Welcome to the first Simpsonville Family Dentistry blog. My hope is that this blog will be a way for me to educate you while also answering questions I get every day so that you and others can have healthier teeth, gums, and keep your teeth longer. I figure I would start with the question I get asked most often which is “Why do I always get cavities and how can I prevent them?”
First we need to understand what dental decay is and dispel one myth, the myth of the “soft teeth”.
I hear every day about soft teeth, and there are some diseases that actually results in a softer enamel and other tooth structures but they are extremely rare. Dental decay is actually more about your bacteria, your mouth pH, and your consumptions of sugar. I doubt anyone reading this hasn’t heard about sugar and cavities, but for some reason, the dental profession stopped there historically. Let’s go through the 3 factors of decay one by one.
- Bacteria: The bacteria of the mouth varies greatly from person to person. Of the 3 factors, we have the least ability to fix or change your bacteria. We each have a different combination of bacteria so I will talk the least about bacteria when I’m telling you how to prevent decay later. A human is born with zero bacteria in the mouth and no risk of decay at all. We know through history that newborns are usually inoculated through the passing of the saliva from caregivers, and they are then at risk of decay since they now have bacteria. The bacteria inoculation occurs through acts such as kissing a baby on the mouth, licking their spoon or pacifier, or any other way where saliva might transfer from one human to a human. This is why you often have similar rates of cavities to your parents. It’s isn’t from your DNA but the fact that you are the one most likely to share saliva with them. I’m not telling you to not kiss your child because I believe it is more important that a child feels love than to be cavity free, and I’m a dentist and care about cavities more than anyone reading this! Plus your child would get bacteria from day care or school or the playground anyways. What I do want you to do is when you have a baby or are around other babies try not to kiss them on the mouth and try to follow items listed later about cavity prevention while being around newborns. Hopefully when I rewrite this blog in the year 2030, I will have more to report, but for now, just know that you have bacteria so you are at risk of decay. Bacteria cannot do anything to cause decay to good hard enamel, so you are probably wonder why it matters. It matters because it can cause teeth to decay by producing acid when it eats sugar which brings us to our next point….
- Mouth pH: Everybody reading this has a different natural pH of their saliva. pH is a measurement that you probably heard in chemistry class and hope you would never hear again since you hated chemistry. Sorry I’m dragging up bad memories, I promise to keep it as simple and short as possible. pH measures how acidic or basic a material is. Acidic materials are materials such soda, citrus fruits, tomatoes, stomach acid, and car batteries (I always loved that all my classes listed car batteries like we know what that tastes like). Basic materials are materials such as broccoli, baking soda, and most green vegetables. pH is measured from 1 to 14 with 7 being neutral (water). Anything below 7 is considered acidic, and anything above 7 is considered basic. When the pH of your mouth goes down the acidic scale to 5.3 or lower, the enamel on your teeth begins to break down. The longer your mouth stays in the acidic pH, the more enamel breakdown you have and the higher the risks you have for cavities. The good news is your body is always breaking down your enamel and rebuilding it so it knows how to fix a little breakdown here or there. The problem falls when the breakdown is happening at a quicker rate than the repair. If your breakdown gets through the enamel without your body repairing it then you have to get a filling because your body can not repair dentin (Dentin is the part of the tooth between the pulp or nerve and the enamel). 3 isn’t very acidic. Soda usually has a pH of 3. Orange juice has a pH of around 4 so both of those are too low. The key to all this pH talk is to know when you have had acidic foods and to try to limit the amount of time your pH is too low. Google pH of foods and you can find a lists of pH for everything you eat. You will sadly find that we love acidic foods and hate basic foods, but having an education of which is which will help you make better food decisions for your teeth.
- Sugar: Dentists have beat you over the head for your whole life about sugar, but we probably never told you why. Sugar is the enemy to healthy teeth because it is a food source for the bacteria of our mouth just as it is for us. Many of us have a sweet tooth, but we have nothing on bacteria. Bacteria like sugar more than any of us, and when they eat it they love to spit out lactic acid which decreases your pH which breaks down enamel. Sugar without bacteria won’t hurt our teeth, but the combination is bad news for enamel especially if the sugar source is also acidic in nature.
Now that I have your eyes glazed over with science, I’m going to give you an analogy of something in the real world. The wood on a barn gets wet and the wood is softened which allows termites in. The termites eat the wood for food which creates more holes so that other termites get in. The more termites that get in the quicker destruction of the house.
The rain would be the acid (from food, acid reflux, or from a bacteria with sugar). The termites are the bacteria which produce bigger holes letting more bacteria in which speeds up the destruction. Like the house above, the more often you have a professional look at it, the smaller the damage will be.
