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New Facts on Prevention of Tooth Decay

Recently, I had the pleasure of spending the day with a noted expert on Dental Caries (tooth decay or cavities). For many years, scientists have been actively studying tooth decay. Just as any other science, the science of tooth decay is evolving. What we thought we knew when I graduated from dental school in 1992 is now only part of the story. All of us do well to keep our minds open to changes in science when it comes to disease processes that can and often do affect our lives.

Dental Caries (tooth decay) is the world’s most prevalent infectious disease. In fact, it is so prevalent (common) that many people have the attitude that there isn’t anything a person can do to stop it. While it is a formidable opponent, there are plenty of things all of us can do to reduce its effects. I have already discussed in detail in past articles the Big Five in prevention of tooth decay—Tooth brush, Floss, Professional Cleaning, Fluoride, and Proper Diet. Proper implementation of these five items will nearly eliminate tooth decay in the individual as well as in the society at large. However, many of us find that one or more of these five items is difficult or impossible. Consider for example, the person whose hands are so arthritic that flossing is out of the question. For these people, even brushing might be virtually impossible. What are these people supposed to do?

In the next few weeks, I am going to try to help you to understand a few new concepts in the prevention of tooth decay that may help you to reduce your own future experience with today’s most prevalent infectious disease—tooth decay.

Much is unknown about tooth decay. One of the items that is definitely known about tooth decay is that what are termed in the field “fermentable carbohydrates” predispose a person to get tooth decay. So, what are fermentable carbohydrates? Items like refined sugar, flour (including items like bread, crackers, and pancakes), potato chips, simple sugars like those found in fruits are considered fermentable carbohydrates. The bacteria that cause tooth decay metabolize (use up in their life processes) fermentable carbohydrates faster than other foods. This fast use of available food supply makes acid more rapidly. Remember that acid made by the bacteria on your teeth is what causes tooth decay and not food directly. The more often a person eats fermentable carbohydrates, the more likely it is for that person to have tooth decay. Another item that is definitely known about tooth decay is that low salivary flow predisposes a person to get tooth decay. A person should produce on average about 1 ml of saliva every waking minute. This saliva has a diluting effect on the acid that plaque (the bacteria on your teeth) is producing. Make less saliva, and the acid level in your saliva is stronger. Acid dissolves calcium and phosphorus from the teeth. Once those items are dissolved from a tooth, the tooth structure is destroyed. This is tooth decay. Low salivary flow is common, of course, in older people. But what you may not know is that low salivary flow is just as common in people who exercise frequently especially while the exercise is occurring. High stress will also significantly reduce salivary flow. As well, a person who is dehydrated for any reason will certainly produce less saliva. Dehydration predisposes to tooth decay because it reduces salivary flow. Another item that predisposes to tooth decay is leaving plaque in place for a long time. Plaque left in place produces acid which dissolves certain chemicals in the teeth and causes tooth decay. Plaque left in place for more than a couple of days produces much more acid than plaque that is just a few hours old. Old plaque is more damaging to teeth than newer plaque.

From a general standpoint, it is a well known fact that if you reduce intake of fermentable carbohydrates, make sure saliva flow is not inhibited, and remove the plaque from the teeth often, your decay rate will most certainly be lower than it would otherwise be. These items are scientific fact. There is much more to say about how to reduce your rate of tooth decay and that will be the focus of these articles in a few weeks to come.

- This article was written by Dr. Mike Christensen and published in the Daily Miner and News, and Enterprise. Local Kenora News Publicatons (1998-2006)

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