 Young people are particularly vulnerable |
It is particularly common in children and young adults, and rates have been fuelled by an increase in sugars in the diet, and poor dental hygiene.
What causes tooth decay?
The problem is caused by sticky deposits called plaque that collect, in particular, around the gum line, the edges of fillings and the grooved surfaces of the teeth.
Plaque is made up of food debris, saliva and the bacteria that are normally present in the mouth, and convert food into acids.
If plaque is allowed to collect over time it will harden into a substance called tartar.
Both tartar and plaque contain acids which, over time, can dissolve away the protective, hard enamel coating of the tooth, and create holes, or cavities.
Most cavities form over a period of months, or even years.
They are usually painless, but they can grow very large, and damage the much softer internal structures of the tooth such as the dentin and the pulp, which is found at the core.
If they remain untreated, they can kill the nerve and blood vessels of the tooth, and ultimately the tooth itself.
What are the symptoms?
The most obvious sign of tooth decay is toothache, particularly after hot or cold foods or drinks. However, pain may not be present until decay has reached an advanced stage.
Pits or holes may also be visible in the teeth.
Most tooth decay is discovered at an early stage during a routine check up.
A serious complication can be the development of a tooth abscess - the build up of pus resulting from a bacterial infection of the centre of the tooth.
Infection may spread out from the root of the tooth and to the bones supporting the tooth.
Plaque and tartar also irritate the gums, and lead to a gum disease called gingivitis.
Is diet a factor?
Yes. Eating a diet rich in sugar and starch increases the risk of tooth decay, and sticky foods can be a particular problem because they are more likely to remain on the surface of the teeth.
Frequent snacking also increases the amount of time that acids are in contact with the teeth.
In the absence of good oral hygiene, it doesn't take long for damage to begin. The acids generated by the breakdown of food stuff in the mouth can begin to attack the tooth enamel within 20 minutes of a meal.
It is thought that tooth decay only became a widespread problem with the establishment of sugar plantations in the 18th century, and worsened with the subsequent widespread cultivation of sugar beet in Europe .
How do you prevent decay?
The best way to keep your teeth in health condition is to ensure that you clean them regularly to get rid of any plaque build up.
Most dentists recommend that you clean your teeth at least twice a day. Using a toothpaste containing fluoride is probably a good idea as this provides the teeth with added protection from the effects of acid.
Flossing between the teeth is also a good idea, as is rinsing out your mouth after eating sticky foods.
It is also important to have a regular check up at the dentist - most suggest once every six months to a year.
Unfortunately, even good oral hygiene does not prevent decay as the bacteria congregate in areas inaccessible to brushes and floss.
How is decay treated?
Once the structure of a tooth has been damaged by decay, there is no way to repair it.
However, if decay is picked up at an early stage its progression can be blocked.
Decayed material can be removed, and replaced with a restorative material such as silver alloy, or plastic. This is known as a filling.
If the decay is more extensive, then another option is a crown. The decayed or weakened area is removed and repaired and a covering jacket - the crown - is fitted over the remainder of the tooth.
If the nerve in a tooth has died, either from decay or a blow, then a dentist will consider root canal work.
This involves removing the centre of the tooth, including the nerve and blood vessel tissue.
The root is then filled with a sealing material, and the process is completed with either filling, and possibly a crown।
Prevention
Oral hygiene
Personal hygiene care consists of proper brushing and flossing daily. The purpose of oral hygiene is to minimize any etiologic agents of disease in the mouth. The primary focus of brushing and flossing is to remove and prevent the formation of plaque. Plaque consists mostly of bacteria. As the amount of bacterial plaque increases, the tooth is more vulnerable to dental caries. A toothbrush can be used to remove plaque on most surfaces of the teeth except for areas between teeth. When used correctly, dental floss removes plaque from areas which could otherwise develop proximal caries. Other adjunct hygiene aids include interdental brushes, water picks, and mouthwashes.
Professional hygiene care consists of regular dental examinations and cleanings. Sometimes, complete plaque removal is difficult, and a dentist or dental hygienist may be needed. Along with oral hygiene, radiographs may be taken at dental visits to detect possible dental caries development in high risk areas of the mouth.
Dietary modification
For dental health, the frequency of sugar intake is more important than the amount of sugar consumed. In the presence of sugar and other carbohydrates, bacteria in the mouth produce acids which can demineralize enamel, dentin, and cementum. 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. Also, chewy and sticky foods (such as dried fruit or candy) 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, the American Dental Association and the European Academy of Paediatric Dentistry recommend limiting the frequency of consumption of drinks with sugar, and not giving baby bottles to infants during sleep. Mothers are also recommended to avoid sharing utensils and cups with their infants to prevent transferring bacteria from the mother's mouth.
It has been found that milk and certain kinds of cheese like cheddar can help counter tooth decay if eaten soon after the consumption of foods potentially harmful to teeth., chewing gum containing xylitol (wood sugar) is widely used to protect teeth in some countries, being especially popular in the Finnish candy industry. Xylitol's effect on reducing plaque is probably due to bacteria's inability to utilize it like other sugars. Chewing and stimulation of flavour receptors on the tongue are also known to increase the production and release of saliva, which contains natural buffers to prevent the lowering of pH in the mouth to the point where enamel may become demineralised।
Other preventive measures
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 of pit and fissure caries, the most common form of dental 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.
Fluoride therapy is often recommended to protect against dental caries. It has been demonstrated that water fluoridation and fluoride supplements decrease the incidence of dental caries. Fluoride helps prevent decay of a tooth by binding to the hydroxyapatite crystals in enamel. The incorporated fluoride makes enamel more resistant to demineralization and, thus, resistant to decay. Topical fluoride is also recommended to protect the surface of the teeth. This may include a fluoride toothpaste or mouthwash. Many dentists include application of topical fluoride solutions as part of routine visits.
Furthermore, recent research shows that low intensity laser radiation of argon ion lasers may prevent the susceptibility for enamel 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 has been successfully tested on animals, and is in clinical trials for humans as of May 2006.
0 Comments:
