/ 22 November 2011

Dental cavities: the hole truth

As any dentist will tell you, tooth decay is the most common health disorder in humans. In SA, those most at risk are children and young adutls.

As any dentist will tell you, tooth decay is the most common health disorder in humans. In South Africa, those most at risk are children and young adults, and it is the leading cause of tooth loss in these age groups.

But there are also worrying statistics concerning the general oral health of all South Africans, such as the fact that 41% of women and 30% of men suffer from some form of oral disease (and you can safely assume that cavities and associated disease are at the top of that list) and that 64% of women and 59% of men have lost some of their teeth.

How do cavities occur? Within about 20 minutes of eating something, bacteria that are normally present in the mouth convert sugars and starches into acids. This mixes with saliva and other food debris and forms a sticky white substance on our teeth and gums called plaque.

If this is not removed from the teeth with regular brushing and flossing, it turns into a hard substance called tartar.

The long-term consequences of having tartar and plaque on your teeth are gingivitis or periodontitis, diseases that result in infection and inflammation, which destroy tissue in the gums.

Those at higher risk of gingivitis and periodontitis are people with poor dental health, those in general poor health, pregnant women (hormonal changes are known to increase the sensitivity of the gums) and those with uncontrolled diabetes.

By the time gingivitis or periodontitis has set in, sufferers will have mouth sores and bleeding gums. The gums will also be tender to the touch and swollen. Sufferers can also be prone to abscesses, which can be extremely painful.

In more serious cases, trench mouth can occur. This is characterised by severe and painful swelling of the gums, profuse bleeding, fever and ulcers between the teeth.

Children and adolescents are more prone to dental cavities because of bad eating habits. As sucrose is generally accepted to be the biggest culprit for dental cavities, we can safely assume that these age groups are the biggest consumers of sucrose-laden foods such as sweets, sugary snacks and soft drinks.

There is little doubt that the country’s national water fluoridisation programme has had a positive impact on the population as a whole.

Studies have shown that over the past 30 years the severity and prevalence of dental cavities in South African children have reduced dramatically.

But studies also show that the level of untreated cavities is still high.

This brings us to the obvious conclusion that not enough South African children are getting the access they need to a dentist, particularly, as one would expect, children from disadvantaged communities, and even more so if they live in a rural area.

As one study showed, only 31% of rural South Africans have ever visited a dentist, compared with 60% of urban dwellers.

The irony is that the one area of healthcare where professionals are not in short supply is dentistry.

But the real problem is that only 11% of South Africa’s oral-health professionals work in the public sector.

Compulsory community service for dental graduates introduced in July 2010 will certainly have a positive impact on redressing the imbalance in service distribution. About 200 newly qualified dentists are expected to report for the service every year.

Education is also crucial. Getting people to brush their teeth twice a day with fluoride toothpaste and to floss would result in a vast improvement in their dental health, as would visiting a dentist twice a year and avoiding sugary snacks so that cavities do not occur in the first place.

Dental cavities will be the topic of Bonitas House Call on November 26 at 9am on SABC2