Many years ago one of our global toothpaste behemoths ran a TV advertisement which had a cute eight year old bouncing out of the dentist’s chair, beaming a set of dazzling peroxide teeth and exclaiming with great pride: “No fillings today, mom!”
No doubt that kind of advert has had most of us brushing in a frenzy twice a day ever since. But nearly all of us will have the need for a filling at some stage or another. The fact is, tooth decay, or dental caries as it’s known, is one of the most common disorders to afflict human beings. And it runs a close second to the common cold.
The reason why dental caries are so ubiquitous has a lot to do with what we eat, namely our love of carbohydrates. In every person’s mouth there resides a very complex ecosystem that is home to huge colonies of bacteria. Some estimates have it at about 25?000 species!
Two types of bacteria in particular metabolise the food we eat — especially carbohydrates and sugars — into lactic acid. This acid then affects the hard tooth structure, known as enamel, by making it vulnerable to decay.
We’ve heard toothpaste adverts make mention of plaque. This occurs when the bacteria are not removed and collect around the teeth and gums in a slimy, pale yellow substance.
Dental caries are initially asymptomatic. But left untreated, bad breath and an unpleasant taste in the mouth become evident.
As the situation worsens the cavity increases and starts to affect the nerve or the structure of the tooth itself and the pain caused can be excruciating. It can also lead to infection and, eventually,to the loss of the tooth.
Treatment for tooth decay varies. Using a drill, a dentist will remove the decayed tooth material and fill the cavity with appropriate material, ranging from silver alloy to gold, porcelain, or composite resin. Because the last two more closely match the natural colour of teeth enamel they are normally used as fillings for front teeth.
Many dentists believe that silver alloy and gold are the strongest options and tend to use them as filling for back teeth. A crown, which is dental restoration, is recommended when the decay is more severe and has weakened the actual tooth structure, which can lead to a broken tooth.
Again, the decayed areas, including the weakened structure of the tooth are removed or repaired before the crown is fitted or capped over the remainder of the tooth. Crowns can also be made of porcelain or gold, or what’s called “porcelain fused to metal”, which consists of a metal shell with a veneer of porcelain fused over it before it is fired in a high-heat oven.
Root canal work needs to be done when the nerve inside the tooth has been damaged or has died. The pulp inside the tooth, which includes the nerve and the bold vessel, is removed along with all the decayed tooth material, before the actual root channel is filled with a sealant and the tooth is then filled and, if necessary, capped with a crown.
As with all things medical, prevention is always less painful and much cheaper than cure. Many of us avoid seeing the dentist until the last possible moment, but it really does pay to have a check up every six months.
Seeing an oral hygienist twice a year for a serious clean up also pays dividends. And brushing twice a day and flossing at least once a day should be nothing less than second nature.
Another way of preventing dental decay is to take a closer look at your diet. Obviously, the more carbohydrates and sugary foods you eat, the more dental caries you can expect.
Try and avoid sticky foods, such as dried fruit, sweets and confectionary that stick to the surface of your teeth. Also, be aware that if you are constantly taking snacks between meals, you are giving the acid more time to do its damage.
Dental caries will be the topic of Bonitas Health Talk on September 17 on SABC2 at 9am