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Cavities

The Mouth's Contents:

In order to better understand the dental caries process, it would be helpful to understand the naturally occurring substances of the mouth that play a role in the caries process

Saliva, Saliva helps protect the mouth and provide many benefits for oral health. The hard and soft tissues of the mouth are being constantly bathed by the saliva. It helps to keep these tissues lubricated, aids in the removal of food debris, has a buffering effect thereby reducing acidity in the mouth, and helps to protect against certain bacteria and viruses.

Plaque - Plaque materializes in the mouth as a soft, sticky substance that adheres to teeth and other tissues. Plaque is composed from bacterial colonies and other microorganisms and yeast, bunched collectively in a semisolid organic substance. In addition, dental plaque contains bacteria and their by-products, food debris, white blood cells, as well as exfoliated body tissues. Plaque multiplies as it attaches to the tooth surfaces and soft tissues. Plaque immediately begins to form following tooth cleaning, and usually takes between 45-60 minutes to grow to levels that can be measured. With time, this plaque accumulation continues, and other more harmful bacteria begin to appear.

Calculus - If plaque is allowed to mature for awhile, it will begin to form a hardened and mineralized substance called calculus, using minerals available in the saliva. This happens quicker in some individuals and slower in others. When this appears, calculus must be removed professionally. The calculus will continue to thicken as dental plaque continues to adhere to its surface, and in turn hardens if not removed.

Bacteria - The mouth contains approximately 700 different species of bacteria that have been identified to date. Several of these bacteria are friendly bacteria, helping to control the harmful bacteria. However, Streptococcus mutans has been identified as the strain of bacteria that causes the most harm and helps to cause dental caries formation. S. mutans attaches to teeth without much difficulty, and produces acid as its end-product, that helps to cause tooth demineralization.

The Decay Process:

For dental caries formation, sticky and sugar-containing foods, and bacterial organisms that produce acids as their end-products, are required to dissolve tooth enamel and produce dental cavities. Sucrose is the sugar in foods that act in response to bacteria to form acid, thereby causing tooth decay.

Not just snack foods, but all carbohydrate foods, when they are digested, ultimately split to form the single sugar molecules, fructose and glucose. They are found in many snack foods. These simple sugars are referred to as fermentable carbohydrates, as they form acids when exposed to bacteria in the mouth, thus causing the enamel crystals to start to wear away. The carious lesion then begins to form, first dissolving away the enamel crystal, and then the underlying dentin structure of the tooth. An early carious lesion that has not penetrated the enamel layer completely may be arrested or reversed using good oral hygiene techniques and fluoride containing dental products; including toothpastes, mouthwashes, and fluoridated water. Also, sugary snacks should be replaced with dairy-containing snacks, as these have been shown to reverse the caries process. When you eat, acid is formed by the bacteria in your mouth; your saliva also becomes acidic. Thus, limiting the number of times you eat during the day can reduce the acid exposure.

Kinds and Phases Dental Caries:

Dental caries, known also as dental decay, begins on the tooth surface. Sometimes, a "white spot" is seen on the enamel surface. Not all white spots proceed to the carious state, but some do. Minerals and fluoride found in the saliva, can help fight dental caries at this weakened area of the tooth. However, if this spot continues to weaken, and dissolve the enamel crystals to the point where the enamel is permanently damaged, the decay process has begun, and requires professional attention. The dentist will clean out the cavity and fill it with either a composite or amalgam filling. If this area is not treated, it can progress through the enamel and then the dentin layer of the tooth, until it reaches the dental pulp in the middle of the tooth. Children that are young develop teeth that are more susceptible to dental caries when they are erupting. Some children develop baby bottle syndrome, if they sleep with a bottle containing a sweetened drink. This will ruin their teeth.

At times, adults have cavities that continue to get worse at a slower rate. The visible darker cavities are the result of eating and drinking darkly coloured foods and beverages. Dental caries that form on the root surfaces of the teeth can be found in adults who have had or are now experiencing gum recession. The root surfaces are softer than the enamel on the crown portion of the teeth. Root surface caries occur in adults that have decreased saliva, or dry mouth (xerostomia), possibly due to medications they are taking for a medical condition. Cavities can also form at the interface of a tooth and a filling that was placed. This is called "recurrent decay," and occurs because these areas are not cleaned properly, or the filling wasn't placed properly. This is an area of plaque retention, and is more prone to decay.

Cavity Prevention:

When you visit your dentist, you should ask about ways to best prevent dental caries. The dentist will review factors that can cause you and your family to get caries and how to resolve this problem. The dentist may review your diet and other problems that you may have. However, the best ways to prevent tooth decay, are reducing the amount of bacteria in your mouth, using fluoride-containing products, and the placement of dental sealants

Fluoride helps to prevent tooth decay by strengthening the tooth's enamel structure. Your dentist may also recommend different fluoride products, such as mouthwashes and gels. You should brush and floss twice daily for at least two minutes each time.

Dental sealants are thin, clear, or white, coatings that protect the chewing surfaces of the teeth, where plaque bacteria and food debris can collect and stick to the tooth. They are placed on all premolars and molars. This procedure should be performed following eruption of your children's teeth into their mouth.

In conclusion, make sure to visit your dentist for regular check-ups, and make a very good effort to reduce the bacteria in your mouth with daily brushing and flossing with fluoride-containing products. Also, reduce the amount of fermentable carbohydrates that are consumed by reducing the amount and frequency of your snacks. However, you can never get rid of all the bacteria in your mouth. You may want to try sugarless gum that contains xylitol. Xylitol can stimulate salivary flow and reduce dental caries.