The Real Cause of Cavities – Things You Need to Know

Written By


Expert Reviewed By

Dr. Lauryn Lax, OTD, MS

Dr. Lauryn, OTD, MS is a doctor of occupational therapy, clinical nutritionists and functional medicine expert with 25 years of clinical and personal experience in healing from complex chronic health issues and helping others do the same.

Woman In Pain, Cavities

Cavities are holes in your teeth. Learn about cavities, tooth decay and gut bacteria.

What causes cavities?

Contrary to popular belief, it’s not just sugary sodas or bad genetics… The real cause of cavities and your dental health as a whole depends on your gut health.

The Oral Microbiome

Woman In Bed Suffering From Pain Due To Cavities

The “oral microbiome” is the ecosystem of over 300 bacterial species that exists in your oral cavity.  including your mouth, ears, nose, and throat.

Like the gut microbiome, the oral microbiome influences the health of your body as a whole—from cavities, bleeding gums and the smell of your breath, to memory and brain function, blood glucose and metabolism, inflammation, heart health and more (1-4).

7 Essentials to Know About the Gut-Dental Health Connection

Here are 7 essentials you should know about the gut-dental health connection:

1. Cavities, ulcers & other oral health problems are rooted in a weak gut microbiome.

The very first signs of digestive imbalances can often occur in your mouth through signs like a red swollen tongue (B-vitamin deficiency and immune imbalances), thrush and white fuzzy tongue (candida and yeast overgrowth), mouth ulcers and inflamed gums (malabsorption and autoimmune attack) and cavities.

2. Bacteria in your mouth influence the bacteria in your gut.

Bacteria in your mouth naturally pass to your gut when you eat, drink, or swallow saliva. Most people know that the food we eat influences our oral health, but have you ever considered why your dentist told you “Candy will rot your teeth?” Answer: The composition of your oral microbiome changes according to what you eat, how much water (and the quality of water) you drink and our exposure to chemicals in hygiene products. The less bacteria-feeding foods equals better oral health and gut health.

3. Chemicals in oral hygiene products disturb the gut microbiome.

A little known fact is that many oral health products (toxic toothpastes, mouthwashes) can also destroy healthy bacteria—creating conditions for undesirable bacteria to thrive. The mouth may as well be considered the true gateway to health—since it leads directly into the gastrointestinal system.

4. Your oral microbiome is also the only vascular system of your body that has direct contact with both the external and internal environment—particularly through your teeth.

Your teeth are the only non-shedding surfaces in the body (i.e. they don’t regularly lose and replenish cells), which allows for a thin layer of bacteria called biofilm to form on them. If unhealthy bacteria or biofilm get out of control, they can have serious effects on your teeth, gums, and by the rest of the body (5).

5. Bacteria in our mouth look identical to the bacteria in our small intestine.

Research has shown that the bacteria living in the mouth is, both in diversity and in composition, are a close representation of the bacteria inhabiting the upper GI tract (6).

Importantly, however, the bacterial composition of the fecal microbiota (colon) was shown to be different from those of salivary and gastric fluid microbiota. What this may mean?

If an individual has low stomach acid or bacterial overgrowth in your small intestine, they may be more at risk for that same gut bacteria in their mouth. Additionally, test sampling and screening the mouth microbiome via saliva and mucosal swabbing and sampling of dental biofilms could be further insight into what’s going on inside (your gut) (7).

6. Patients experience better dental surgery outcomes if their oral microbiota is healthy.

Dental Chair, Dental Clinic, Dental Or Surgical Interventions To Address Cavities

You are less likely to have ill side effects following a root canal, jaw surgery or wisdom teeth operation if your gut (and oral microbiome) is healthy.

A study of 95 patients who required dental or surgical interventions were evaluated for oral cavity microbiota risk factors associated with general or local infections prior to their surgery. Those with unhealthy oral microbiota were found to be more at risk for negative side effects following surgery (ie. Spread of disease, infection, immune suppression) (8).

7. Chemicals in your toothpaste may trigger gut inflammation.

The chemical Triclosan was introduced in 1972 for use as a surgical scrub in hospitals. Since then, it has increasingly been added to a wide variety of products.

Today, Triclosan is found in toothpaste, mouthwash and other household products (including soaps, sanitizers, cosmetics, deodorant, personal care products, dish detergent, first-aid, kitchenware, toys, and workout clothing).

