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What is tooth decay, and what causes it?
Tooth decay is the disease known as caries or cavities. Unlike
other diseases, however, caries is not life threatening and
is highly preventable, though it affects most people to some
degree during their lifetime.
Tooth decay occurs when your teeth are frequently exposed
to foods containing carbohydrates (starches and sugars) like
soda pop, candy, ice cream, milk, cakes, and even fruits,
vegetables and juices. Natural bacteria live in your mouth
and forms plaque. The plaque interacts with deposits left
on your teeth from sugary and starchy foods to produce acids.
These acids damage tooth enamel over time by dissolving, or
demineralizing, the mineral structure of teeth, producing
tooth decay and weakening the teeth.
How are cavities prevented?
The acids formed by plaque can be counteracted by simple saliva
in your mouth, which acts as a buffer and remineralizing agent.
Dentists often recommend chewing sugarless gum to stimulate
your flow of saliva. However, though it is the body's natural
defense against cavities, saliva alone is not sufficient to
combat tooth decay.
The best way to prevent caries is to brush and floss regularly.
To rebuild the early damage caused by plaque bacteria, we
use fluoride, a natural substance which helps to remineralize
the tooth structure. Fluoride is added to toothpaste to fight
cavities and clean teeth. The most common source of fluoride
is in the water we drink. Fluoride is added to most community
water supplies and to many bottled and canned beverages.
If you are at medium to high risk for cavities, your dentist
may recommend special high concentration fluoride gels, mouth
rinses, or dietary fluoride supplements. Your dentist may
also use professional strength anti-cavity varnish, or sealants--thin,
plastic coatings that provide an extra barrier against food
and debris.
Who is at risk for cavities?
Because we all carry bacteria in our mouths, everyone is at
risk for cavities. Those with a diet high in carbohydrates
and sugary foods and those who live in communities without
fluoridated water are likely candidates for cavities. And
because the area around a restored portion of a tooth is a
good breeding ground for bacteria, those with a lot of fillings
have a higher chance of developing tooth decay.
Children and senior citizens are the two groups at highest
risk for cavities.
What can I do to help protect my teeth?
The best way to combat cavities is to follow three simple
steps:
- Cut down on sweets and between-meal snacks. Remember,
it's these sugary and starchy treats that put your teeth
at extra risk.
- Brush after every meal and floss daily. Cavities most
often begin in hard-to-clean areas between teeth and in
the fissures and pits--the edges in the tooth crown and
gaps between teeth. Hold the toothbrush at a 45-degree angle
and brush inside, outside and between your teeth and on
the top of your tongue. Be sure the bristles are firm, not
bent, and replace the toothbrush after a few weeks to safeguard
against reinfecting your mouth with old bacteria than can
collect on the brush. Only buy toothpastes and rinses that
contain fluoride (antiseptic rinses also help remove plaque)
and that bear the American Dental Association seal of acceptance
logo on the package. Children under six should only use
a small pea-sized dab of toothpaste on the brush and should
spit out as much as possible because a child's developing
teeth are sensitive to higher fluoride levels. Finally,
because caries is a transmittable disease, toothbrushes
should never be shared, especially with your children.
- See your dentist at least every six months for checkups
and professional cleanings. Because caries can be difficult
to detect a thorough dental examination is very important.
If you get a painful toothache, if your teeth are very sensitive
to hot or cold foods, or if you notice signs of decay like
white spots, tooth discolorations or cavities, make an appointment
right away. The longer you wait to treat infected teeth
the more intensive and lengthy the treatment will be. Left
neglected, caries can lead to root canal infection, permanent
deterioration of decayed tooth substance and even loss of
the tooth itself.
Sources:
The medical management of dental caries, by Burton
L. Edelstein, DDS, Journal of the American Dental Association,
Jan. 1994; How severe is the threat of caries to old teeth?
By M.I. MacEntee, et al., Journal of Prosthetic Dentistry,
May 1994; Tooth decay, American Dental Association, 1994;
Modern management of dental caries: the cutting edge is not
the dental bur, by Maxwell H. Anderson, DDS, et. al., JADA,
June 1993; Changing paradigms in caries management, by Maxwell
H. Anderson, DDS, Periodontology and Restorative Dentistry,
March 1992; Preventing dental caries: breaking the chain of
transmission, by Ernest Newbrun, DMD, JADA, June 1992; Prevention
of dental caries, by Andrew J. Rugg-Gunn, Dental Uptake, Jan/Feb
1990;
Preventive dentistry: dental caries, by John C. Greene, DMD,
et. Al., Journal of the American Dental Association, Dec.
22/29, 1989.
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