The patient who comes every 6 months will often get a filling while the person who comes when things hurt often get a root canal or extraction.
Now the questions is, can you do anything to slow down or stop the decay? The answer is yes. Everyone can slow down their decay rate, and many can stop getting decay all together! Even if we can’t stop it completely in some people, slowing it down will allow you to have your teeth longer, have less time in a dental chair, and save money. Here’s some stuff you can do to help with decay:
- FLUORIDE: Fluoride has been the best thing to happen to dentistry in all of our lifetimes. The addition to fluoride to the water led to decrease in dental decay since its addition. We see many 30 and 40 year old patients who have never had a cavity in our practice which was unheard before fluoride. I can also often tell when children were raised on bottle water or well water which usually contains no fluoride due to higher decay rates. Fluoride has the ability to strengthen enamel making it less susceptible to breakdown from acid. Fluoride today is found in our water and in our toothpaste unless otherwise stated. Many patients benefit from a prescription toothpaste with higher fluoride content and by getting fluoride applications at their cleanings which is like a fluoride booster. Fluoride is a neat material in that it is overwhelming effective, safe, and favorably thought of in the dental community, medical community, and the CDC, but is overwhelming hated on google. I just like to list that as a heads up.
- LESS ACIDIC FOODS: I’m not telling you to not eat acidic foods and drinks. I just want you to limit the time you have an acidic environment in your mouth. When you eat acidic foods or drinks, do snack or sip for long periods of times. The more time you stretch out the drink or snack, the longer the period your teeth will be at risk from the acid. I would much rather you drink a can of soda in 10 minutes than I would sip on it for 2 hours because the 2 hour acidic environment is worse than the 2 hour one. If you do eat or drink acidic foods, don’t brush your teeth for 20 minutes because the enamel is softer in that period and you can remove it with toothbrush and toothpaste. The other option other than waiting 20 minutes is to return your pH to normal with a basic item just as a xylitol gum or mint (more on this later) or by swishing with a mixture of baking soda and water. This is a neat website to tell you more about dental decay and acid.
- GET ACID REFLUX UNDER CONTROL: Be aware that it isn’t just food acid that can break down enamel. It is also stomach acid which is more acidic than soda. Many people who have uncontrolled acid reflux often have very high decay rates because they are sipping stomach acid all day and their body can’t repair fast enough.
- LIMIT SUGAR: Limiting sugar is always good for your teeth. Also be aware that the stickier the candy, then the longer it will stick to your teeth and the more damage it can do. Also the more acidici the candy, the more damage. That is why as a dentist, I would prefer you to eat a chocolate bar (which has sugar) than sour gummy candy (sticky and acidic) or caramel (sticky).
- XYLITOL: Xylitol is a natural alternative sugar that has been found to help with dental decay. Xylitol is thought to do 3 things that help lower decay rate: return mouth to more basic pH, be a sugar that bacteria will absorb but not use to produce acid, and increase saliva. All 3 of those things will help with decay. A less effective bacteria can’t produce acid. A more basic pH will cause less breakdown of enamel. More saliva will also help with decay since saliva is the body’s natural cavity preventer. There are a lot of xylitol products on amazon and at stores. Spry is the easiest to find at a store in my area. You can read about it on the link above, but your goal is to go for 5 gums or mints a day which equals 5 grams of xylitol.
- SALIVA: Most patients have enough saliva so this isn’t a real concern. If you have noticed that you are having a dryer mouth due to medications you take, please find which over the counter dry medication works best for you. No matter how well you do on the other 5 points, nothing matches our natural saliva. Without saliva, cavities come quickly and it is heartbreaking for me to see the destruction that 3 months of dry mouth can do.
- GOOD HOMECARE: Sadly nothing above matters if you don’t have good homecare. You must brush at least twice a day and floss once. Nothing we do twice a year at your dental visit will equal what you do all the other days. Remember that the tooth has 5 sides. You can clean 3 with brushing, but you will only get the other 2 by flossing. If you are one of my anti flossers, please use a product that will clean between the teeth. Some of these products include: Airflosser, WaterPik, a interdental stick or proxibrush. There are also many cool new flossers which many of our patients really like such as Gumchucks and flossers with toothbrush handles.
- REGULAR DENTAL VISITS: Regular dental visits always lead to finding problems quicker. The problems also result in less tooth removal, lower costs, and less tooth loss. Teeth without tarter or calculus are easier to clean which results in lower decay rates. The less preventive appointments a patient has always leads to more extractions, root canals and crowns.
I hope you have found this helpful. If you have any questions, feel free to contact us at 864-963-3481 or by email.