Dental Caries Disease

Cavities and Tooth Decay

Gum disease is a serious condition that affects millions of men, women, and children throughout the world. The gum disease gingivitis is a milder form of gum disease that can be easily treated by adopting a proper brushing and flossing routine. However, if gingivitis remains untreated, it can progress into periodontitis.

Periodontitis is caused by a severe build-up of bacteria on the teeth and along the gum line that eventually results in bone loss. As the alveolar bone, which supports the teeth, deteriorates, teeth can become loose and fall out. Periodontitis is one of the main causes of tooth loss, especially among adults aged 65 and older.

According to an article published in the Journal of Periodontology, you are at increased risk of losing your teeth to periodontitis if you are:

Injury

Auto Accidents, Falls, and Trauma from Sports

While periodontitis is more likely to lead to the loss of multiple teeth, dental caries can lead to the loss of an individual tooth. Dental caries are caused by the presence of plaque on the tooth's surface and are most commonly known as cavities or tooth decay. When a cavity initially develops, it damages the outer surface of the tooth. As it continues to break down the tooth's surface, it gains access to the inside of the tooth, where it can cause significantly more damage and tooth pain.

Accidents or events that cause sudden impact to the facial area can lead to the loss of a tooth or several teeth. For example, a person can fall on an unforgiving surface such as concrete and snap off the bottom portion of a tooth, permanently damaging the nerves and structure of the tooth. An individual involved in a fist fight could receive a forcible blow to the mouth area that knocks a tooth out of its socket.

Tooth loss from injury can be caused by:

• Motor vehicle accidents
• Biking accidents
• Falls
• Assault
• Contact sports

Fresh Breath Clinic

Bad Breath - Causes and Treatment

Chronic bad breath, also known as halitosis, can be very embarrassing, but it is nearly always treatable. As is the case with many common dental problems, curing bad breath is frequently as simple as improving your oral hygiene or changing your diet. However, in other cases, bad breath indicates more serious health problems that may require professional medical attention.

Causes of Bad Breath

Bacterial Infections

Chronic bad breath, also known as halitosis, can be very embarrassing, but it is nearly always treatable. As is the case with many common dental problems, curing bad breath is frequently as simple as improving your oral hygiene or changing your diet. However, in other cases, bad breath indicates more serious health problems that may require professional medical attention.

Certain Foods

The most common cause of bad breath is bacterial buildup in the mouth, especially around the teeth, gums, and tongue. These bacteria feed on carbohydrates such as sugars left in the mouth after eating, causing the buildup known as plaque that is responsible for gum disease (gingivitis) and tooth decay (cavities). As these bacteria break down food and multiply, they emit a foul odor. Decaying teeth and infected gums make the odor worse.

Certain Medical Conditions

In certain cases, bad breath can be linked to medical conditions that do not directly affect the teeth, gums, or tongue. Sinus infections and other such conditions that cause a nasal discharge into the throat may be responsible for bad breath, as may throat and respiratory infections. The blood sugar fluctuations associated with diabetes often make the breath smell unpleasantly fruity. Acid reflux (GERD) can also cause bad breath.

Certain forms of bad breath may even indicate life-threatening medical conditions. Some cancers and metabolic disorders may cause chronic bad breath. In addition, liver failure can cause the breath to smell like fish, while kidney failure can cause a urine-like breath odor. If you have an unusual breath odor, such as these, that persists, you should be examined promptly by your doctor.

Treating and Preventing Bad Breath

Many people rely on mints, chewing gum, and other such products to control bad breath, but these strategies simply mask the odor without addressing its underlying causes. The most common cause of bad breath is food breakdown and bacteria in the mouth, which can be easily remedied with improved dental hygiene. Regular flossing and brushing in conjunction with periodic professional cleaning appointments are enough to control plaque and keep the mouth healthy and odor free. The other important step many people take is to avoid behaviors that can cause bad breath, such as eating certain foods and using tobacco products.

