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Frequently Asked Questions About Dental Health

Does my diet really affect my dental health?

Yes, diets low in certain nutrients reduce resistance to oral and dental infections, that is, periodontal disease (gum disease) and decay. A healthy immune system is essential to controlling periodontal disease.  Excessive consumption of sugar, especially soda pop, candy bars, or in a baby bottle contributes to the rapid development of dental decay.

The trace nutrient fluoride, may not be adequately supplied in municipal water supplies. Supplementation with oral tablets and topical application will reduce the incidence of dental decay by more than 60%.

Together, a balanced diet, daily use of fluoride, effective brushing, and sensible eating habits can reduce the risk of, or even prevent, infectious dental disease.

Please don't hesitate to call our office if you need more information on diet or fluoride supplementation and its relationship to dental health.

Can I Prevent Cavities?

To prevent your teeth from decaying, you can do two things — reduce the amount of bacteria in your mouth, and strengthen you teeth's defenses. Although you can never totally get rid of bacteria in your mouth, you can reduce it greatly by brushing regularly and flossing daily, seeing your dentist and dental hygienist twice a year for a thorough cleaning and check-up, and by reducing the number of times each day that you eat fermentable carbohydrates or drink sugary drinks.

Some prescription mouthwashes can help prevent decay by reducing the number of bacteria in the mouth. Chewing sugarless gums, especially those with xylitol, can help prevent decay by increasing the flow of saliva, which has antibacterial properties.

Fluoride is the best resource available for protecting teeth from decay and healing early acid damage. Fluoride strengthens teeth by penetrating the tooth structure and replacing lost minerals to repair acid damage. Sealants, which provide a protective coating over the tops of vulnerable molars and premolars, block bacteria and acids from sticking in the tiny grooves on the chewing surfaces of these teeth. And general good nutrition will keep the quality of saliva high enough to protect against acid and provide minerals for re-mineralization.

How Do Teeth Decay?

To understand what happens when your teeth decay, it's helpful to know what's in your mouth naturally. Here are a few of the elements:

Saliva — Your mouth and teeth are constantly bathed in saliva. Although we never give much thought to our "spit," this simple fluid is remarkable for what it does to help protect our oral health. Saliva keeps teeth and other oral tissues moist and lubricated, washes away some of the food particles left behind after we eat, keeps acid levels in the mouth low, and protects against some viruses and bacteria by carrying immunoglobulins and other substances important for immunity.


Pellicle — Certain proteins in saliva (glycoproteins) are absorbed by the surface of our teeth. This creates a microscopically thin, clear coating on the teeth called "acquired pellicle." The pellicle starts forming immediately after you brush your teeth, and, within a few minutes, you can feel that slippery, moist feeling on your teeth. The pellicle helps shield the teeth against acid that can cause caries. However, the pellicle also forms a prime surface for bacteria and other microorganisms that lead to the development of plaque.
Plaque — Plaque is the scourge of the mouth. It appears as a soft, gooey substance that sticks to the teeth a bit like jam sticks to a spoon. It is, in fact, colonies of bacteria, protozoa, mycoplasmas, yeasts and viruses clumping together in a gel-like organic material. Also in the mix are bacteria byproducts, white blood cells, food debris and dead body tissue. Plaque grows when more bacteria join in, when the bacteria already there start to multiply, or when bacteria byproducts and food debris accumulate. Plaque starts forming immediately after a tooth is cleaned. It builds up to measurable levels after about one hour and takes an average of seven days to fully mature. As it matures, more and more different types of microorganisms appear, the plaque thickens and gum inflammation begins. Plaque that forms on the crowns of the teeth, the part that shows above the gums, is called supragingival plaque; plaque under the gums is called subgingival plaque
.
Calculus — If left alone long enough, plaque begins to mineralize and harden into calculus, also known as tartar. Calcium, phosphorus and other minerals from saliva become incorporated into the plaque, form crystals and harden the plaque structure. Plaque begins to mineralize within 24 hours and it is fully hardened and transformed to calculus within 12 to 20 days. Then, new plaque forms on top of existing calculus and this new layer can also become calcified. For that reason, calculus is usually found in layers.
Bacteria — We all have many different strains of bacteria in our mouths. Some bacteria are good for us because they help control populations of more destructive bacteria. When it comes to decay, Streptococcus mutans is the bacterial strain that does the most damage. It attaches easily to teeth and produces a lot of acid. Another common acid-producing bacteria, lactobacillus, is less destructive because it can attach only to plaque, not to the tooth itself. A third type of bacteria, actinomyces also plays a role in tooth decay. Other bacteria cause periodontal disease and include porphyromonas gingivalis, prevotella intermedia and bacteroides forsythus.

