Five Ways to Reduce Your Risk of Tooth Decay
Tooth decay or dental caries is one of the most common diseases affecting children and adults worldwide. Recent statistics published in Australia show that 45% of children have experienced dental decay whilst adults, on average, have 22.2 decayed, missing or filled teeth. Alarmingly, the disease process is largely preventable.
What is Tooth Decay?
Tooth decay or dental caries is a transmissible bacterial disease process that causes destruction of tooth substrate. The caries process is characterised by breakdown of enamel (the outer protective layer of the tooth) and later the dentine (body and root of the tooth) from bacterial by-products within dental plaques.
How Does a Cavity Form?
- Bacteria adhere to the tooth surface and begin to grow and recruit more bacteria. If these bacteria are not removed during toothbrushing and interproximal cleaning (flossing) they will form a dental plaque. Numerous studies demonstrate that after 24 hours a dental plaque has matured and becomes cariogenic – capable to causing decay.
- Bacteria within the dental plaque breakdown sugars, specifically fermentable carbohydrates, from the food and drinks you consume to produce acid. This acid dissolves the calcium and phosphates from the underlying enamel; this process if called demineralisation or an acid-attack.
- The demineralised or weakened portion of the tooth can potentially be remineralised or hardened when the dental plaque if removed allowing the calcium and phosphates found in toothpaste and saliva to integrate back into the affected enamel matrix.
- If acid attacks and subsequent demineralisation are continuous or outweigh the remineralisation process the enamel matrix will be significantly weakened and collapse. At this point a cavity has formed.
- Unless treated, the decay will progress towards the nerve in the tooth where symptoms will likely develop. If left untreated the nerve will become infected, the tooth will ‘die’ and an abscess will start to form around the root of the tooth.
What Causes Tooth Decay?
There are multiple risk factors which increase an individual’s risk of dental caries. Arguably the most influential and modifiable risk factors include:
- Poor Oral Hygiene – Improper plaque removal or complete lack thereof means that plaque and bacteria mature whilst sitting undisturbed on teeth surfaces. Research clearly shows us the longer a dental plaque has been in situ the more cariogenic or likely to cause decay it becomes.
- Frequent Consumption of Sugary Foods – A high risk caries diet is one which includes the consumption of drinks and foods, with high sugar content, multiple times per day. For example: sipping on flavoured drinks throughout the day/night; snacking on candy or lollies throughout the day.
- Absence of Fluoride – Fluoride plays a pivotal role in the prevention of dental decay. Fluoride ions from salvia integrate into the demineralised tooth structure, along with calcium and phosphates, to form a crystalline structure which is more resistant to acid attack and less likely to develop a cavity.
Are Any Teeth More at Risk Than Others?
Yes. When adult teeth first erupt, especially molar teeth, the deep pits and grooves sometimes have not finished forming meaning these teeth are more susceptible to developing decay. Often dentists will place a fissure sealant to seal off the deep groove and minimise the risk of decay whilst the tooth finishes forming and undergoes hardening.
Once all adult teeth have erupted into position the most common surface for decay is the proximal surface, the front and back surface that contact adjacent teeth; especially in premolar and molar teeth. Research tells us this is directly linked with oral hygiene. Whereby, effective cleaning between teeth requires flossing or equivalent interproximal care as toothbrush bristles are too large to reach between the tight contacts on teeth.
In older adults with gum recession and reduced saliva production the root surface of the tooth, normally covered by the gum, is prone to decay. The root surface, which is dentine, does not have the protection from the enamel and is softer than enamel therefore decays less resistant to the caries process.
Signs and Symptoms of Dental Caries
Often there are no symptoms when decay is in the early stages. It is not until the decay has reached the dentine that pain and sensitivity arise. The most common presentations of caries include:
- White, grey, black and/or brown spots.
- Sensitivity to cold, hot, sweet.
- Food getting caught between teeth.
- Floss tearing or fraying.
- Visible cavity in tooth.
Five Tips to Minimise Your Risk of Tooth Decay
- Regular dental examinations – Early identification of early decay lesions and demineralisation spots may never require a filling with appropriate preventive treatment and home care.
- Correct tooth brushing technique using a fluoride containing toothpaste – Fluoride ions are absorbed by saliva from toothpaste and make teeth more resistant to acid-attacks.
- Avoid or limit snacking on sugary foods and drinks – Frequent consumption of sugary snacks results in frequent acid attacks on teeth meaning drastically increased risk of decay.
- Floss once a day – Remember you only have to FLOSS THE TEETH YOU WANT TO KEEP
- Do Not Rinse After Brushing – Research demonstrates that toothpaste needs to be present for 30 minutes for maximum absorption of fluoride, calcium and phosphates into saliva. Saliva rich in fluoride, calcium and phosphates is optimal for neutralising acid attacks and remineralising weakened enamel lesions.
Preventing dental decay will save you plenty of time and money at the dentist! Thus, we recommend you see a dental professional twice a year for comprehensive dental examination where we can identify any early decay lesions and intervene with non-invasive treatment.