Tooth Decay

Decay, or caries, is destruction of the hard tooth, by acid dissolving. As the destruction occurs, a small cavity or hole can result.

Decay is caused by plaque. The bacteria in your mouth are usually harmless. Food or drinks that are high in carbohydrates, specifically a type of carbohydrate known as fermented carbohydrate, cause these bacteria to turn the carbohydrates into acid. The acid will then combine with the bacteria, and small morsels of food, to produce plaque.

Plaque can result in the complete or partial destruction of the tooth. In its early stages, caries is not usually painful, but may later lead to tooth ache as the nerve inside that tooth becomes involved. Caries may affect more than one tooth at a time and may affect more than one site on the same tooth. Teeth that have been previously filled can get further decay (particularly around old fillings). Decay is still a common condition in children and adults and may in some cases lead to the loss of teeth due to extensive breakdown. Good oral hygiene techniques are a quick, easy and effective way to prevent Decay and to treat it in the earliest stages.

Grooves in teeth can be particularly difficult to clean, making these areas prone to Decay. A Dentist may be able to seal these grooves with a clear or tooth-coloured plastic (fissure sealing) that will prevent bacteria from becoming caught in these grooves.

Most tooth and gum problems are due to poor oral hygiene. It is essential to regularly remove the bacteria (plaque) that naturally form on teeth, to prevent Decay. A toothbrush with a small head and soft bristles will more than adequately clean the teeth without causing damage to the teeth or gums. Always make sure the teeth are brushed both inside and out to ensure thorough cleaning.
Hold the brush with the bristles at an approximately 45 degree angle to the teeth and gums and move the brush with a small circular action (concentrating on one tooth at a time). When a circular motion is too difficult to manage try using a small horizontal scrubbing action. Use firm pressure but never press too hard. It is important to clean both the teeth AND the gum next to the teeth.

Brushes can only clean some surfaces of the teeth. To clean between teeth, it is important to use floss. Flossing can be a little difficult to start with but after a few weeks practise it becomes very easy. Most floss comes with instructions on the pack. It is important for the floss to pass slightly below the gum line to clean out the small crevice between the tooth and the gum. Brushing and flossing will not remove good fillings. Only fillings that are in poor condition may be removed by flossing and are best replaced before any further decay has the chance to form.

TREATMENT OPTIONS
As with all dental conditions your Dentist should be consulted. If decay is detected early enough it may be possible to heal (remineralise) any damage without the need to fill the tooth. Your Dentist will diagnose and treat your particular problem. Ask your Dentist about how to brush and floss your teeth.

DIET HINTS
• Try not to snack between meals. Eating between meals without brushing afterwards, allows plaque to build up which can result in decay
• After eating it is important to clean your teeth to remove food particles, which can help the bacteria to grow. The bacteria then convert the food into acid, which causes decay.
• Food containing fermented carbohydrates are more likely to cause plaque and Tooth decay. These include sweet and sticky things, such as chocolate, sweets, sugar and fizzy drinks. Starchy foods, such as crisps, white bread, pretzels, and biscuits also contain high levels of fermented carbohydrates.
• Remember that even drinks can be very acidic. Soft (fizzy) drinks and sports drinks should not be used during or after exercise. Saliva normally helps to protect against decay. Exercise causes your saliva to dry up, allowing these drinks to dissolve away the teeth. Water is much safer.
• Make sure that you clean your teeth before going to sleep. Going to bed without brushing allows plaque to grow on teeth and gums during the night.
• Because plaque bacteria convert most foods into acid, an apple (or carrot) a day will not keep the Dentist away!

ORGANISATIONS & SUPPORT GROUPS
Indian Dental Association (www.ida.org.in)

PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice
1. Follow the Diet Hints.
2. Your Pharmacy stocks a wide range of suitable toothbrushes.
3. Brushes can only clean some surfaces of the teeth. To clean between teeth, it is important to use floss. There are many brands and types of dental floss. Ask your Pharmacist for the type of floss recommended by your Dentist.
4. Toothpastes containing fluoride help to prevent decay by strengthening the tooth against acid attack.
5. Follow the Diet Hints.
6. Sugarless chewing gum, available from your Pharmacy, can help to increase the flow of protective saliva to the teeth and gums. Saliva helps to neutralise acid, which causes decay.