The Challenges of Dentistry (Part 1)

One of the best things about being a dentist is that different days bring different challenges. Some are easy, some are baffling, and some are just plain fun.  However, most of our time is spent on five things:  Decay, gum disease, sensitivity, dry mouth, and broken teeth.

Today I’m going to talk about decay. I’m starting with this for a couple reasons.  The first is the fact that decay is the number one thing we deal with.  The second is that our amazing scheduling coordinator Kristen told me it is nutrition awareness month and I should do a blog about that.  I was unaware!  Anyway, I figured decay is dependent on nutrition to some extent so why not.

Tooth decay, or “caries” destroys tooth structure causing defects we call cavities. Many things are needed to allow decay to happen.  Bacteria, plaque, sugar, and acids all need to be present for a cavity to start.

Everyone has bacteria in their mouth. Some people have more caries causing bacteria, some have more gum disease causing bacteria.  The type of bacteria you have cannot be altered.  This comes from predetermined genetics.  However, the levels of bacteria can be controlled.  This is where plaque comes in.

Bacteria need plaque to stick to teeth. Without plaque, this bacteria is relatively harmless.  The best-known way to keep plaque off your teeth is to brush and floss.  Nothing can substitute for that!  All the products on all the infomercials cannot remove plaque like effective brushing and flossing.

We have found, and studies confirm, that a mechanical tooth brush does a better job of removing plaque than a manual brush. We see amazing results from people using a vibrating tooth brush like Sonicare. A toothpaste containing fluoride helps kill cavity forming bacteria as well as helping to refortify weakened tooth structure. While any fluoride containing toothpaste is acceptable, there are some really good toothpastes out there right now that not only help remove plaque, but also help fight gingivitis and tartar build up.  Many toothpastes also provide minerals for the rebuilding of damaged tooth surfaces.  The two I like the best are Crest Pro Health and Colgate Total.

While brushing is essential, flossing is the number one thing you can do to prevent tooth decay.  Most of adult decay (teens on up) begins where the teeth touch.  We call this the contact area.  If you don’t disrupt the bacteria sitting between your teeth on a daily basis tooth break down begins.  Floss is the only thing that effectively breaks that contact and allows oxygen to stop bacterial growth.  Floss is also vital in cleaning away plaque along the edges of filling and crowns.  These edges are often below the gum line where a tooth brush can’t reach.

We often recommend mouth washes for patients with high decay rates. A mouth wash containing fluoride.  This helps reduce the bacterial levels after you have brushed and flossed.  The fluoride in the mouth wash not only helps kill cavity forming bacteria, it also binds with the freshly cleaned tooth surface to strengthen the tooth against future decay as well as cut down on tooth sensitivity.

Watch for my next entry. We will talk about the role of sugars and acids in the decay process.

Thanks for reading,

Dr. Bruce