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Tooth Decay: A Preventable Disease

What is tooth decay, and what causes it?
Tooth decay is the disease known as caries or cavities. Unlike other diseases, however, caries is
not life threatening and is highly preventable, though it affects most people to some degree
during their lifetime.
Tooth decay occurs when your teeth are frequently exposed to foods containing
carbohydrates (starches and sugars) like soda pop, candy, ice cream, milk, cakes, and even fruits,
vegetables and juices. Natural bacteria live in your mouth and forms plaque. The plaque
interacts with deposits left on your teeth from sugary and starchy foods to produce acids. These
acids damage tooth enamel over time by dissolving, or demineralizing, the mineral structure of
teeth, producing tooth decay and weakening the teeth.
How are cavities prevented?
The acids formed by plaque can be counteracted by simple saliva in your mouth, which acts as a
buffer and remineralizing agent. Dentists often recommend chewing sugarless gum to stimulate
your flow of saliva. However, though it is the body's natural defense against cavities, saliva
alone is not sufficient to combat tooth decay.
The best way to prevent caries is to brush and floss regularly. To rebuild the early damage
caused by plaque bacteria, we use fluoride, a natural substance which helps to remineralize the
tooth structure. Fluoride is added to toothpaste to fight cavities and clean teeth. The most
common source of fluoride is in the water we drink. Fluoride is added to most community water
supplies and to many bottled and canned beverages.
If you are at medium to high risk for cavities, your dentist may recommend special high
concentration fluoride gels, mouth rinses, or dietary fluoride supplements. Your dentist may
also use professional strength anti-cavity varnish, or sealants--thin, plastic coatings that provide
an extra barrier against food and debris.
Who is at risk for cavities?
Because we all carry bacteria in our mouths, everyone is at risk for cavities. Those with a diet
high in carbohydrates and sugary foods and those who live in communities without fluoridated
water are likely candidates for cavities. And because the area around a restored portion of a
tooth is a good breeding ground for bacteria, those with a lot of fillings have a higher chance of
developing tooth decay.
Children and senior citizens are the two groups at highest risk for cavities.
What can I do to help protect my teeth?
The best way to combat cavities is to follow three simple steps:
- Cut down on sweets and between-meal snacks. Remember, it's these sugary and starchy
treats that put your teeth at extra risk.
- Brush after every meal and floss daily. Cavities most often begin in hard-to-clean areas
between teeth and in the fissures and pits--the edges in the tooth crown and gaps between teeth.
Hold the toothbrush at a 45-degree angle and brush inside, outside and between your teeth and
on the top of your tongue. Be sure the bristles are firm, not bent, and replace the toothbrush
after a few weeks to safeguard against reinfecting your mouth with old bacteria than can collect
on the brush. Only buy toothpastes and rinses that contain fluoride (antiseptic rinses also help
remove plaque) and that bear the American Dental Association seal of acceptance logo on the
package. Children under six should only use a small pea-sized dab of toothpaste on the brush
and should spit out as much as possible because a child's developing teeth are sensitive to higher
fluoride levels. Finally, because caries is a transmittable disease, toothbrushes should never be
shared, especially with your children.
- See your dentist at least every six months for checkups and professional cleanings.
Because caries can be difficult to detect a thorough dental examination is very important. If you
get a painful toothache, if your teeth are very sensitive to hot or cold foods, or if you notice signs
of decay like white spots, tooth discolorations or cavities, make an appointment right away. The
longer you wait to treat infected teeth the more intensive and lengthy the treatment will be. Left
neglected, caries can lead to root canal infection, permanent deterioration of decayed tooth
substance and even loss of the tooth itself.
Sources:
The medical management of dental caries, by Burton L. Edelstein, DDS, Journal of the American Dental Association, Jan. 1994;
How severe is the threat of caries to old teeth? By M.I. MacEntee, et al., Journal of Prosthetic Dentistry, May 1994;
Tooth decay, American Dental Association, 1994;
Modern management of dental caries: the cutting edge is not the dental bur,
by Maxwell H. Anderson, DDS, et. al., JADA, June 1993;
Changing paradigms in caries management, by Maxwell H. Anderson, DDS, Periodontology and Restorative Dentistry, March 1992;
Preventing dental caries: breaking the chain of transmission, by Ernest Newbrun, DMD, JADA, June 1992;
Prevention of dental caries, by Andrew J. Rugg-Gunn, Dental Uptake, Jan/Feb 1990;
Preventive dentistry: dental caries, by John C. Greene, DMD, et. Al., Journal of
the American Dental Association, Dec. 22/29, 1989.

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