Posts for tag: tooth decay
Although we've known for some time how tooth decay forms, it's still prevalent across the population—even more so than cancer or heart disease. Along with gum disease, it's a leading cause of tooth loss.
Fortunately, our knowledge about tooth decay has grown considerably, to the point that we now recognize a number of risk factors that make it more likely a person will develop this disease. By first identifying them in individual patients, we can take steps to address them specifically to reduce the chances of this destructive disease.
Genetics. Researchers have identified around 40 to 50 genes that can influence cavity development. The best way to assess your genetic risk is through family history—if numerous close family members contend with tooth decay, your risk may be high. If so, it's important to be extra vigilant with addressing other areas over which you have more control.
Saliva. Cavities are directly caused by oral acid, a byproduct of bacteria, that can erode tooth enamel over prolonged contact. This is minimized, though, through a normal saliva flow that neutralizes acid and helps remineralize enamel. But poor saliva production can slow acid neutralization. You can improve your saliva flow by drinking more water, changing medications or using saliva-boosting products.
Oral hygiene. You can reduce bacteria (and thus acid) by removing their "room and board"—dental plaque. This accumulating film of food particles harbors the bacteria that feed on it. Daily brushing and flossing, accompanied by regular dental cleanings, effectively removes dental plaque, which in turn lowers the levels of oral bacteria and acid.
Dental-friendly diet. Even if you diligently address the previous risk factors, your diet may fight against your efforts. Diets high in processed and refined foods, especially sugar, provide abundant food sources for bacteria. On the other hand, a diet primarily of whole foods rich in vitamins (especially D) and minerals like calcium and phosphorous strengthen teeth against decay.
Preventing tooth decay isn't a "one-size-fits-all" approach. By identifying your own particular risk, we can craft a care strategy that can be your best defense against this destructive dental disease.
Tooth decay is one of two dental diseases most responsible for tooth loss (gum disease being the other). In the absence of treatment, what starts as a hole or cavity in a tooth's outer layers can steadily advance toward its interior.
Most people associate cavities with the crown, the part of a tooth you can see. But cavities can also occur in a tooth's roots, especially with older adults. Root cavities pose two distinct difficulties: They can lead to more rapid decay spread than crown cavities within a tooth; and they're harder to detect.
Tooth roots are ordinarily covered by the gums, which protects them from bacterial plaque, the main cause for decay. But roots can become exposed due to receding gums, a common problem with seniors who are more susceptible to gum disease.
Unlike the enamel-covered crowns, tooth roots depend on gum coverage for protection against bacteria and the acid they produce. Without this coverage, the only thing standing between tooth decay and the roots is a thin material called cementum.
If decay does enter a tooth's interior, saving it often requires a root canal treatment to remove decayed tissue in the inner pulp and root canals, and then replacing it with a filling. But if we're able to discover a root cavity in its early stages, we may be able to fill it like a crown cavity.
The best strategy, though, is to prevent root cavities from forming. This starts with a dedicated daily regimen of brushing and flossing to remove dental plaque. If you're at high risk for root cavities, we may also recommend antibacterial mouthrinses and other aids.
Regular dental visits are also a must: a minimum of twice-a-year dental cleanings to remove stubborn plaque and calculus (hardened plaque) deposits. For added protection against root cavities, we can also apply fluoride varnish to strengthen teeth. And regular visits are the best way to detect any cavity in its early stages when treatment is less invasive.
A heightened risk of dental problems like root cavities are a part of the aging process. But partnering together, we can lower that risk and increase the longevity of your teeth.
If you would like more information on root cavities, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Cavities.”
Although dental care has made incredible advances over the last century, the underlying approach to treating tooth decay has changed little. Today’s dentists treat a decayed tooth in much the same way as their counterparts from the early 20th Century: remove all decayed structure, prepare the tooth and fill the cavity.
Dentists still use that approach not only because of its effectiveness, but also because no other alternative has emerged to match it. But that may change in the not-too-distant future according to recent research.
A research team at Kings College, London has found that a drug called Tideglusib, used for treating Alzheimer’s disease, appears to also stimulate teeth to regrow some of its structure. The drug seemed to cause stem cells to produce dentin, one of the tooth’s main structural layers.
During experimentation, the researchers drilled holes in mouse teeth. They then placed within the holes tiny sponges soaked with Tideglusib. They found that within a matter of weeks the holes had filled with dentin produced by the teeth themselves.
