During the Halloween season, everything seems to be a little spookier, but few things elicit a bigger scare for kids — and college students — than cavities.

Cavities are a real and pressing danger for college students. If you eat a lot of candy, stay up all night without brushing your teeth or simply don’t make it to the dentist for your semi-annual checkup, you could easily get a cavity this Halloween season.

But what exactly is a cavity? A little research and a conversation with a dental hygiene student shed some light on the topic.

What is a cavity?

The first thing to know about cavities is that they always start with a spot of decay. Our mouths are home to many different kinds of bacterial microbes. Depending on what we eat and how we clean our teeth, some of these microbes can overpopulate on the surfaces of our teeth.

A certain kind of these bacterial microbes, mutans streptococci, love sugar almost more than we do. This bacteria uses carbohydrates as an energy source and then produces acids as a byproduct. These acids erode the enamel armor around our teeth and begin the process of tooth decay. If tooth decay goes ignored, the bacteria will erode a pathway through a tooth’s enamel into the inner tooth’s dentin, said Mollie Mitchell, a junior dental hygiene student from Chattanooga, Tennessee.

“Enamel surrounds the dentin,” Mitchell said. “Enamel is actually a lot harder than dentin, so when cavities begin, they begin at the enamel because that’s the outside surface. As they progress, they move inward towards the dentin.”

How do you treat a cavity?

Once the decay reaches the dentin, the bacteria can quickly travel to the nerves of a tooth and can eventually kill the entire tooth. Once a nerve is compromised, the cavity will become extremely painful to live with and treat, so it is important to treat cavities as early as possible.

“Whenever you have a cavity that is beginning, we call that an incipient lesion, because there is actually a chance that [the enamel] may remineralize if you are using fluoride and if you’re brushing and flossing like you should be and removing that bacteria,” Mitchell said. “But once [the cavity] enters the dentin, it moves a lot quicker because the dentin isn’t quite as strong or hard as the enamel, and so once it enters the dentin, you’re going to have to have a restoration.”

These incipient lesions are described by dentists as “watch spots.” In regular checkups, a dentist may catch these spots and give the patient advice on how to reverse them before they become cavities. Once a cavity is formed, a dentist has to restore the tooth with a filling.

Mitchell said there are two types of filings: amalgams and composites.

“Amalgams are the silver that you can see in the mouth,” she said. “It doesn’t match the tooth — it looks like metal, [while] composites are tooth-colored,” said Mitchell.

So, good news: if your teeth turn out to be riddled with cavities, there’s at least the option to keep them white with composite fillings.

More good news: good dental hygiene is all you need to maintain a filling.

“As long as the dentist has done [his or her] job and made sure that amalgam or that composite was done correctly and it fits your tooth and the contours are correct, it should match the anatomy exactly of your tooth, of how it was before,” Mitchell said. “So really you just would be brushing or flossing just as you were before.”

But maybe a bit more frequently because after all, you had to get a cavity fixed. No judgment, though.

Bad genetics?

Confession time.

In my own experience, I have struggled to prevent cavities. Every time I enter the dentist’s office, I begin to sweat. My last appointment ended in terror after the dentist told me I had nine spots of decay and three of those would require fillings. This brought my cavity count to ten, not including the six spots that are categorized as “watch spots.”

I explained to the dentist how hard I work to keep my teeth clean. My dentist responded by saying that it could just be bad genetics, which is not the first time I’ve heard that phrase concerning my teeth. So I thought I’d ask Mitchell about it.

“What we’re taught in our program is that a tooth is a tooth,” Mitchell said. “Genetically, there is no way that you’re going to be more prone to cavities or not.”

I guess that means blaming my cavities on “bad genetics” isn’t entirely acceptable. It’s simply not true.

“But some families will obviously have more cavities than others, and it’s all environmental,” Mitchell said. “It’s your diet. It’s how you were taught to clean your teeth. It’s how often you’re taking care of them.”

So, I might still be able to blame my family, but not as directly as I might like.

At the end of the day, your teeth are your own responsibility.

Am I always going to have to deal with cavities?

You can get cavities at any age in your life, but children tend to be more susceptible to tooth decay. This is mainly because children are developing their adult teeth. Mitchell said that it is important for children to use fluoride and drink fluoridated water, so they develop strong teeth. After young adulthood, people tend to have fewer cavities.

“The biggest time that we see people having cavities is from childhood up until their 20s, and then it usually goes stagnant for a while until you hit about your fifties,” Mitchell said. “As you get older, you get something called recession, which is when the gum moves away from the tooth and the root surface of the tooth gets exposed, and the root surface is not nearly as hard as the enamel because there is no enamel.”

Recession leads to older adults getting root cavities.

It’s Halloween, so what about sugar?

“The number one thing I tell people is, you can have as much candy as you want, but the frequency is more important than the amount,” Mitchell said. “If you’re going to eat candy, you need to sit down and eat it all in like thirty minutes and then brush your teeth afterward. But if you’re snacking on candy corn all day long, or you’ve got a big Coke and you’re drinking on it from 9 in the morning until noon, that’s the longer period of time that your teeth are exposed to the acidic breakdown.”

In other words, candy is OK for your teeth, as long as you continue to take care of them. When considering your diet, think about your teeth. They can handle candy in moderation if you give them the proper care.

We hope you and your teeth have a fun, safe and healthy Halloween.