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13.03.2009 Health

Preventing Tooth Decay

By Dr. Emmanuel Kwesi Coomson Region Hospital, Koforidua ([email protected]) - Ghanaian Chronicle

Tooth decay comes about as a result of the effect of acid on the hardest part of the tooth; the enamel. This acid is produced by bacteria in the mouth (in plaque) as they feed on carbohydrate mostly sugars that we eat. Over time, the acid eats away the enamel to create a cavity that leads to tooth decay. Tooth decay therefore can be prevented by eliminating the contributing factors.

Dental hygiene helps to prevent tooth decay. Dental hygiene care consists of proper brushing and flossing of the teeth. Dentists recommend brushing the teeth with a very soft nylon brush twice a day two to three minutes per session. Brushing mechanically removes plaque and food particles from the teeth. Removing plaque means getting rid of the bacteria that causes decay and removing food particles means depriving bacteria in the mouth of the carbohydrate they need to produce acids to cause tooth decay.

The use of the chewing stick helps mechanically to remove plaque from the accessible parts of the teeth. It may contain some alkaloid which may reduce acidity of the mouth and help prevent tooth decay. In the least, the saliva produced while chewing the stick is good for the teeth. Thus, in the absence of the toothbrush, the chewing stick is encouraged.

The tooth brush is not effective in removing plaque and food particles from between the teeth. This is because the spaces between the teeth are too small. Dental floss can be used adequately to get between the teeth. Dental floss consists of an untwisted thread made from fine, short, silk or synthetic fibres that is frequently waxed. The floss is held between the finger and passed up-and-down and back-and-forth between the teeth of the teeth in order to remove plaque. Daily flossing is recommended.

A mouthwash refers to a medicated liquid that is gargled and swished in the mouth to cleanse it and to freshen the breath. Most mouth washes help remove particles from the teeth as well as kill bacteria. Being a liquid is able to go where the brush and floss cannot reach. Thus, mouth washes are very helpful in preventing tooth decay.

Sometimes, complete plaque removal with the toothbrush is difficult. Professional dental hygiene care must be sought at least once a year. This consists of regular dental examinations and cleanings by a dentist or dental hygienist. Radiographs or X-ray pictures may be taken at dental visits to detect possible dental caries development in high risk areas of the mouth.

Modification of our food and drinks can also help prevent dental or tooth decay.

In the presence of sugar and other carbohydrates, bacteria in the mouth produce acids which can demineralise enamel, dentin, and cementum and promote cavity development. The more frequently teeth are exposed to this environment, the more likely dental caries are to occur. Therefore, minimizing snacking is recommended, since snacking creates a continual supply of nutrition for acid-creating bacteria in the mouth.

Instead, stick to a well balanced diet three times daily. Also, chewy and sticky foods such as candies or toffees tend to adhere to teeth longer, and consequently are best eaten as part of a meal. Brushing the teeth after meals is recommended. For children, it is recommended that the frequency of consumption of drinks with sugar is limited.

It has been found that milk and certain kinds of cheese can help counter tooth decay if eaten soon after the consumption of foods potentially harmful to teeth.

Chewing gum containing xylitol is widely used to protect teeth in some Scandinavian countries. Xylitol is a sugar alcohol which tastes sweet but is not sugar. This means bacteria in the mouth cannot feed on it to produce acids to damage the teeth. Also, the act of chewing and the stimulation of flavour receptors on the tongue are also known to increase the production and release of saliva, which contains natural buffers to neutralise the acid in the mouth produced by the action of bacteria on food.

The chewing sponge is able to stimulate the production of lots of saliva which is effective in preventing tooth decay although it may not be effective in mechanically removing plaque between the teeth.

The use of dental sealants is a means of prevention. A sealant is a thin plastic-like coating applied to the chewing surfaces of the molars. This coating prevents the accumulation of plaque in the deep grooves and thus prevents the formation caries. Sealants are usually applied on the teeth of children, shortly after the molars erupt. Older people may also benefit from the use of tooth sealants, but their dental history and likelihood of caries formation are usually taken into consideration.

The choice of toothpaste is very important. All toothpaste and mouthwash used must contain fluoride in order to prevent tooth decay. Fluoride helps prevent decay of a tooth by hardening the enamel making it difficult for acids to demineralise. Fluoride in drinking water is good but too much can cause unsightly teeth discolouration.

In the developed countries, recent research shows that low intensity laser radiation has been noted to reduce the susceptibility of the enamel to caries and white spot lesions.

Also, as bacteria are a major factor contributing to poor oral health, there is currently research to find a vaccine for dental caries. As of 2004, such a vaccine had been successfully tested on animals and is in clinical trials for humans as of May 2006.