Ever wonder just exactly what causes cavities? Once upon a time, “Toothworms” — miniscule, yet relentless pests — were thought to be responsible for this widespread malady. This belief persisted from ancient times through the 17th Century; William Shakespeare even made reference to the baneful beasts in his play Much Ado about Nothing. (“What, sigh for a toothache? [It] is but a humor or a worm.”) Today, however, we know why no one ever observed an honest-to-goodness toothworm: it’s because they’re much too tiny to see with the naked eye.
Actually, it isn’t worms, but much smaller organisms that cause tooth decay. These harmful plaque bacteria (along with many helpful microorganisms) live in the mouth, and build up on surfaces of the teeth when they aren’t cleaned properly. They feed on sugar in the diet, and release substances that erode tooth enamel, which causes small holes called cavities. Cavities, in turn, are what’s responsible for most toothaches.
While we may scoff at old legends, one fact remains: Even today, according to the National Institutes of Health, tooth decay is the number one chronic disease of both children and adults; and it’s almost entirely preventable. We can’t blame it on toothworms — but what can we do about it?
Glad you asked! The best way to avoid decay is through prevention. That means brushing your teeth twice a day with a fluoride toothpaste, and flossing them every day. It also means eating a balanced diet and avoiding acidic and sugary foods — like soda, some juices, and sweet, sticky snacks. If you do consume these types of foods, limit them to mealtimes; that gives your saliva enough time in between to neutralize the acids naturally. And, of course, make an appointment see us twice a year for a complete check-up and professional cleaning.
If you do begin to notice the symptoms of tooth decay (toothache, for example) it’s important to come in to the dental office right away, so we can treat the problem before it gets worse. Prompt action can often help save a tooth that might otherwise be lost. Besides filling the cavity, we may be also able to recommend ways to help prevent the disease from affecting other teeth. And if you need a more extensive procedure to relieve the problem — such as a root canal — we can make sure you get the appropriate treatment.
We’ve come a long way since the “toothworm” days — but we can still do a lot more to make tooth decay a thing of the past.
If you would like more information about tooth decay and cavity prevention, please contact us or schedule an appointment. You can learn more in the Dear Doctor magazine article “Tooth Decay — The World’s Oldest & Most Widespread Disease” and “Tooth Decay — How To Assess Your Risk.”
$9.1 billion: That's how much we Americans spent in 2018 on Halloween festivities, according to the National Retail Federation. And a sizeable chunk of that was for candy—a whopping 600 million pounds worth. That, my friends, is a lot of sugary goodness. For kids, it's what Halloween is all about—scoring a sack full of sticky, gooey, crunchy candy. For parents, though, all that sugar raises concerns for their kids' dental health.
That's because of something that loves sugar as much as little humans: oral bacteria. The more these microscopic creatures consume, the more they reproduce, which consequently leads to more mouth acid, a by-product of their digestion. Elevated acid levels can dissolve the mineral content in enamel and create the conditions for tooth decay.
To cut to the chase, excessive candy consumption increases the risk of tooth decay. Short of banning candy and ruining your kids' holiday fun, what then can you do to lower that risk this Halloween?
Here are a few tips:
Limit candy to mealtimes. The mouth's acid levels tend to rise while we're eating. The body counters with saliva, which has the capacity to neutralize acid and restore lost minerals to enamel. But if your kids are snacking on sweets over a long period, saliva can't get ahead of the recurring waves of acid. So, try to limit your kids' candy consumption to a few pieces at mealtimes only.
Don't brush right after eating candy. The short period during and after eating of high acid levels can still soften tooth enamel. If your child brushes soon after eating candy, they could also remove tiny bits of softened enamel. Instead, wait at least 30 minutes to an hour before brushing to allow saliva time to remineralize the enamel.
Encourage alternatives to candy as Halloween treats. While candy is a huge part of Halloween, it needn't have a monopoly on all the celebratory fun. So, encourage your little tricksters to accept—and their treaters to provide—other kinds of treats like small toys, glow sticks, or other items that count as treasure to children (be sure they're age-appropriate, though).
