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Caries Control

October 11th, 2012

Dental caries, commonly called tooth decay, remains an all too common disease.  This is unfortunate since the causes and modes of prevention are well known.  Tooth decay is a bacterial infection of the hard tissue of the mouth.  The types of bacteria that can grow on the tooth are very limited but hard to get rid of once established. The disease is communicable and can be passed by saliva on utensils, drinking glasses, etc.  In fact, children are born without the bacteria and are most often infected by their mothers testing or sharing food or by putting their fingers in the parent’s mouth and then in their own.  Careful handling can prevent this inoculation.
There are three major factors which mediate the process of tooth decay.  They are discussed below in order of importance.
Diet
The bacteria on the teeth use carbohydrate in the mouth, most commonly plain sugar but also other carbohydrates, to grow and reproduce.  They produce acid as a byproduct of this and the acid weakens the tooth structure.  Each time additional carbohydrate is added, the acid levels are above the danger point for up to 20 minutes.  It’s this contact time that does the damage.  Things that are consumed over long periods (sucking candies and sticky snacks) or are in the mouth constantly (soda sipping and other sweets) do the real damage.  Remember, it’s not how much but how often.
Fluoride
Whether present in the toothpaste, water, or in tablet form it hardens areas of enamel that have begun to weaken from acid attack.  It doesn’t last long in the body and so it must be replenished every day.  In severe cases, higher prescription levels may be given until the disease is under control.  While it can slow or prevent decay, fluoride can’t overcome the effects of a poor dental diet.
Oral Hygiene
It takes only 24 hours for bacterial plaque to grow on a clean tooth surface.  So it must be removed every day.  While many products claim superiority in removing plaque, the good old fashioned toothbrush and floss remain as good as any.  You need to take the time to do and effective and thorough job.  Rinses, water sprays, and the like do little to keep the plaque level down.
An additional word abut acid levels.  Remember the pH scale for acid and base measurement.  Neutral is 7 (pure water) and very acidic is 0 (hydrochloric acid as used in swimming pools).  Any level below 5.5 begins to weaken the tooth enamel.  Constantly keeping below that level will do real damage and lead to higher decay rates.  Some common items are orange juice (3.6a), apple juice (3.4), Gatorade (3.1), Diet Coke (3.0), Coke and Pepsi (2.3), and lemon juice (2.0).

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