Healthy Eating

If you want to prevent cavities, how often you eat can be just as important as what you eat. That's because food affects your teeth and mouth long after you swallow. Eating those cookies with dinner will do less harm to your teeth than eating them in the middle of the afternoon as a separate snack. Of course, overall poor nutrition can contribute to periodontal (gum) disease and can have other long-term effects on your mouth. Learning how food affects your oral health - long-term and short-term - is the first step toward mouth-healthy eating.

Immediate effects of Food

Changes begin in your mouth the minute you started to eat certain foods. Bacteria in your mouth become more acidic and the acid starts the process that can lead to cavities.

How does this happen?

All carbohydrate foods eventually break down into simple sugars: glucose, fructose, maltose and lactose. Some foods, called “fermentable carbohydrates,” break down in the mouth, while others don't break down until they move further down the digestive tract.

It's the fermentable carbohydrates that work with bacteria to begin the decay process and eventually destroy teeth. They include the obvious sugary foods, such as cookies, cakes, soft drinks and candy; but they also include less obvious foods such as bread, crackers, bananas and breakfast cereals.

Certain bacteria on your teeth use the sugars from these foods and produce acids. These acids dissolve minerals inside the enamel crystals of your teeth in a process called demineralization. Teeth also regain minerals in a natural process called remineralization. Saliva helps this process, as does fluoride and some foods.

Dental decay begins inside the enamel crystals when minerals are being lost faster than they are being regained.

The longer food stays near the bacteria on the tooth, the more acid will be produced. So sticky carbohydrates can do more acid damage. But other foods that pack into crevices are also cariogenic, that is, able to cause decay. Potato chips are a terrific example. Eat a handful of chips and see how long you have to work to get all the stuck bits out from between your teeth. Teeth with a lot of nooks and crannies, such as molars, are more likely to trap food and are more susceptible to decay. To make matters worse, tooth-unhealthy foods don't just create acids on your teeth while they are being eaten. The acids stick around for the next half-hour.

People who sip soft drinks or sweetened coffee throughout the day, or who eat many small sweet or carbohydrate snacks provide a sugar source for the bacteria to produce acid almost constantly. And since acid damage is cumulative, decay is more likely. Studies have shown that those who eat sweets as snacks between meals have higher incidences of decay than those who eat the same amount of sweets with their meals.

On the brighter side, some foods are actually protective because they increase saliva flow and neutralize the acids produced by bacteria, making the enamel less likely to be demineralized. For example, aged cheese eaten immediately after food helps buffer the acid. That's another reason why eating sweets between meals causes more cavities. Between-meal snackers not only have an overall longer period when their teeth are exposed to acid, they don't have other foods eaten as part of a meal to moderate the effects of the sugar.

Chewing sugarless gums also can help protect your teeth against cavities. Xylitol, an ingredient in some sugarless gums, has been shown to reduce the amount of bacteria in the mouth and help buffer the teeth against the effect of acid. Most sugarless gums and sugarless candies increase the flow of saliva, which has natural antibacterial properties.

Long term effects

Like the rest of your body, your mouth depends on overall good nutrition to stay healthy. In fact, our mouths are highly sensitive to poor nutrition, which can lead to premature tooth loss, serious periodontal (gum) diseaseand bad breath. Many nutritional problems will affect the mouth before the rest of the body. This is because the cells in the lining of the mouth - called the oral mucosa - are constantly being created and destroyed. In some areas of the mouth, cells completely turn over, with a whole new group of cells taking the place of old cells, in three to seven days.

What to Eat

The current and best recommendation for overall good nutrition is to follow the Dietary Guidelines for Americans, developed by the U.S. Department of Agriculture and the Department of Health and Human Services. The guidelines are simple in concept:

• Choose a variety of grains daily, especially whole grains.
• Choose a variety of fruits and vegetables daily.
• Choose a diet with plenty of grain products, fruits and vegetables.
• Choose a diet low in saturated fat and cholesterol.
• Choose beverages and foods to moderate your intake of sugars.
• Choose and prepare foods with less salt.
• If you drink alcoholic beverages, do so in moderation.
• Aim for a healthy weight and be physically active each day.