The Environmental Health Perspectives (EHP) found the chemical in 75% of urine samples tested in one study (9), and the Center for Disease Control and Prevention detected Triclosan in 58% of US waterways (10).

It is practically unavoidable in the U.S., and both topical exposure as well ingestion is linked to to a weakened immune system, allergies, uncontrolled cell growth and gut inflammation, including colitis and colon cancer cell growth (11, 12).

Other chemicals in oral care products, including fluoride, sulfate, artificial sweeteners, and microbeads also top the Environmental Working Group’s list of toxic endocrine disruptors, immune threats and carcinogenic chemicals. For example, fluoride can inhibit biofilms of certain bacteria (13).

It may also alter the gut microbiome by increasing Escherichia coli and Enterococcus spp while decreasing Lactobacillusspp.and Bifidobacterium spp (14, 15).


  1. Chapple, I.L.C., Genco, R.J. (2013). Diabetes and Periodontal Diseases: Consensus Report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. Journal Of Clinical Periodontology. doi: 10.1111/jcpe.12077
  2. Shoemark D.K., Allen S.J. (2015). The Microbiome and Disease: Reviewing the Links Between the Oral Microbiome, Aging, and Alzheimer’s Disease. Journal of Alzheimer’s Disease, 43(3). doi: 10.3233/JAD-141170
  3. Dhadse, P., Gattani, D., & Mishra, R. (2010). The link between periodontal disease and cardiovascular disease: How far we have come in last two decades ?. Journal of Indian Society of Periodontology, 14(3), 148-54.
  4. Gao, L., Xu, T., Huang, G., Jiang, S., Gu, Y., & Chen, F. (2018). Oral microbiomes: more and more importance in oral cavity and whole body. Protein & cell, 9(5), 488–500. Advance online publication. doi:10.1007/s13238-018-0548-1
  5. Kilian, M., Chapple, I.C.L., Hannig, M., Marsh, P.D. . . . Zaura, E. (2016). The Oral Microbiome – An Update for Oral Healthcare Professionals. British Dental Journal, 221. doi: 10.1038/sj.bdj.2016.865
  6. Tsuda A, Suda W, Morita H, et al. Influence of proton-pump inhibitors on the luminal microbiota in the gastrointestinal tract. Clin Transl Gastroenterol. 2015;6:e89
  7. Kodukula, K., Faller, D. V., Harpp, D. N., Kanara, I., Pernokas, J., Pernokas, M., Powers, W. R., Soukos, N. S., Steliou, K., … Moos, W. H. (2017). Gut Microbiota and Salivary Diagnostics: The Mouth Is Salivating to Tell Us Something. BioResearch open access, 6(1), 123-132. doi:10.1089/biores.2017.0020
  8. Zawadzki PJ, Perkowski K, Starościak B, et al. Identification of infectious microbiota from oral cavity environment of various population group patients as a preventive approach to human health risk factors. Ann Agric Environ Med. 2016;23:566–569
  9. Calafat AM, et al. Environ Health Perspect 116(3):303–307 (2008).
  10. Koplin et al. 2002. Pharmaceuticals, hormones, and other organic wastewater contaminants in U.S. streams, 1999-2000: a national reconnaissance. Environmental Science Technology. 36 (6), pp 1202–1211. DOI: 1021/es011055j
  11. Clayton, E. M., Todd, M., Dowd, J. B., & Aiello, A. E. (2010). The impact of bisphenol A and triclosan on immune parameters in the U.S. population, NHANES 2003-2006. Environmental health perspectives, 119(3), 390-6.
  12. Yang et al. 2018. A common antimicrobial additive increases colonic inflammation and colitis-associated colon tumorigenesis in mice. Science Translational Medicine. 10 (443): 4116. DOI: 10.1126/scitranslmed.aan4116
  13. Kaur G et al. 2016. Combinatorial Effects of Aromatic 1,3-Disubstituted Ureas and Fluoride on In vitro Inhibition of Streptococcus mutans Biofilm Formation. Frontiers in Microbiology. 7:861. DOI=10.3389/fmicb.2016.00861.
  14. Staun Larsen L, Baelum V, Tenuta L, M, A, Richards A, Nyvad B: Fluoride in Dental Biofilm Varies across Intra-Oral Regions. Caries Res 2017;51:402-409. doi: 10.1159/000475510
  15. Luo, Q., Cui, H., Peng, X. et al. Dietary High Fluorine Alters Intestinal Microbiota in Broiler Chickens. Biol Trace Elem Res (2016) 173: 483.
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