|Trivial Pursuit question:
Which is the most widespread disease in the world?
If you think about it, caries is the most prevalent disease in the world. Most people we know have one or more fillings in their mouth. It is estimated that around 98% of people has or will develop caries at some point in their life.
Does that mean that it is normal to have caries in our mouth?
It is expected but it is not normal.
Caries is a disease that can be prevented, inhibited and eliminated.
What exactly is caries?
Caries is a bacterial infection that causes the destruction of teeth. Apart from the bacteria, other factors have to be active, in order for the tooth destruction to begin. These factors are the enviromental conditions that exist in the mouth, and the nutrition.
How are teeth destroyed by caries?
Bacteria accumulate on the tooth surfaces and develop into the dental microbial plaque. Certain species of bacteria (S. mutans, lactobacilli) are mainly responsible for caries. These bacteria metabolize (break down) the carbohydrates that exist in our mouth (and come from our nutrition) and produce acids that lower the oral pH. When the oral pH decrease under a certain point, teeth start to decalcify (that means they loose their inorganic substances). The destruction of the organic matrix comes after that and a cavity is formed. This cavity becomes a nest for more bacteria to develop and so on... If caries isn't restraint (usually by a filling) then the bacterial toxins might enter the pulp (tooth nerve) and cause pulpitis, pain, pulpal necrosis and abscess.
How can I protect my teeth?
Caries is a multifactorial disease. It needs certain conditions and factors to develop. If all of these factors and conditions don't exist caries, won't develop. Therefore, our task is to control those factors and prevent the presence of caries.
What should I do?
- Brushing: Regular and thorough brushing (twice daily at least, after the main meals). Use of dental floss for interdental cleaning.
- Fluoride: Fluoride is our best ally against caries. The toothpaste should contain fluoride, and usually it's good to use a supplementary fluoride mouthwash for rinsing. As far as children are concerned, in certain situations it is advisable to have a supplementary dosage of fluoride taken daily, in the form of lozenges. That way, their teeth can become more resistant to caries, even before they erupt in the mouth.
- Nutrition: Holdback on sugar and generally on sugar containing foods (sweets, candies, chocolates, soda refreshments, cookies, ready made snacks that contain sugar, juices, etc.).
- Food frequency: Sugar quantity isn't the only factor that affects caries, but it's frequency as well. The same quantity of sugar will cause larger destruction if taken in many meals instead of one. Therefore we should contain our sugar intake to the main meals.
- Saliva: Saliva is an important factor that neutralizes the acidity of dental plaque. That's why if it's impossible to brush our teeth after a meal, the best thing to do is rinse with water or chew a sugar free gum for a few minutes. This helps in the production of saliva and the faster normalization of the oral pH.
- Regular visits to the dentist: Regular check ups help in the early diagnosis of caries. The sooner caries is diagnosed the smaller the restoration that needs to be done. If caries is diagnosed in the very early stages, it might still be in a reversible state. With the proper treatment we can stop (arrest) the cariogenic activity, without even the need of a filling!