To help people understand these guidelines, the USDA also developed the Food Guide Pyramid, which suggests relative amounts of different types of foods that should be eaten for a well-balanced meal.

Our diets, like the pyramid, should have a strong base of breads, cereal, rice and pasta; at least five servings a day of fruits and vegetables; significant amounts of calcium-containing milk, yogurt and cheese; and proteins such as meats, beans, eggs and nuts. Fats and sweets should be eaten sparingly.

To prevent tooth decay, you should follow a few additional guidelines to keep the amount of acid created by the bacteria on your teeth to a minimum. Here are some tips:

• Limit between-meal snacking to reduce the amount of time your teeth are exposed to acid. If you snack, choose foods that are not fermentable carbohydrates.
  • Best choices Cheese, chicken or other meats, nuts or milk. These foods are believed to be “anti-cariogenic”. That is, they may actually help protect tooth enamel by counteracting acidity or by providing the calcium and phosphorus needed to remineralize teeth.
  • Moderate choices Firm fruits like apples and pears, and vegetables. Although firm fruits contain natural sugars, they have a high water content that dilutes the effects of the sugar and they stimulate the flow of saliva, which has antibacterial factors and helps protect against decay. Vegetables do not contain enough carbohydrates to be dangerous.
  • Worst choices Candy, cookies, cakes, crackers, bread, muffins, potato chips, french fries, pretzels, bananas, raisins and other dried fruits. These foods provide a source of sugar for certain bacteria on the teeth to produce acid. The problem can be worse if the foods stick to or get caught between teeth.
• Limit the amount of soft drinks or any other sugar-containing drink, including coffee or tea with added sugar, cocoa, and lemonade. Fruit juices contain natural sugars that can also cause decay. Limit the amount of time you take to drink any of these drinks instead of sipping them throughout the day. A can of soda finished with a meal is better than a can of soda finished over two hours because your teeth are exposed to high acid levels for a shorter amount of time.
  • Better choices Unsweetened tea, milk and water, especially fluoridated water. Tea also has fluoride, which can strengthen tooth enamel and milk can also help deter decay. Water helps flush away food debris and can dilute the sugar acids.
• Avoid sucking on hard candies or mints, even the tiny ones. They have enough sugar to increase the acid produced by bacteria to decay levels. If you need a mint, use the sugarless varieties.
• Very acidic foods (such as citrus fruits) can make the mouth more acidic and may contribute to tooth demineralization and erosion. The effects of acid exposure are cumulative, so every little bit counts.
• Brush your teeth after eating to remove the plaque bacteria that create the destructive acids. If you cannot brush after every meal, brush at least twice a day to thoroughly remove all plaque bacteria.
• Chewing sugarless gum that contains xylitol can help reduce the risk of cavities It not only helps dislodge some of the food stuck to your teeth, but it also increases saliva flow to help buffer the acids

Effects of Tooth Loss

Dental implants can replace missing teeth and restore a natural appearance to the smile

Changes in the Jaw Bones, Teeth and Face after Tooth Loss

The loss of teeth create many problems from the dissolving away of bone structure, loss of support for the face giving an increased appearance of age and wrinkles, damage to the remaining teeth that must still bear the full stresses of chewing. Once enough teeth are missing then food choices and nutritional changes begin to cause medical problems and affect your general well being.

Loss of a Single Tooth

Even after the loss of one tooth, the jaw bone irreversibly changes if an implant does not replace the tooth. Without chewing pressure to stimulate the bone it begins to dissolve away immediately after extraction and continues forever unless an implant is placed. If left long enough, bone grafting is necessary before an implant can be used.

Loss of an Entire Jaw of Teeth

Facial Cosmetic Problems after Tooth Loss

The deterioration of the jaw bone effects the appearance of how the face “drapes” over the bone. This causes Facial sagging, premature ageing, and loss of function due to shrinkage in the upper and lower jaw bones & makes you look older than your natural age and adds more non-age related wrinkles then mother nature intended for you.