If you never ate any food and brushed your teeth twice a day, the decay process would never get started. But the minute you put food in your mouth, the sequence begins.

In a clean mouth, the pellicle, a microscopically thin, clear coating on the teeth formed by certain proteins in the saliva, starts forming immediately after brushing. Soon after, microorganisms attach themselves to the pellicle and begin to form plaque on the teeth. At this point, mouth tissues and plaque have a pH of about 6.2 to 7.0. pH is a measure of acidity or alkalinity on a scale of 1 1 to 14. A pH of 7 indicates a substance is totally neutral, neither acid nor alkaline. Lower numbers on the scale indicate a substance has more acid and higher numbers mean the substance is more alkaline. At a normal pH of 6.2 to 7.0, the mouth is close to neutral and no damage is being done to the teeth. If the pH drops below 5.5, the enamel that covers the portion of the tooth above the gums starts to demineralize, which means it loses some of the minerals in its structure and begins to break down. Between a pH of 5.5 and 6.0, the acid can begin to destroy the roots of the teeth under the gum line.

So how do our mouths become acidic? That's where the sugar connection comes in. And it's not just candy and ice cream we're talking about. All carbohydrate foods, as they are digested, eventually are broken down into simple sugars: glucose, fructose, maltose and lactose. Some of this digestion begins in the mouth with digestive enzymes in saliva. Foods that break down into simple sugars in the mouth are called fermentable carbohydrates. These include the obvious sugary foods, such as cookies, cakes, soft drinks and candy; but also bread, crackers, bananas, potato chips and breakfast cereals.

The process of digestion begins in the mouth. The sugars created by that process are used by the bacteria, which form acids as a byproduct. These acids cause the mouth's pH to drop and begin to dissolve the mineral crystals inside the teeth.

The longer the pH remains lower than 5.5, the more acid damage will be done. Therefore, carbohydrate foods that tend get stuck to teeth tend to do more acid damage. Teeth with a lot of nooks and crannies, such as molars, are more likely to trap food and are therefore more susceptible to caries. Plus, every time you eat a fermentable carbohydrate, the pH of your mouth remains below 5.5 for up to several hours, depending on the quality of your saliva. People who sip soft drinks or sweetened coffee throughout the day or who eat many small carbohydrate snacks will have an acidic mouth almost constantly.

What's worse is that bacteria love sugar, and they thrive and multiply in an acid environment. So the more sugar you eat, the more acidic your mouth and the more bacteria
will grow. The more bacteria you have, the more acid will be produced when you eat sugar. The cycle builds on itself, creating an ever more destructive environment for teeth.

Types And Stages Of Decay

When acids first start dissolving the tooth, a white spot appears on the enamel. This is where the demineralization has begun to weaken the enamel and start a cavity inside the tooth. At this stage, the tooth can remineralize and fix the weakened area itself with the help of minerals in saliva. But if the decay continues and breaks through the surface of the enamel, the damage is permanent. The decay must be cleaned out and the cavity filled by a dentist. Left untreated, the decay will continue. It has been known to eat away at a tooth all the way through the enamel, through the dentin and down to the pulp of the tooth.
In young children, teeth that have just recently emerged have weak enamel and are highly susceptible to acid decay. Acute caries, which destroys enamel quickly, is common in children and young adults. This type of decay can eat through enamel and leave a large cavity in a matter of months.

Older adults sometimes have chronic caries, cavities that don't seem to progress or progress at a very slow rate. They will tend to be darker in color because the edges get stained from normal eating and drinking.

Plaque

Plaque is the scourge of the mouth. It appears as a soft, gooey substance that sticks to the teeth a bit like jam sticks to a spoon. It is, in fact, colonies of bacteria, protozoa, mycoplasmas, yeasts and viruses clumping together in a gel-like organic material. Also in the mix are bacteria byproducts, white blood cells, food debris and dead body tissue. Plaque grows when more bacteria join in, when the bacteria already there start to multiply, or when bacteria byproducts and food debris accumulate. Plaque starts forming immediately after a tooth is cleaned. It builds up to measurable levels after about one hour and takes an average of seven days to fully mature. As it matures, more and more different types of microorganisms appear, the plaque thickens and gum inflammation begins. Plaque that forms on the crowns of the teeth, the part that shows above the gums, is called supragingival plaque; plaque under the gums is called subgingival plaque.