It literally seems as though not a day passes that I don't hear, "Dr. Lepard, why do I have tooth decay and how do I stop it?" Tooth decay or cavities is on the rise in our culture for a number of reasons. Treatment may vary greatly according to the situation. The good news is that all of the causes of tooth decay have answers. An experienced, well educated dentists and hygienists have those answers.
Tooth decay is a disease. Disease is defined as a pathological condition due to an infection, genetic defect or environmental stress. The vehicle for this tooth disease is plaque. Plaque is the sometimes clear, sticky goo that latches onto your tooth every day. Plaque literally bathes your tooth in decay - producing acid every second it is left on the vulnerable tooth surface. It is fed especially by the breakdown of sugary food and drink sources. Some plaque sources are readily identified i.e. a chocolate bar - but there are hidden ones as well - Read on!
1. First on the list are poor oral hygiene practices. Today manual toothbrushes and floss are not the only way to remove the plaque. In fact, automated brushes are one of the most effective ways to break up the party the plaque is having on your teeth. Floss can be assisted by various oralirrigators. Styles and kinds of these devices are suggested in my office according to each individual's own unique situation. Coaching by the hygienist on follow-up visits yield the most effective way to improve your oral hygiene. And remember-plaque produces mouth odors not unlike rotten eggs!
2. Poorly formed enamel and deep tooth crevices are number 2 in causing bacteria from within. This plaque seeks to find the most accessible areas to grow and destroy enamel. Frequently I use a tiny camera, called an Intra-oral camera to show a patient where the problem is occurring or where they are most vulnerable. Educating my patients goes a long way in giving them the complete picture on what is going on. Something as simple as dental sealants can be used to prevent decay in the grooves and crevices that have NOT been infected. Fluoride is another defense mechanism in the interruption of plaque formation.
3. Poor diet and a diet high in sugar are next in the reasons for tooth decay. Some of the same practices that expand the waistlines also destroy tooth enamel. Food and drink high in carbohydrates break down quickly in the "sticky goo". Patients frequently tell me that things like candy make their teeth sensitive --- they are experiencing the acid formation in the soup of the plaque. Beware---there are hidden sugar and acids out there. Fruit juices can have as much sugar or a non-diet soft drink. And speaking of diet soft drinks - read the label - it has acid in the mix. This is not good for your teeth. Our dental hygienist can help you evaluate your diet to help you steer clear of the poor choices and make better ones.
4. Dry mouth conditions, called xerostomia, many times are produced by prescription medications. It is not uncommon for patients, especially in their 6th decade and older to be taking multiple prescriptions that inhibit or stop saliva flow. Saliva has naturally occurring components that inhibit plaque growth and adherence. Interrupting this process causes decay to appear even on front teeth and can destroy previous dental work. It is always a part of the dental exam to find these connections and halt decay. Many times the eventual outcome for the senior citizen is tooth infection and loss. Diabetes is another cause of dry mouth (xerostomia) and is on the rise with an estimated 45 to 50 million new cases by the year 2025. Many are pre-diabetic for a number of years before the frank disease of diabetes is diagnosed. Our hygienist and myself are trained to be aware of these conditions that threaten our patient's health.
5. Tooth grinding and bruxism are all too common. Environmental stresses influence tooth grinding. Tooth grinding strips away the hard outer enamel layer leaving the softer dentin exposed. Dentin, which is 600 times softer than the tooth enamel is much easier for the plaque to break down. Teeth stripped become easy victims of tooth decay/cavities. Approximately 70% of patients who GRIND their tooth have no idea that they do! Outward signs to the patient can be small chips on the edges of the top and bottom front teeth or a "flattening" of the tooth ---- they begin to look even from one corner to the other. A simple guard, called a bite guard or night guard can stop the destruction.
Today the GOOD news is that NO one should have their dental health destroyed by tooth decay. Identifying the causes and prescribing the correct therapies can give the patient a smile they can be proud of for a lifetime. White tooth colored fillings, crowns and veneers that brighten the smile or even dental implants to replace missing teeth can resolve pre-existing problems. Dental health and a great smile are available for a lifetime with correct frequency and consistency of health practices. As in sports, you need a coach; your dentist and hygienist can assist you in preserving your smile.