Fighting Cavities

Here's what we know about teeth, according to the hundreds of years of research in conventional dentistry. Most of this information comes directly from the American Dental Association (ADA), a not-for-profit dental association. The ADA is considered the leading source of oral health related information for dentists and their patients. If you're super dorky, like me, here's the link for the ADA's Center for Evidence-Based Dentistry. If you're worrying about your dental hygiene and you think it's best to go and get your teeth and gums checked out, look into dental practices such as Bow Lane Dental Group that will be able to make your smile healthy looking again.

1. There are four tissues that make up a tooth. Enamel, dentin, and cementum are the hard tissues of a tooth. The pulp is the soft tissue in the center.
2. Enamel forms the outer surface of the crown of the tooth. It's the hardest tissue in the body. Enamel allows the tooth to able to withstand a great amount of stress, seeing as your teeth are your chompy-chompers! Once enamel is completely formed, it can't grow more or repair itself, but it does have the ability to remineralize. This means that areas experiencing early demineralization (loss of minerals) are able to regain minerals and stop the caries (cavity) process. I have difficultly understanding why that's not considered an ability to repair...
3. Dentin makes up the main portion of the tooth; it's softer than enamel but harder than bone. Dentin is permeated with microscopic canals (dentinal tubules). These tubules contain fibers that transmit pain stimuli and nutrition throughout the tissues. Dentin does have the ability for further growth.
4. Cementum is the tissue that covers the root of the tooth in a very thin layer. It is not as hard as enamel or dentin, but it is harder than bone. It contains fibers that help stabilize the tooth within the bone.
5. The pulp is located in the center of the tooth, and is surrounded by dentin. The pulp is made up of blood vessels, connective tissue, nerve tissue, and cells that are able to produce dentin. The pulp nourishes the tooth and produces and repairs dentin. If the pulp tissues dies, then a root canal procedure is recommended to save the tooth.

Here's what else we know about teeth:

1. Approximately 96% of tooth enamel is composed of minerals. These minerals will become soluble when exposed to acidic environments. All acidity weakens teeth, but the amount of time that acids are in contact with teeth that determines the amount of damage. If mineral breakdown is greater than build up from sources such as saliva, cavities can result. Remineralization can also occur if the acid is neutralized by saliva. Rinsing with water can help.
2. At 77°F, the pH of pure water is very close to 7, and is considered neutral.
3. Enamel begins to demineralize at a pH of 5.5. When the pH at the surface of the tooth drops below 5.5, demineralization proceeds faster than remineralization.
4. Dental caries (caries is Latin for "rottenness"), is also known as tooth decay or cavities. Cavities are considered a breakdown of teeth due to the activities of bacteria, most notably Streptococcus mutans. (Of interest: Many studies show that chewing xylitol gum may reduce salivary S. mutans levels.) Before the cavity forms in the dentin, the process is reversible, but after it spreads to the dentin, it is not.
5. In the presence of sugar and other carbohydrates, bacteria in the mouth produce acids that can demineralize enamel, dentin, and cementum.The bacteria break down the hard tissues of the teeth by making acid from food debris or sugar on the tooth surface. The more frequently teeth are exposed to this environment the more likely dental caries are to occur.
6. Bacteria collect around the teeth and gums in a sticky, creamy-colored deposit called plaque, which acts as a biofilm (a thin, slimy film of bacteria that adheres to a surface).
7. Some sites collect plaque more commonly than others, like in the pits and fissures of the surface of the molars and cervical margins of the teeth.
8. The primary focus of brushing and flossing is to remove and prevent the formation of plaque.
9. As the amount of bacterial plaque increases, the tooth is more vulnerable to dental caries when carbohydrates in the food are left on teeth after every meal or snack.
10. A toothbrush can be used to remove plaque on accessible surfaces, but not between teeth or inside pits and fissures on chewing surfaces. When used correctly, dental floss removes plaque from areas that could otherwise develop caries.
11. There are certain things that can increase your risk for dental caries, such as tooth location and surface. Caries are most commonly found on incisors, canines, premolars, and fissure sites in molars.

Other things that increase your risk of caries include:

• Foods that cling to the teeth, such as candy or chocolate.
• Frequent snacking and sipping on sugary drinks.
• Bedtime infant feeding.
• Inadequate brushing of teeth.
• Dry mouth.
• Heartburn.

Here's what we know about taking care of your teeth and preventing cavities:

1. Regular professional cleaning of the teeth. The importance of general dentistry cannot be understated - 2 prophylactic cleanings are recommended per year. (This can be problematic for many, for multiple reasons outlined in my previous post.)
2. Brush your teeth at least two times per day (make sure one of these times is before you go to bed).
3. Floss between the teeth at least once a day; more so if you have a problematic tooth that catches food. Toothpicks can be helpful for getting food out of hard to reach areas.
4. Do not brush immediately after meals, especially those that are high in acid. Instead of brushing, consider rinsing your mouth with plain water.
5. Chewy and sticky foods (such as dried fruit or candy) tend to adhere to teeth longer, so they are best eaten as part of a meal. For children, the American Dental Association recommends limiting the frequency of consumption of drinks with sugar, and not giving baby bottles to infants during sleep.
6. The ADA recommends brushing twice a day with a fluoride toothpaste.

This is the 2nd post in a series of three. See How to Avoid a Root Canal and Fighting Cavities for the other two articles.