Dentin regeneration isn’t a new phenomenon, but other occurrences of regrowth have only produced it in tiny amounts. The Kings College research, though, gives rise to the hope that stem cell stimulation could produce dentin on a much larger scale. If that proves out, our teeth may be able to create restorations by “filling themselves” that are much more durable and with possibly fewer complications.
As with any medical breakthrough, the practical application for this new discovery may be several years away. But because the medication responsible for dentin regeneration in these experiments with mouse teeth is already available and in use, the process toward an application with dental patients could be relatively short.
If so, a new biological approach to treating tooth decay may one day replace the time-tested filling method we currently use. One day, you won’t need a filling from a dentist—your teeth may do it for you.
Tooth decay is more prevalent than diseases like cancer, heart disease or influenza. It doesn't have to be—brushing with fluoride toothpaste, flossing, less dietary sugar and regular dental cleanings can lower the risk of this harmful disease.
Hygiene, diet and dental care work because they interrupt the disease process at various points. Daily hygiene and regular dental cleanings remove dental plaque where oral bacteria flourish. Reducing sugar eliminates one of bacteria's feeding sources. With less bacteria, there's less oral acid to erode enamel.
But as good as these methods work, we can now take the fight against tooth decay a step further. We can formulate a prevention strategy tailored to an individual patient that addresses risk factors for decay unique to them.
Poor saliva flow. One of the more important functions of this bodily fluid is to neutralize mouth acid produced by bacteria and released from food during eating. Saliva helps restore the mouth's ideal pH balance needed for optimum oral health. But if you have poor saliva flow, often because of medications, your mouth could be more acidic and thus more prone to decay.
Biofilm imbalance. The inside of your mouth is coated with an ultrathin biofilm made up of proteins, biochemicals and microorganisms. Normally, both beneficial and harmful bacteria reside together with the “good” bacteria having the edge. If the mouth becomes more acidic long-term, however, even the beneficial bacteria adapt and become more like their harmful counterparts.
Genetic factors. Researchers estimate that 40 to 50 hereditary genes can impact cavity development. Some of these genes could impact tooth formation or saliva gland anatomy, while others drive behaviors like a higher craving for sugar. A family history of tooth decay, especially when regular hygiene habits or diet don't seem to be a factor, could be an indicator that genes are influencing a person's dental health.
To determine if these or other factors could be driving a patient's higher risk for tooth decay, many dentists are now gathering more information about medications, family history or lifestyle habits. Using that information, they can introduce other measures for each patient that will lower their risk for tooth decay even more.
If you would like more information on reducing your risk of tooth decay, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What Everyone Should Know About Tooth Decay.”
You've heard it. Your parents heard it—maybe even your grandparents too. Dentists have been alerting people for more than half a century that high sugar consumption contributes to tooth decay.
That message hasn't changed because the facts behind it are the same in the 2020s as they were in the 1950s: The bacteria that cause tooth decay feast on sugar and other leftover carbohydrates in the mouth. This causes them to multiply and increase their production of acid, which softens and erodes tooth enamel.
What has changed though, especially over the last couple of decades, is a growing understanding of how sugar consumption may affect the rest of the body. Just like the evidence of sugar's relationship to tooth decay, current scientific studies are now showing there are strong links between sugar and diseases like diabetes, heart disease and liver disease.
What's startling about what researchers are finding is that cases of these diseases are growing, Especially in younger people. This is a parallel trend to our skyrocketing increases in per capita sugar consumption: the average American now eats the equivalent of 19.5 teaspoons of added sugar every day. Health experts generally agree we should consume no more than 6 teaspoons a day, and children 4.
This is vastly more than we consumed a generation ago. One reason is because processed food manufacturers have increased sugar in their products, hiding under technical, unfamiliar names in ingredient lists. But it's still sugar, and an estimated 74% of processed foods contain some form of it.
But the real surge in sugar has come from our increasing consumption of sodas, as well as energy and sports beverages. These beverages are high in sugar—you can meet your daily allowance with just one 12-oz can of soda. These beverages are now the leading source of sugar in our diets, and, according to experts, a highly dangerous way to consume it.
In effect, dentists of old were on to something: too much sugar is bad for your teeth. It now turns out that it may be bad for your overall health too. Strictly limiting it in your family's diet could help lower your risk of tooth decay and dangerous diseases like diabetes.