critical part of raising the pH of the mouth, reducing the pathologic plaque, and remineralizing the teeth with a healthy saliva flow. All tooth decay issues also have a mouth breathing component.

The more you mouth breathe, the more clogged your nose gets, the less you can nasal breathe. If the mouth is open, the mouth dries out, no saliva flows, and your mouth stays acidic. The teeth do not get remineralized. No saliva, and tooth decay takes off like wildfire.  Saliva plays a critical role in healing teeth (it’s the Elixer Fixer for your Dry Mouth!).

Watch yourself, your partner, and/or your child for mouth breathing. Watch while reading, or watching TV, or playing video games. Is their mouth open, even slightly? Watch during sleep – at 2:00 AM, not at 10PM – while in a deep sleep. See if the mouth is open. Maybe even record one night.

Myofunctional disorders are an often overlooked part of tooth decay causes. Working with a myofunctional therapist, while it might seem unnecessary, would be a very smart idea. They will help you learn proper tongue rest posture and nasal breathing which are critical for decay prevention as well as for so many other reasons.  They can make a big difference in your oral development and oral health.

Additionally, see an ear, nose, and throat doctor and /or an allergist if you cannot breathe through your nose.  Allergies or a deviated septum should be addressed because nasal breathing is critical to systemic health.

Dental Office Prevention Care

What your dental hygienist can do for you:

  • Help you change the pathologic plaque to healthy plaque. 
  • Teach you how to remove all the plaque. 
  • Help you remineralize your teeth and reverse tooth decay. 

I strongly encourage you to bring your toothbrush to the appointment with you and go to a sink and learn to use it PROPERLY.  Moms and Dads should join in, too, if the children are the focus. 

And, this is important: plaque does not only live on the teeth but also the tongue, throat, tonsils, roof of the mouth, in the saliva, on dental appliances like retainers and dentures, as well as the lips and gums.  We need to clean and remove the pathological plaque from the ENTIRE mouth.

Finding the best tools to get this job done easily and thoroughly are what dental hygienists do best! They are THE oral health prevention specialists. Work with them to have a tooth decay care and prevention plan.

Dental offices can run salivary diagnostic tests for the decay bacteria, as well as fungus/candida and viruses that are all involved with decay. Just as a medical doctor runs tests, so should a dental doctor. We must know what pathogens we are addressing.

Knowing where the problem lies is key to halting and reversing tooth decay. 

Tooth Decay Care Plan Starter Kit

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Disclosing tablets make the plaque easier to see by making it hot pink. Normally plaque is invisible, at least until it is so thick you can’t miss it.  Seeing the plaque helps you see how easy or hard it is to remove, and how good a job you do in removing it. I recommend you use them frequently to help learn how to remove all the plaque.  The ones linked in the pictures are all priced at around 17 cents per tablet.

My in-office disclosing solution is tri-colored. Pink is new plaque, Purple is old plaque (48 hours of older) and blue is acidic (cavity-making) plaque

Now clean off that plaque!

Electric toothbrushes are the best. While you can achieve the same clean with a manual brush, it takes a significantly longer time, and most people just don’t want to sit there for that kind of task. Get the best toothbrush you can afford. It’s an investment in your health.

I love the Kyoui toothbrush. It has a unique bend to the head and can reach all the nooks and crannies. They have both the bent head and a straight head. And, for those with braces, they also have a tiny head called an end tuft brush. This tiny head has angled bristles that will get underneath crowns, braces, and in tight spots. 

I also like the new Sonic Fusion by Waterpik. It is a Waterpik and electric toothbrush in one, irrigation and a super gentle electric toothbrush. I love this combo. 

Use twice a day. It will make a world of difference in your oral health and wellness. 

Regardless of the brush you use and the timer on said brush, brush until your teeth and mouth feel and taste clean (as if I just cleaned your mouth) EVERY DAY.  

Cleaning in-between the teeth is important but my concern is most children do not have the proper dexterity to accomplish this, and sadly, most adults don’t either.  That’s why I like a Waterpik and/or Sonic Fusion, Piksters (dip them in ozone oil (not tasty), BioSal or baking soda!), and GumChucks. Tools that work best in your hands and get the job done are my goal. Ask your fabulous dental hygienist to demonstrate how to use these tools.

Tongue cleaner– yes, you NEED to clean your tongue, as well as the roof of your mouth, gums, and throat.  My favorite tongue cleaner is the Tongue Sweeper. And yes, kiddos need to learn to do this too. 

