Okay, let's talk about how cavities form, because I think this is the major question that people ask when asking about or thinking about oral health. As I mentioned before, cavities are literally holes, they're fenestrations, as the nerds call them, nerds like me call them. Little fenestrations, little holes down into the enamel that if they make it down to the dentin layer of the tooth, most likely do need to be drilled and filled and presumably billed, okay?

But your goal, I think all of our goal is to try and keep our teeth in a state of remineralization by keeping the pH, that is the relative acid-alkaline balance of the mouth, such that the saliva supports remineralization. Now, let's think about how a cavity actually forms. Turns out that no specific food, not even sugar, causes cavities.

Cavities are not caused by sugar. Cavities are caused by bacteria that feed on sugar. And now that's not just a little bit of a twist in the mechanism, that's a critical point. There's no specific food, not even pure sugar, not even like a hard candy, like a delicious Jolly Rancher, I used to like those when I was a kid, that gets stuck in your tooth that causes cavities.

No, it's the bacteria that feed on sugar that then produce acid that burrows down through, that degrades, that demineralizes the tooth in this very focal area that we call a cavity, okay? Now, if that isn't surprising enough, get this. The bacteria that causes cavities by eating sugar and releasing this acid, while there are several of them, the major one is called streptococcus mutans, or what I'll call strep mutans for short.

Strep mutans is not something you're born with. It's actually a communicable bacteria. That's right, you give it to one another through how? Sharing of glasses, sharing of bottles, kissing on the mouth, et cetera. Now, I am not here to tell you not to do any of those things. I'm certainly not here to tell you that.

However, and by the way, in researching this episode, I did learn that there is a specific category of person out there. Typically, they are a dentist or married to a dentist. That have opted, believe it or not, to never kiss their children near or on the mouth so as to help their children not get streptococcus mutans because almost all adults carry it, not all, but it's communicable like a STI or like a flu or like a cold.

It's communicated between individuals. We are not born with it. Now, that's a whole area of, let's just call it bio-social ethics decision-making that I think most people are not going to be too concerned with or at least act on because let's face it, most people are not going to change their overall behavior of kissing or usage of bottles or glasses in order to avoid getting strep mutans.

Most people in the world have strep mutans or will get strep mutans and it lives in the mouth, okay? It just resides there. Strep mutans is there and it's hungry. What's it hungry for? Sugar. When there's sugar present, it eats it, it produces acid. The acid produces cavities, taking teeth from a state of remineralization to demineralization or, and by the way, this is really important.

If your mouth is already in a state that's more demineralization mode, so to speak, well, then it will capitalize on that and it will cause cavities much faster, okay? So keep in mind that acidity is bad for the mouth. Does that mean that you should never consume a lemon or, and by the way, yes, I'm guilty of every once in a while I'll chew a lemon slice or drinking water with lemon in it or carbonated drinks or sodas or tea or anything that has acidic flavor?

No. Likewise, should you completely avoid ingesting any kind of sugar because strep mutans love sugar? No. It turns out strep mutans like sugars in the form of complex carbohydrate sugars too. So if you eat pasta or rice or oatmeal and some bread every once in a while, as I do, I'm an omnivore, I eat meat and fish and eggs and also starches and vegetables and fruits.

I'm an omnivore, as most people are. Well, then strep mutans has an opportunity to eat the sugars that come from those other carbohydrates. Does that mean that if you were to have a zero carbohydrate diet, no sugars, no starches, et cetera, you would reduce the opportunity for strep mutans to consume sugar and release acid?

Maybe, maybe. However, most people won't do that. And strep mutans is a very clever, maybe even diabolical bacteria. And if you were on a zero carbohydrate, zero sugar diet, there's some evidence that strep mutans will figure out ways to feed on other components of food in order to create this acid to then create cavities in your teeth.

So the key thing to understand here is that cavities form not from foods, not from sugars per se, but from strep mutans and other bacteria that eat those sugars and create acid. Hence the critical need to keep your mouth as alkaline as possible, which does not mean that you can ever drink some lemon water or coffee or tea.

Here's the key point that everyone needs to remember, because this dovetails beautifully into how often you should brush and floss and when you should brush and floss specifically. The key point is the degree to which your mouth is in a de-min state or a re-min state, and the degree to which cavities have the opportunity to form is dependent on the amount of time, the amount of time in which your mouth is net acidic or net alkaline, the amount of time that you are in a de-mineralization mode or re-mineralization mode.

Okay, so it's the amount of time. No one, no one can avoid having their mouth be acidic every once in a while or ingesting a sugar or a food that strep mutans can feed on and produce acid. The key is to try and reduce the amount of strep mutans and reduce the amount of acid in the mouth.

That's the best way to reduce cavities and even reverse cavities that have started to form.