Prior to the fluoridation of tooth pastes and municipal water supplies, dental caries was a huge issue in our country. As far back as the late 1800’s, it was thought that bacteria in the mouth formed acid in the presence of fermentable carbohydrates. This is still the accepted theory. The acids remove surface minerals. This process leads to the cavitation (origin of the term “cavity”) of the tooth’s surface.
Infants are not born with the harmful bacteria necessary to cause caries, but these are always transmitted by close intimate contact with caregivers, especially the mother.
Diets high in sugar or simple carbohydrates (breads) which are broken down to sugars in the mouth are very problematic.
Caries, formation increases with both the number of exposures and the length of time of each exposure. In my own practice, I have seen some very interesting cases that reinforce these concepts. One of my adult patients, the mother of a 16 year old, brought her daughter to me for a “second opinion”. The daughter’s dentist had told the mother that her child needed sixteen crowns because of the severe amount of caries present in her mouth. My examination confirmed the severity of the caries problem. The previous dentist had offered no explanation for the daughter’s high caries rate and during my questioning; I could not find any obvious reasons for her problems. Being very conservative, I told the mother that I would attempt to fill her daughter’s teeth. Certainly the financial impact of sixteen crowns would have been devastating, so we scheduled the patient for her first appointment. Upon arrival for her visit, the patient placed an open can of cola on my counter. She had reported only drinking two sodas per day at her first appointment. I asked her again how many sodas she consumed per day and got the same answer, two. Realizing that this was not excessive, I asked the most important question of her dental life. “How long does it take you to finish one soda?” Her response made it clear why she was having severe caries problems. She said “I sip on one all morning and sip on the other all afternoon”. Wow, I suddenly got a totally different picture of only two sodas per day. She was literally bathing her teeth in sugar and acid up to eight hours per day.
Interestingly, I have found that patients who drink diet sodas, frequently during the day, have a greater caries problem. Why? Because the diet sodas are highly acidic.
When counseling patients, I advise patients to limit sugary foods to meal times, followed by rinsing and brushing. I point out that eating half a cake following a meal has a much different effect than snacking on that cake over several hours, especially if they brush after meals.
Hopefully you are getting a better perspective on what factors cause high caries rates.
The fast food craze has not only promoted the ingestion of high fat, high sugar foods, but foods that are totally lacking in nutritional value.
Both children and adolescents consume excessive amounts of soda on a regular basis. Again, by limiting sodas to meal time, parents can have a positive impact on their offspring’s dental health. Sugared gum is also problematic. It is felt that adults, in general, have less problems with caries, but this changes in the elderly. Factors responsible are gum recession, xeristomia (dry mouth), poor diet, and lack of proper oral hygiene. Roots exposed by recession are “softer” than enamel and more susceptible to caries. Salivary flow can diminish as a side effect of certain drugs or diseases. Saliva is an essential buffer in caries formation. Decrease in manual dexterity is certainly a factor in declining oral hygiene.
What can be done with products and procedures to lessen caries formation? Automatic tooth brushes are extremely helpful in reducing plaque (bacteria). I recommend Oral B. Xylitol containing gums are excellent. They inhibit plaque formation, reduce acid formation and are low calorie. Fluoride is essential in making enamel more resistant to acids. Tooth pastes should provide fluoride. Our water supply now contains fluoride, so drink more tap water. Fluoride rinses are available over-the-counter. In office fluoride treatments are also available.
Hopefully, we have given you some insight into the causes and cures for caries formation. At San Diego Dentistry, we are here for you to provide counseling concerning caries or any other of your dental needs.