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Tooth Decay

Bacteria interacts with the food you eat to produce waste products in the form of acids, which cause a breakdown or demineralisation (dissolving of the tooth enamel) of areas underneath the tooth surface. This breakdown of the tooth surface is tooth decay.

Think of it this way: Each time you eat, there's an acid attack on the tooth. A counterattack by your body occurs by rinsing the food and acid away with saliva. The saliva not only buffers or neutralizes the acids, it also contains minerals (calcium and phosphate) that rebuild the areas of the tooth that were demineralised or attacked by the acids.

This rebuilding process is known as remineralisation (process of restoring minerals). This series of attacking and rebuilding is like a tug-of-war in your mouth. It's your body's way of helping protect your teeth from everyday problems. But by fully understanding the cause of dental cavities, and by looking at each of the three factors more closely, we can look at other ways of preventing tooth decay.

Tooth decay is a process that involves a balance of the mineral loss and replacement in a tooth over time in response to daily acid attacks resulting from food consumption. Cavities and the decay process can be prevented by working closely with your dental professional at The Fono and following his or her plan for you.

Eating the proper foods at the right time during meals and avoiding foods or snacks between meals can also help reduce your risk. And brushing your teeth with a fluoride toothpaste at least twice a day is a critical step toward balancing the "tug-of-war" on your tooth surfaces and preventing the tooth decay process from continuing to become cavities. Let's examine this process.

The formation of dental caries, or "cavities", involves three major factors:

  • Food or beverages consumed (your diet)
  • Bacteria in plaque
  • Your current state of oral health

Factor one: bacteria and food 

Bacteria interacts with the food you eat to produce waste products in the form of acids. These can cause a breakdown or demineralisation of areas underneath the tooth surface. This breakdown of the tooth surface is tooth decay.

Think of it this way: Each time you eat, there's an acid attack on the tooth. A counterattack by your body occurs by rinsing the food and acid away with saliva. The saliva not only buffers or neutralises the acids, it also contains minerals (calcium and phosphate) that rebuild the areas of the tooth that were demineralised or attacked by the acids. This rebuilding process is known as remineralisation.

This series of attacking and rebuilding is like a tug-of-war in your mouth. It's your body's way of helping protect your teeth from everyday problems. But by fully understanding the cause of dental cavities, and by looking at each of the three factors more closely, we can look at other ways of preventing tooth decay.

Food and Beverages

Foods and beverages that are consumed for prolonged periods of time between meals can tip the balance of remineralisation/demineralisation in favour of the decay process.

Sticky foods, such as caramels and raisins, should be avoided as between-meal snacks, because the acid attack becomes too much for the saliva to prevent and repair. Eating these same foods during a meal, however, allows for the tug-of-war to be a winning situation for a person and their teeth.

If children are allowed to fall asleep with a baby bottle, or if they're given the bottle to carry around with them, and the liquid, whether it be milk, fruit juices or other drinks, can be used by the bacteria to produce acids, and tooth decay can rapidly occur. This is often known as "baby bottle tooth decay".

To help prevent tooth decay, limit your intake of sugary, sticky foods and sweetened beverages between meals.

Factor two: bacteria in plaque

The plaque bacteria on your teeth should be removed by brushing at least twice a day and flossing once a day. Usually, a clean tooth can stay healthy. Certain bacteria are more likely to cause decay because they can use the sugars and starches you eat better than others.

Bacteria called streptococci mutans and lactobacilli are two types of these culprits. We all have small amounts of these types of bacteria in our mouths, but sometimes they may be present in higher levels. In those situations, you would be at higher risk for tooth decay or more likely to lose the tug-of-war.

Your dental team may use a sample of your saliva to measure levels of these bacteria.

Factor three: your current state of oral health 

The third primary part of the tooth decay situation is your teeth and mouth.

This includes everything from the way the teeth are shaped, formed and positioned, to your saliva, dental treatment and oral health habits. Your saliva is very important in many ways, including slowing the loss of mineral from the teeth and replacing it in the remineralisation process.

But sometimes, certain conditions or medication change the amount and type of saliva in your mouth, allowing the tooth decay process to progress all the way to cavities.

Ways to Help Prevent Tooth Decay

Brushing

Brush your teeth at least twice a day (especially before going to bed at night) with a soft bristle brush and toothpaste.

  • Brush at a 45 degree angle to the gums, gently using a small, circular motion, ensuring that your always feel the bristles on the gums
  • Brush the outer, inner and biting surfaces of each tooth
  • Use the tip of the brush head to clean the inside front teeth
  • Brush your tongue to remove bacteria and freshen your breath

Electric toothbrushes are also recommended. They are easy to use and can remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

Flossing 

Daily flossing is the best way to clean between the teeth and under the gum line. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

  • Take a 30 – 40cm piece of dental floss and wrap it around your middle fingers, leaving about 5cm of floss between the hands
  • Using your thumbs and forefingers to guide the floss, gently insert the flow between teeth using a sawing motion • Curve the floss into a “C” shape around each tooth and under the gum line. Gently move the floss up and down, cleaning the side of each tooth
  • Floss holders are recommended if you have difficulty using conventional floss

Rinsing 

Rinsing after you brush is not recommended as it washes away the fluoride in the toothpaste from your teeth. Simply spit out the excess toothpaste without rinsing so that the fluoride stays in contact with the teeth for longer.

Fluoride Toothpaste

One of the best ways to prevent mineral loss from the tooth or demineralisation and help the replacement process or remineralisation is by using toothpaste that contains fluoride. A small amount used daily helps balance the tug-of-war situation in your favour.

Many scientific studies over a long period of time have proven this to be one of the most effective ways to prevent tooth decay. Brand new advances in toothpaste technology have made this even better by including antibacterial components, such as the tin in stannous fluoride.

Sealants

The deep grooves and pits in some teeth, such as molars, can also be trouble spots for decay. One way to prevent this type of decay is to have your dental team paint a shaded plastic material called a pit and fissure sealant on these areas. Once the sealant hardens, it acts as a barrier protecting the tooth surface from plaque and acids. A sealant does not replace regular brushing and flossing.

Click here to watch a short video on tooth decay

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