Right in time for Halloween candy. Here is a guest post by Dr. Richard Abrams, DDS , of Little Britches Pediatric Dentistry in Longmont, Colorado.
It takes three things to make a nice juicy cavity; a tooth, bacteria, and a substrate for the bacteria.
The tooth is a given (duh), the bacteria that inhabit the oral cavity contain some that are particularly cariogenic (how’s that for the word of the day?) which means “cavity-producing.” Streptococcus mutans is the most popular culprit.
You are not born with this bacteria!
It does not populate the oral cavity until there are teeth, and you likely “get” it from your primary care giver around 12-18 months. How many times have you tasted baby’s food, or had baby’s fingers in your mouth etc.? In goes Mommy’s bacteria (or nanny, or au pair)!
Now, these nice little bugs also need to eat. It just so happens that their favorite treat is anything sweet especially if it contains sucrose (table sugar).
Sucrose is made up of very simple sugar molecules that are way easy to metabolize. Now, it just so happens that these happily grazing little bugs produce acid as their waste product after they devour your treats.
The acid is what actually causes the decay by decalcifying the enamel of the tooth. Once inside the tooth, the dissolution process progresses more easily and rapidly because the inner layer of the tooth (dentin) is softer to begin with, so now you have a lovely cavity.
If left untreated, the decay progresses directly to the pulp tissues of the tooth (the nerve and blood vessels which keep the pearly white alive and well) which are housed in the center of the tooth. OUCH!
Once the decay has invaded the pulp, you now have your first abscess..Congrats! Infection of the pulp tissues leads to pain. If the pulp tissues are infected, there is no place for the infection to spread except out the root tip into the bone. More pain.
Then if you are really lucky the infection, will perforate the bone and start to invade the soft tissue of the cheek or lip or face. Now you look like a soccer ball!
So, how do we prevent this exciting scenario? Remember the three ingredients. We could:
- Strengthen the tooth against acid attack (fluoride and calcium/phosphate-containing substances)
- Don’t feed the animals (eliminate the sweets)
- Eliminate the bad guys (brush and floss)
After each sweet treat, the oral bacteria produce acid for about twenty minutes under normal conditions, in a lab, maybe. However if there is a load of plaque on the teeth, this can be a continuous process within the layers of plaque.
So brush regularly to keep the layers from forming to trap the acid production for posterity. If the teeth are clean, then you brush after your treat to keep the bacteria out and to catch them before they begin to produce acid.
Now this is all in a perfect world; some people have mega bugs. These guys can metabolize about anything and produce acid.
Crackers (generic Saltines) are seemingly harmless. They are made of starch which, if I remember correctly from prehistoric days, is just little sugar molecules strung together in a cute little chain. If your bacteria are pretty stout, they can break down a cracker into simple little sugar molecules. Yummy.
So why not do all three? Brush and floss regularly, especially after feeding the animals. Use fluoride regularly to strengthen the pearlies, and watch the sweet intake.
Imagine how much sugar is in soda!! Yikes! Also know that the acid level in soda is close to that of a battery! Talk about putting jumper cables to your oral bacteria!!
Sports drinks are also very cariogenic. They are more cariogenic than they are healthy, and kids drink them all day and at practice and after practice.
A Hershey bar is much easier to brush away than a gummy worm! Gummies are job security! They are pure sugar and they stick! They stay forever especially between teeth where the brush doesn’t reach.
How about sugarless? Most sugarless stuff is a sugar alcohol. Anything ending in -ol; sorbitol, etc. Some bacteria can even start to metabolize these little gems if given enough time.
We are interested in a new arrival xylitol. Not so very new, but evidence shows that bugs cannot metabolize this stuff and therefore they just move along if it is present in large enough doses and for long enough periods..Now, I got ya! You will have to tune in later to see where xylitol is going!
To learn more about Dr. A and his practice, check out Little Britches.com and if you have questions for the doc you can email him at littlebritches@me.com and he can answer them here in future posts.