Dental updates from Dr. Mckeever.

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THE CARIES (CAVITY) THEORY

Science has positively identified three factors that will cause (or lead to) tooth decay (dental caries): pathogenic bacteria (mutans streptococci and lactobacillus), poor dietary habits, and xerostomia (dry mouth). Protective factors at this point in time include saliva, sealants, antimicrobial agents (chlorhexidine oral rinse, iodine, xylitol artificial sweetener and, more recently, a triclosan/copolymer dentifrice ), fluoride and and effective diet.

The cariogenic bacteria involved cause a subsurface dissolution of the minerals in teeth by producing acids in the pH range of 3.8 to 4.8 (any number with a pH lower than 5.5 will dissolve enamel; water has a pH of 7). They do this by metabolizing simple sugars and carbohydrates into waste products that are extremely acidic (low pH). Acids from dietary sources can also cause surface dissolution of these minerals. By far the most common are "soft" drinks (including power drinks) and fruit juices. Coca-Cola and Pepsi are two of the most acidic (i.e. harmful) soft drinks with A&W Root Beer being one of the least harmful. And, believe it or not, grape juice is one of the worst fruit juices for the teeth along with orange, grapefruit and pineapple juices. Tomato juice has the same pH as acid rain. The most devastating source of acid is the hydrochloric acid from the stomach. People with chronic gastroesophogeal reflux disease (GERD) are extremely susceptable to tooth damage and most bulemic patients can be diagnosed for their malady just by looking at their teeth which literally dissolve away. (Methamphetamine addicts can also be diagnosed by looking at their teeth which actually rot via the decay process).

Xerostomia is, perhaps, the most dangerous pathological factor of all in the formation of cavities. Saliva has many componants that support health, such as antibacterial agents, calcium phosphate and fluroides which re-mineralize teeth, lipids (fats) that form a protective pellicle (coating) over pits and grooves in the teeth, buffering agents that neutralize the destructive acids, enzymes for digestion, mucins for lubrication of foods, and on and on. There is no one product we can apply that replaces the saliva that mother nature gave us. The best we can do for now is to replace some of the missing componants. (There are over 200 listed medications that cause dry mouth including hypertension medication, antihistimines, tranquilizers, diuretics etc.). And, of course, meticulous removal of the sticky plaque in which the cariogenic bacteria reside is a key ingredient in fighting cavities.






posted by Steve at 12:32 PM