Tooth decay is one of the most pervasive diseases of our time but modern dentistry has made major strides in the battle against cavities. Based on years of scientific and clinical research, dentists are now moving towards an approach to dental caries (tooth decay) management that is tailored to your personal risk rather than a “one size fits all.”
The previous method of “drilling and filling” to treat decay does not actually change the conditions that lead to the disease and the risk for further infection still remains. By profiling the degree of risk and implementing individualized preventive strategies, today’s dental professionals are using a more proactive approach — that works.
A Dynamic Infectious Disease Process
The mouth is an ecosystem — living organisms continually interact with every other element in their environment. The teeth are composed of an outer covering of enamel, a highly mineralized crystalline structure composed mainly of calcium and phosphate. They are also bathed in a remarkable fluid — saliva, which plays a crucial role in maintaining a neutral environment or balance between the acids and bases in your mouth.
Acidity is measured by the pH scale, which ranges from 1 – 14. A pH value of 1 is extremely acidic while a pH value of 14 is extremely basic. The pH of the mouth is generally 7 — neutral.
Specific acid producing (acidogenic) bacteria attach themselves to dental plaque, the whitish sticky biofilm that collects and forms on the teeth. When you eat sugars or carbohydrates, these particular bacteria break down the sugars and produce acid as a by-product, which also makes the mouth more acid. At about pH 5.5, the minerals just below the enamel surface of the teeth begin to dissolve or “de-mineralize.” During this process, more calcium and phosphate leave the surface of the teeth than enter it — the first step in the decay process. And because the layer beneath the enamel, and the roots of teeth are made of dentin, which is softer than enamel, it is more susceptible to decay. For example, the roots of an exposed tooth will de-mineralize quickly and easily with even weak acids at pH 6.2 – 6.8, which is closer to neutral saliva.
Disease Indicators work by showing you what could happen based on what has happened. Identifying them includes the use of modern dentistry’s most sophisticated tools for early diagnosis of decay. They include:
* Visible cavities (decay) that is visible in teeth ranging from very early (microscopic) detection using, for example, laser technology, to cavities that are visible to the naked eye.
*X-ray pictures show early decay that is visible by using today’s highly sensitive yet low dosage x-rays.
*White spot lesions are the first sign of decay in the contacting areas of adjacent teeth that are often reversible with fluorides.
Cavities within the last 3 years — any previous cavities add to your risk.