Tooth Drifting and Destruction to the Remaining Teeth

The chewing forces have shifted to the front teeth and due to overloaded stress the front teeth begin to flare and fan apart creating spaces. The fanning and spaces get worse over time. This fanning eventually leads to looseness and gum disease and the loss of the front teeth. When two molars are missing, the upper teeth erupt down.

This shows severe over eruption of an upper molar with most of this tooth's roots now being out of the bone structure. The tooth will become loose and fall out during chewing and usually at an inconvenient time. Even a single missing teeth can lead to drift (this is just like taking a brick out of an arch way and seeing the arch collapse). That one missing tooth can set you up for a “domino effect” of losing teeth for the rest of your life. The next molar begins to drift forward. Gum disease due to the movement and misalignment of the teeth can cause more tooth loss and decay.

Sinus Expansion Destroying Bone When Upper Teeth are Missing

When theupper teeth are present the sinus stays in its proper position. One the teeth are missing, the sinus begins to expand and destroy bone from the “inside out.” Teeth in the bottom jaw erupt and traumatize the upper gum tissue. If a partial denture is being worn it causes bone damage from the other side of the sinus doubling the deterioration. If the sinus is looked at internally (in cross-section), one can see that the walls become paper thin in all directions, In order to restore the missing bone structure, a predictable procedure called

“sinus lifting”

is done to regrown the damaged and missing bone. This allows implants to be used in these areas.

Oral health and overall health: Why a healthy mouth is good for your body

Taking care of your mouth, teeth and gums isn't just a matter of good grooming. It can prevent infections, and maybe even diseases, throughout your body.

Taking good care of your mouth, teeth and gums is a worthy goal in and of itself. Good oral and dental hygiene can help prevent bad breath, tooth decay and gum disease - and can help you keep your teeth as you get older.

Researchers are also discovering new reasons to brush and floss. A healthy mouth may help you ward off medical disorders. An unhealthy mouth, especially if you have gum disease, may increase your risk of serious health problems such as heart attack, stroke, poorly controlled diabetes and preterm labor.

The case for good oral hygiene keeps getting stronger. Understand the importance of oral health - and its connection to your overall health.

Plaque as cause of common conditions?

Long-term gum infection can eventually result in the loss of your teeth. But the consequences may not end there. Recent research suggests that there may be an association between oral infections - primarily gum infections - and poorly controlled diabetes, cardiovascular disease and preterm birth. More research is needed to determine whether oral infections actually cause these conditions, which include:

• Poorly controlled diabetes If you have diabetes, you're already at increased risk of developing gum disease. But chronic gum disease may, in fact, make diabetes more difficult to control, as well. Infection may cause insulin resistance, which disrupts blood sugar control.
• Cardiovascular disease Oral inflammation due to bacteria (gingivitis) may also play a role in clogged arteries and blood clots. It appears that bacteria in the mouth may cause inflammation throughout the body, including the arteries. This inflammation may serve as a base for development of atherosclerotic plaques in the arteries, possibly increasing your risk of a heart attack or stroke.
  Some research suggests that people with gum infections are also at increased risk of heart attack and stroke. The more severe the infection, the greater the risk appears to be. And gum disease and tooth loss may contribute to plaques in the carotid artery. In one study, 46 percent of participants who'd lost up to nine teeth had carotid artery plaque; among those who'd lost 10 or more teeth, 60 percent of them had such plaque.
• Preterm birth Severe gum disease may increase the risk of preterm delivery and giving birth to a low birth weight baby. The National Institute of Dental and Craniofacial Research, in fact, estimates that as many as 18 percent of preterm, low birth weight babies born in the United States each year may be attributed to oral infections.
  The theory is that oral bacteria release toxins, which reach the placenta through the mother's bloodstream and interfere with the growth and development of the fetus. At the same time, the oral infection causes the mother to produce labor-triggering substances too quickly, potentially triggering premature labor and birth.