Dental caries is the process of tooth decay. It occurs when bacteria called dental plaque, consume sugar and produce acid that dissolves tooth enamel and dentine.
Immediate treatment in the form of restoration (i.e. filling) is essential.
The first stage of tooth decay is called demineralisation, and it can be reversed at this time.
Fissure caries occurs because plaque becomes trapped in the bottom of the grooves in the top of the tooth where the enamel is very thin and easily penetrated by the plaque acid. This is the most common form of caries in children.
Factors affecting dental caries
Plaque produces acid, dissolving the enamel. Saliva neutralizes the plaque acid and contains minerals to repair the tooth structure. However, a sticky film that excludes the saliva holds the bacteria together. If the plaque is not removed, the tooth underneath it is constantly being dissolved and never repaired, leading to caries formation. Regular tooth brushing and flossing are essential to remove the plaque and let the saliva do its job.
Our Saliva is the body’s natural defense against caries. We all have an individual saliva flow rate and mineral composition. It takes about two hours of normal flow to remove the plaque acid produced after eating and return the mouth to resting phase. You can speed the process up by chewing a sugar free gum for 5-10 mins. Smoking, stress, some medications, and caffeine and alcohol drinks slow down the saliva production and increase the risk of caries. Minimizing these factors and drinking tap water to keep well hydrated will make the most of your saliva.
Diet. Plaque bacteria live on carbohydrates, in particular, sugars. By limiting sugary snacks, or eating them with meals, you are reducing the amount of damage the plaque acid can do. The consistency of the food is important too. Sticky lollies or dried fruit, for example, are in your mouth longer as they stick to the tooth surface.
Time could be a factor if you are eating or drinking anything containing sugar more frequently than every 2 hours. Your mouth would never get a chance to rest. The longer the time your teeth are in an acid environment the more likely they are to decay. Caries doesn’t form overnight. Long term bad habits in diet and or cleaning, or deficiencies in your saliva, are to blame. If you are unsure if you are putting yourself at risk, talk to your dentist or hygienist.
Your Tooth structure or shape can affect caries as some teeth have deeper groves than others, making cleaning more difficult. Fissure sealants can be placed in these grooves to reduce the risk of caries. You can strengthen your enamel by using fluoride toothpaste regularly. Fluoride works to prevent caries because when it is incorporated into the enamel structure is takes a stronger acid to dissolve the tooth. Fluoride supplements, like any medication, need to be in a dose appropriate to your age and decay rate.
Your best protection against dental caries is daily brushing, flossing, using fluoride toothpaste and maintaining regular dental visits. If you think you have a high caries rate, talk to you dentist or hygienist about tooth brushing and flossing techniques and aids, remineralising agents and fluoride, saliva testing, fissure sealants or dietary counseling.