Caries is the process of tooth destruction. This occurs when foods containing carbohydrates (sugars and starches) such as milk, raisins, cakes, bread or candy are consumed and left on the teeth. Bacteria that live in the mouth thrive on these foods, producing acids as a result. Under the right conditions and over a period of time, these acids destroy tooth enamel, resulting in tooth decay.
Dental Caries is a Transmissible Bacterial Infection
Dental caries is a transmissible disease and mutans streptococci is the principal bacteria responsible for its initiation. This bacteria is not present at birth, but is acquired, usually from the mother. Acquisition can also be from other caregivers by means of passage of saliva and shared utensils. The “window of infectivity” is estimated to be between 6 and 36 months of age. A high level of bacteria in the mother’s mouth increases the rate of transmission to the infant. Children who are infected at this early age can have a higher lifetime incidence of dental caries.
The following are some ways that can help prevent tooth decay:
- Brush twice a day with fluoride toothpaste
- Angle the brush at about a 45 degree angle up onto the tooth and into the gum line.
- Brush all surfaces (insides, outsides, and tops) of all the teeth.
- Use a soft-bristled brush and use a gentle brushing motion.
- Don’t over scrub or use too much pressure.
- Make sure you brush every tooth and cranny.
- Clean between your teeth daily with floss or interdental cleaner.
- Eat nutritious and balanced meals and limit snacking in between meals.
- Check with us about the use of supplemental fluoride
- Ask us about applying dental sealants (a plastic protective coating) to the chewing surfaces of the back teeth in order to protect them from decay.
- Visit us regularly.
Diet, Brushing and Flossing
Make sure that all surfaces of the teeth are brushed (insides and out), at least twice a day with a fluoride toothpaste focusing along the gum line as well as the chewing surfaces of the back teeth. For infants, begin using a “pea size” amount of toothpaste and encourage spitting it out.
The only way to effectively clean in between the teeth is by using floss. Once it is gently inserted and wiggled down, do not use a back and forth motion. This can cause damage to the tooth over time and injure the soft tissues. Flossing is a technique that your child will need your help with until they have the manual dexterity to accomplish it on their own. It is also not uncommon for parents to help brush their children’s teeth until the ages of 6 and 7 (or later depending on the child), at which time, hopefully, brushing skills can be effectively mastered.
- Many of us forget that diets high in carbohydrates not only consisting of sugars, but starches as well can place children at extra risk for tooth decay. Foods with starch include breads, crackers and snacks such as pretzels and potato chips.
- The more retentive foods (those that stick to the teeth) pose more potential for harm.
- Limit the number of snack times in between meals, preferably saving foods with sugar or starches for meal times.
- Clear the snack from the teeth as soon as possible. Even a simple swish and rinse with water will help
- Try to provide healthy snacks such as cheese, yogurt, vegetables, and fruit.
- Try sugarless gum as a substitute for snacking or chew it following a snack to stimulate the flow of saliva.
For children who are at moderate or high risk of developing cavities (e.g. those with a history of caries, poor brushing technique, poor diet), additional fluoride modalities could be beneficial:
- Over the counter fluoride rinses such as ACT or Phosflur used in conjunction with twice daily brushing in addition to a fluoride toothpaste.
- For children over 6 who are high risk, a prescription brush-on dentifrice with a high concentration of fluoride content (e.g.”Prevident”) can be used as a replacement for their regular dentifrice.
- Office application of Topical Fluorides via trays or Fluoride Varnishes could enhance protection of the tooth structure and aid in its repair.
Application of Sealants to protect the chewing surfaces of the molars can be very effective in protecting those very retentive, susceptible sites. They provide a barrier from food and bacteria accumulating in the crevices of these teeth. The application is painless and easy.
The use of sugarless gum, especially with Xylitol, helps to stimulate saliva, which in turn aids in putting minerals back into the tooth structure (remineralization) aiding in its repair.
Additional Hygiene Tips for those with Braces
Extra time and effort is necessary to keep orthodontics appliances clean and the teeth with its gums healthy. When plaque and debris collect around braces they can produce unsightly white spots that can lead to decay.
Some additional ways to help keep teeth and gums healthy while wearing appliances:
- Using specialized brush tips get in between the braces and under the wires
- Using floss threaders under the wires
- Using oral irrigators to dislodge food and debris from around the teeth
- Using over the counter fluoride mouth rinses (Phosflur) and prescription toothpastes (Prevident) to give the teeth extra protection
- Brushing after meals and staying away from harmful foods that are retentive
- Visiting us more frequently for cleanings, concentrated fluoride applications (Fluoride Varnish) and hygiene reinforcement