Takeaway messages:
Visit Your dentist regularly
Do your caries risk assessment HERE
Use Fluoridated toothpaste
Reduce frequency of sweetened food and drinks.
Which disease do you think is the most common today? It’s not cancer, heart disease, or influenza. In every continent, every demographic, and every age group, tooth decay is the most common disease. Despite the fact that tooth decay rarely poses a life-threatening threat, it can cause a person to miss work or school, increase household expenses, and significantly affect the quality of life.
Cavities are traditionally treated by simply drilling and filling — that is, removing the decayed area of the tooth and replacing it with a filling. Over the past few decades, increasing amounts of research have provided us with new insights into how tooth decay occurs and provided us with new approaches for treating it.
The approach is a Risk Factors Approach. Where you identify risk factors associated with tooth cavitation and improve your dental game accordingly.
Saliva:
First, a lack of saliva is a major risk factor. In general, the salivary glands release two liters of saliva daily into the mouth. Having a pH of 7 (the middle of the pH scale; the strongest acids have a pH of 1, while the strongest bases have a pH of 14) allows a neutral acid-base balance.
Natural saliva protects our teeth by preventing them from being attacked by bacteria. This protective function is important because digestion occurs in the mouth. While you eat, tiny particles of food are broken down on the surfaces of your teeth, releasing small amounts of acid. The chemical substances in saliva keep the pH of the mouth from tilting too much toward the acidic, which can break down tooth enamel.
But many people don’t produce enough saliva — a condition called xerostomia or “dry mouth.” In some people, increasing age slows saliva production. Taking certain medications can also cause dry mouth.
If not enough saliva is produced, it can cause serious damage to the teeth, regardless of its cause. The outer coating of the tooth, enamel, is the hardest substance in the body. Nevertheless, when teeth are subjected to a pH of 5.5 (moderately acidic), the enamel begins to dissolve, seriously weakening the tooth’s structure.
Role of Diet:
The second most important risk factor for tooth decay is diet. In adults and children, sweetened beverages are responsible for a large amount of excess sugars in their diets, contributing to obesity. When sugar is consumed in food or drink, it is metabolized (processed) by oral bacteria, which may produce acids as their end product. Cavities are a direct result of these acids.
The effect of diet is not only determined by what you eat, but also by when you eat. In response to eating or drinking, the pH level in your mouth drops. Fortunately, in about 30 minutes, thanks to saliva and helpful bacteria, the mouth is back to normal. When you eat too often, however — snacking throughout the day and constantly drinking sugary drinks — the normal process of recovering to a normal pH does not have enough time.
Plaque:
There is a thin layer of proteins, fluids, biochemical substances, and microbes covering the surfaces in your mouth called a biofilm or plaque. A person’s biofilm plays a major role in their susceptibility to tooth decay. An healthy mouth neutralizes excess acids and contains helpful bacteria to keep harmful ones at bay. Problems can occur when the biofilm is continuously pushed toward an acidic state.
Plaque can be removed by brushing and flossing, but if it is left to build up and harden, it is known as dental calculus. The bacteria that cause oral health problems thrive in tartar, which cannot be removed by brushing or flossing.
Scientists used to think that tooth decay was caused by only two types of bacteria, Streptococcus mutans and some Lactobacillus species. However, with improved methods of genetic identification, we now know that about 40% of adults and children in the US with severe tooth decay do not have Streptococcus mutans in their mouths. In light of that finding, we now view tooth decay as a disease driven by a high prevalence of acid (low pH) instead of a disease caused by bad bacteria.
Genetic Factors:
The final major risk factor for decay is genetics. There are some 40 to 50 genes that play a role in your risk for developing cavities. Some affect anatomy or physiology: how your teeth are formed or how much saliva you produce. Others may have a behavioral impact: for example, whether or not you have a craving for sugar — a “sweet tooth.” While the overall influence of genetic factors on cavities is thought to be about 9%, for some it may have a big effect. Genetic variation can explain why individuals with the same diet, environment and oral hygiene habits have a very different outcome with respect to cavities.
What’s Your Risk:
When your dentist fills your cavity. They are merely treating the end result, but it doesn’t change the reason why the cavity developed — and it doesn’t keep you from getting more.
In this scenario, a dental assessment can help you determine whether you are at risk for developing cavities. You might be taking a medication that inhibits saliva production; perhaps your biofilm is out of balance; or perhaps your diet is a contributing factor.
An individual’s risk factors are determined by a Caries risk assessment.
Currently, people can begin by filling out a short form, answering questions such as:
“What medications do you take?”
“Do you often snack between meals?”
“Do you notice plaque on your teeth between brushings?”
You can use the answers to not only pinpoint issues that may increase your risk of cavities, but also have a basic understanding of the health of your mouth going forward. They can also perform tests on your mouth chemistry and assess your biofilm, which can provide specific information about your risk factors.
Does the system really work? Years of research, including a recent large study in the San Francisco Bay Area, demonstrate that it does. In fact, caries risk assessment is now the standard of practice taught in every accredited dental school in the United States. And while it isn’t yet a routine part of all dental checkups, the practice is becoming more and more widespread.
What You Can Do to Control Cavities:
Are there any steps you can take if you know the risk factors? In general, the answer is yes. Using a fluoride toothpaste or mouthwash with a higher (more basic) pH can help you maintain healthier (less acidic) conditions in your mouth and promote a healthier oral environment.
The fluoride itself benefits your teeth: It is assimilated into your tooth structure, and it reduces the processes that cause demineralization (erosive erosion of your enamel).
In small amounts, fluoride is added to some municipal water systems to reduce the incidence of cavities — as is the case with toothpastes and mouth rinses when used as directed.
Toothpaste and rinses that contain xylitol can help prevent cavities. Studies have shown some evidence of its therapeutic benefits and its ability to interfere with acid-loving bacteria.
Changing your diet can also be helpful. Sugar intake needs to be reduced, and food and drinks (not including water) should be restricted around mealtimes to prevent biofilm buildup.
An assessment of your oral health risks may reveal other conditions, such as dry mouth from medications, which may make positive dietary changes even more crucial.
Conclusions:
Despite our growing knowledge about it, tooth decay is likely to remain a common condition for the foreseeable future. Our evidence shows that it’s quite possible for individuals to significantly reduce their risk of decay and become cavity-free.
Knowing how the oral biofilm mediates disease — and how acidic pH levels affect it — allows us to determine each patient’s risk for tooth decay and tailor a plan to counter it. Hopefully, caries risk assessment will become part of routine dental care as more people become aware of its benefits.