Mouthwash- I am not a big mouthwash fan but I do recommend gargling with a baking soda/water mixture. The throat and tonsils also have plaque and lots of bad bacteria and other bad guys hanging out in the tonsillar crypts, which sounds spooky and kind of is. Keep ’em clean!

Toothpaste. I get asked daily, “what’s the best toothpaste?”  It depends on what problem you’re trying to address. Toothpaste is not the cure, just part of the solution. 

Here are some problems and the corresponding toothpaste rec. 

  1. Heavy plaque buildup:
    Use a toothpaste containing xylitol. Five servings of xylitol spread out throughout the day will reduce the plaque attached to the tooth by 60%, and that’s without brushing. Add a toothbrush and wow! Research shows that as little as six to 10 grams a day will do the trick. Xylitol gum, mints, toothpaste, even sprinkle some straight from the package, it tastes great. Just don’t overdo it or it can cause gastric distress…  and as a patient pointed out to me, not everyone can process xylitol so if it does not agree with you then don’t use it.
    Numerous toothpastes contain xylitol so find your favorite. My favorites: Spry, Carifree (Fluoride free version), Boka (mint and coco ginger) and Risewell
  2. Sensitive teeth: 
    Toothpastes with remineralizing agents in them help to desensitize teeth by adding minerals back into the tooth structure.  Remineralization helps heal the tooth surface. 
    Risewell and Boka toothpastes have nano hydroxyapatite crystals to remineralize the tooth.  These crystals contain tooth-building blocks of calcium and phosphate. Tom’s of Maine Rapid Relief toothpaste contains Arginine and remineralizes the surface. 
  3. Growing a good healthy plaque microbiome:
    Revitin is a great toothpaste for feeding the good bacteria with prebiotics. It is a different toothpaste made with great, healthy ingredients. 
  4. Killing the bad bugs:
    Dentalcidin and Dentalcidin LS contain all-natural bio botanicals, which kill off the bad bugs while preserving the good ones.  

Non-toothpaste bug-killing bonus products:

  • Basic Bites – medicine that tastes great!  It contains arginine to remineralize and desensitize teeth, raises the pH and adds xylitol to the mouth. Use is AFTER brushing – yes go to bed with this on the teeth.  It comes in chocolate and caramel.
  • Biocidin TS – a BioBotanicals throat spray

Remineralizing agentBioSal is an over-the-counter remineralizing powder that I recommend you mix with a little ozone oil and work it into the gumline with toothbrush or in-between the teeth with Piksters.

Next up: test the pH of the mouth, especially first thing in the morning- that will tell us how acidic the mouth was all night.  (Was it open from 1:00 a.m. to 4:30 a.m., drying out, with no saliva to maintain the pH??) When the pH of the mouth drops below 6.5, minerals come out of the tooth surface at the gumline and when it drops below 5.5 they come out of the top of the teeth, on the biting surface o and demineralize the enamel.  pH is critical to stopping that demineralization of the tooth structure.

Close your mouth! One of my favorite tools is called a Myo Munchee– it is a silicon mouthpiece that you gently chew and can wear to bed. Gently chewing pumps your parotid glands and stimulates saliva which remineralizes the teeth. The chewing action cleans the teeth and it also teaches keeping lips together and nasal breathing.  (FYI, this is not an affiliate link!)

I also like a new tape called Myotape– which goes around the lips and reminds them to stay closed without sealing them shut.

There is a lot to do and can indeed be overwhelming so I hope this tooth decay care plan helps simplify things. Tooth decay can be like playing whack-a-mole, so having a plan and addressing it at the base, root cause is vital to conquering it. Find a good care team that will take care of you – the whole you!

Stay healthy,


Hello, I'm Barbara Tritz

Unveiling the Stories Behind Dental Hygiene

Loving science, especially biology, from an early age, Barbara is a registered dental hygienist, certified biological hygienist, and orofacial myofunctional therapist. In 2019, she received the Hu-Friedy/ADHA Master Clinician Award from the American Dental Hygienist Association.

Share your thoughts below!


  1. Peter Frix

    The Kyoui Sonic 3000 Electric Toothbrush cleans further, farther, faster than my sonicare. Some tooth surfaces are very simple to clean with it. Others take a little time to learn ‘how’ to position the brush. It feels great, actually very relaxing to use. I am a BIG fan – thanks Barbara for the blog entry and the recommendations.

  2. Dr. Vadim Valdman

    Very informative post! People often neglect such issues, which leads to more serious problems. Visiting a doctor and maintaining a proper diet and oral hygiene are very important to prevent tooth decay.

    • Barbara Tritz

      Thank you Dr. Valdman! You are correct. Prevention is so much better than trying to repair. Thanks for stopping by!



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