Halloween is a great time of family fun, and candy may always play a prominent role in the merriment. Just be sure to practice moderation with sweet Halloween treats to avoid dental problems down the road.
If you would like more information about how to manage your family's sugar consumption for optimum dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “The Bitter Truth About Sugar” and “Nutrition & Oral Health.”
We often don't realize how important something is until it's gone. Like saliva: you're usually not aware that it's cleaning the mouth, neutralizing mouth acid or helping with digestion. But that could change if your saliva flow drops below normal: your health may soon suffer with your mouth taking the brunt.
In particular, reduced saliva flow increases your risk for tooth decay and periodontal (gum) disease. Both diseases are linked to oral bacteria. While many of the myriad strains in the mouth are beneficial, a few bacteria can infect and inflame gum tissues. Bacteria also produce acid, which can soften and erode enamel and make the teeth more susceptible to decay.
Saliva inhibits bacteria in a number of ways. It first clears the mouth of leftover food so not as much stays behind to form bacterial plaque, a thin film of food particles that builds up on teeth. You still need to brush and floss daily to remove plaque, but it's less effective without saliva's cleansing action. Saliva also contains antibodies that destroy disease-causing bacteria and other organisms, which keeps their populations in the mouth low.
One of saliva's most important functions, though, is buffering acid. The mouth's ideal pH level is neutral, but many foods we eat can cause it to become more acidic.Â Even a slight acidic rise after eating can soften the minerals in enamel. But saliva goes to work immediately and usually restores normal pH within a half hour to an hour. It also aids in re-mineralizing the enamel.
For these reasons, it's important for you to find out the cause of chronic dry mouth and treat it. If it's a side effect of your medication, talk to your doctor about an alternative, or drink more water before and after you take your dose. Certain products can also stimulate saliva flow, like chewing gum with xylitol, an alcohol-based sweetener that has dental health-protecting properties too.
Although you often don't notice this unsung bodily fluid swishing in your mouth, it's important that you take care of it. Keeping your saliva flowing will help ensure better oral health.
If you would like more information on the importance of saliva to health, 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 “Saliva: How it is used to Diagnose Disease.”
The basics for treating tooth decay have changed little since the father of modern dentistry Dr. G.V. Black developed them in the early 20th Century. Even though technical advances have streamlined treatment, our objectives are the same: remove any decayed material, prepare the cavity and then fill it.
This approach has endured because it works—dentists practicing it have preserved billions of teeth. But it has had one principle drawback: we often lose healthy tooth structure while removing decay. Although we preserve the tooth, its overall structure may be weaker.
But thanks to recent diagnostic and treatment advances we’re now preserving more of the tooth structure during treatment than ever before. On the diagnostic front enhanced x-ray technology and new magnification techniques are helping us find decay earlier when there’s less damaged material to remove and less risk to healthy structure.
Treating cavities has likewise improved with the increased use of air abrasion, an alternative to drilling. Emitting a concentrated stream of fine abrasive particles, air abrasion is mostly limited to treating small cavities. Even so, dentists using it say they’re removing less healthy tooth structure than with drilling.
While these current advances have already had a noticeable impact on decay treatment, there’s more to come. One in particular could dwarf every other advance with its impact: a tooth repairing itself through dentin regeneration.
This futuristic idea stems from a discovery by researchers at King’s College, London experimenting with Tideglusib, a medication for treating Alzheimer’s disease. The researchers placed tiny sponges soaked with the drug into holes drilled into mouse teeth. After a few weeks the holes had filled with dentin, produced by the teeth themselves.
Dentin regeneration isn’t new, but methods to date haven’t been able to produce enough dentin to repair a typical cavity. Tideglusib has proven more promising, and it’s already being used in clinical trials. If its development continues to progress, patients’ teeth may one day repair their own cavities without a filling.
Dr. Black’s enduring concepts continue to define tooth decay treatment. But developments now and on the horizon are transforming how we treat this disease in ways the father of modern dentistry couldn’t imagine.
Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.
“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into caviÂties. How did this happen?
Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.
While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.Â Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.
This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”
Here are some other basics of infant dental care that every parent should know:
Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.
“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”
If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”