Teeth are meant to last a lifetime. It is a myth that you have to lose teeth as you get older. The two most common reasons that adults lose teeth are 1. Loss of support around the teeth due to gum disease and 2. Large cavities/dental decay. This article will focus on cavities/dental decay.
Bacteria are present in all our mouths. (Yes, even in the mouths of your dentist!) Some of these bacteria feed on sugar and put out an acid that eats away at your tooth to create the cavity. What may surprise you is that the frequency of sugar is more important than quantity of sugar. Each time bacteria contact sugar they produce acid for about 20 minutes. So eating a whole roll of LifeSavers candy at once means 20 minutes of acid production, but eating each one throughout the day means 20 minutes each time you have one.!
Many medications have a side effect of dry mouth (xerostomia) other medications reduce saliva flow. Either of these increase your risk of cavity formation because there is less rinsing action of the saliva on your teeth. For example, people with allergies get more cavities than those who aren’t allergy sufferers. Antihistimines, which are used to treat allergies, also dry up your saliva (a side effect). The dry mouth increases the risk of tooth decay and gum inflammation. (The recommendation is to increase fluids (but not sugar-filled ones) when you’re taking antihistimines and brush more often with fluoride toothpaste.)
What else can you do if this is a problem for you? If possible try to switch to a medication that does not have dry mouth as a side effect. Use plain water and/or sugarless gum or candy to help with your dry mouth. Sugared drinks and candies will increase your risk of cavities. There is some evidence that xylitol (used as a sweetener) may help decrease your risk of cavities. For severe cases of dry mouth, there are saliva substitutes available by prescription.
When a cavity is just starting, we call it incipient decay. Incipient decay areas may experience sensitivity to sweets, cold, or hot. . . but there may also be no symptoms at all. Unfortunately, pain can also signal nerve involvement—meaning the decay has penetrated to the dental pulp where the nerve and blood vessels of the tooth are. When a cavity is this deep, it needs more than “just a filling” to fix. You’re often looking at a root canal if you want to keep the tooth or having the tooth removed.
Tooth roots can be exposed if you have gum disease. Our tooth roots are covered by cementum which is not as hard as the enamel that covers the part of the tooth that’s normally exposed to saliva and bacteria in your mouth. Tooth roots can decay faster than other areas of your tooth.
So now that you’ve had your decay removed and the tooth filled (or crowned), you don’t need to worry any more, right? Actually the opposite is true. Fillings do eventually break down and need to be replaced. This can be from normal wear and tear caused by the expansion and contraction of teeth and fillings over time as we eat and drink items of various temperatures. Teeth or fillings can also fracture or break. Bacteria accumulate in any defect and cause what we call recurrent decay. (It’s the same process as what happens for dental decay, just in a different spot.) A crown has less tooth surface area exposed, so there are fewer places a cavity can start, but you can still get decay around a crown.
If you are prone to cavity development, you will want to brush at least twice a day (three or four times a day can also be your normal). You will also want to floss at least once a day to keep areas in between your teeth clean. Make water or non-sugared beverages your usual and if you do have a sugared beverage try to drink it fairly quickly to minimize acid exposure to your teeth. You can also ask your dentist about fluoride for home use either as a rinse, a brush on, or to use in a tray.
*Note: The information in this article is not intended to replace the clinical judgement of your healthcare professionals.
Dr. Jennifer Robb is a general dentist who sees both adults and children.
1612 Cooper Foster Park Rd.
Lorain, OH 44053