Oral health refers to the health of our teeth and our mouth. Maintaining good oral health includes keeping our teeth free from cavities and keeping our gums free from disease. It is important to take care of our mouth and teeth starting in childhood. If we don't, we could have problems with our teeth and gums - like cavities or even tooth loss. Periodontitis is an infectious, destructive inflammatory disease of the soft and hard tissues or gums (gingivitisgingivitis) surrounding the teeth and is the leading cause of tooth loss.
Why it is so important to take care of teeth? Because we have only two sets of teeth to last for a lifetime! Poor oral health can affect more than just our mouth; it can affect other areas of our body as well. Teeth and gums reveal the inside story of our overall health - from the signs of diabetes to heart disease to osteoporosis.
To understand what happens when our teeth decay, it is helpful to know what's in our mouth naturally.
- Saliva - Our mouth and teeth are constantly bathed in saliva. We never give much thought to our spit, but this fluid is remarkable for what it does to help protect our oral health. Saliva keeps teeth and other parts of your mouth moist and washes away bits of food. Saliva contains minerals that strengthen teeth. It includes buffering agents. They reduce the levels of acid that can decay teeth. Saliva also protects against some viruses and bacteria. Bacteria can live in our mouth in the form of plaque, causing cavities and gingivitis, which can lead to periodontal (gum) disease. In order to keep our mouth clean, we must practice good oral hygiene every day.
- Plaque - Plaque is a soft, gooey substance that sticks to the teeth a bit like jam sticks to a spoon. Plaque also accumulates on the surface where toothbrushes can't reach. Plaque contains colonies of bacteria and other organisms, clumping together with bits of food. Also in the mix are bacteria byproducts, white blood cells and body tissue. Plaque grows when bacteria attach to the tooth and begin to multiply. Plaque starts forming right after a tooth is cleaned. It builds up to measurable levels in about an hour. As time goes on, the plaque thickens. Within two to six hours, the plaque teems with bacteria that can cause cavities. Plaque also produces substances that irritate the gums, making them red, sensitive and susceptible to bleeding. This can lead to gum disease, in which gums pull away from the teeth and form pockets that fill with bacteria and pus. If the gums are not treated, the bone around the teeth can be destroyed and teeth may become loose or have to be removed.
- Calculus - If left alone long enough, plaque absorbs minerals from saliva. These minerals form crystals and harden the plaque into calculus. Then new plaque forms on top of existing calculus. This new layer can also become hard.
- Bacteria - We have many types of bacteria in our mouths. Some bacteria are good; they help control destructive bacteria. When it comes to decay, Streptococcus mutans and Lactobacilli are the bacteria that cause the most damage to teeth. We can never get rid of all the bacteria in our mouth. But we can take steps to control bacteria.
How our Teeth Decay?
The bacteria in our mouth need food to live and multiply. When we eat sugary foods and other carbohydrates, the bacteria use them as food, too. The bacteria then produce acids that can dissolve tooth enamel (outer layer of the tooth).
It is not just candy and ice cream we are talking about. All carbohydrate foods eventually break down into simple sugars. These include glucose and fructose. Some of this process begins in the mouth.
Foods that break down into simple sugars in the mouth are called fermentable carbohydrates. These include the obvious sugary foods, such as cookies, cakes, soft drinks and candy. But they also include pretzels, crackers, bananas, potato chips and breakfast cereals.
Bacteria in our mouth turn the sugars in these foods into acids. These acids begin to dissolve the mineral crystals in teeth. The more times we eat each day, the more times our teeth are exposed to an acid attack.
This attack can lead to tooth decay, also known as dental caries. First, the acid begins to dissolve calcium and phosphate crystals inside a tooth. A white spot may appear on the enamel in this weakened area. But the loss of minerals develops beneath the surface of the enamel. The surface may still be smooth.
At this stage, the tooth can be repaired with the help of fluoride, proteins and minerals (calcium and phosphate) in the saliva. The saliva also helps reduce the acid levels from bacteria that attack the tooth.
Once the decay breaks through the enamel to cause a cavity, the damage is permanent. A dentist must clean out the decay and fill the cavity. Left untreated, the decay will get worse. It can destroy a tooth all the way through the enamel, through the inside dentin layer and down to the pulp or nerve of the tooth. That's why it is important to treat caries at a very early stage, when the process can be reversed.
How can we get rid of Plaque?
The best way to remove plaque is by brushing and cleaning between the teeth twice every day. Brushing removes plaque from the tooth surfaces. Brush your teeth twice per day with a soft-bristled brush. The size and shape of your toothbrush should fit your mouth and allow you to reach all areas easily. Use an antimicrobial toothpaste containing fluoride, which helps protect your teeth from decay. Clean between the teeth once a day with floss or interdental cleaners to remove plaque from between the teeth, where the toothbrush can not reach. Flossing daily is essential to prevent gum disease.
Is it safe to use toothpicks?
In a pinch, toothpicks are effective at removing food between teeth, but for daily cleaning of plaque between teeth, floss is recommended. When you use a toothpick, don't press too hard, as you can break off the end and lodge it in your gums.
How do I brush my teeth?
- Place your toothbrush at a 45-degree angle against the gums.
- Move the brush back and forth gently in short (tooth-wide) strokes.
- Brush the outer tooth surfaces, the inner tooth surfaces, and the chewing surfaces of the teeth.
- Use the tip of the brush to clean the inside surfaces of the front teeth, using a gentle up-and-down stroke.
- Brush your tongue to remove bacteria and freshen your breath.
- You should brush your teeth well for no less than three minutes and your brush should be replaced once every three months.
Good oral health involves more than just brushing and cleaning between the teeth. To keep your teeth and mouth healthy for a lifetime of use, there are steps that you should follow.
Understand your own oral health needs: Talk with your dentist, other oral health care specialist or hygienist about any special conditions in your mouth and any ways in which your medical/health conditions affect your teeth or oral health. For example, cancer treatments, pregnancy, heart diseases, diabetes, dental appliances (dentures, braces) can all impact your oral health and may necessitate a change in the care of your mouth and teeth. Be sure to tell your dentist if you have experienced a change in your general health or in any medications you are taking since your last dental visit.
Many of us say we have "sensitive teeth." We usually mean that we feel twinges of pain or discomfort in our teeth in certain situations. These may include:
- Drinking or eating cold things
- Drinking or eating hot things
- Eating sweets
- Touching the teeth with other teeth or the tongue
There are two types of tooth sensitivity:
Dentinal sensitivity occurs when the dentin (middle layer) of a tooth is exposed. Normally, the dentin is covered by enamel above the gumline and by cementum below the gumline. Dentin is made up of tiny openings called tubules. Inside each tubule lies a nerve branch that comes from the tooth's pulp (the nerve center of the tooth). When the dentin is exposed, cold or hot temperature or pressure can affect these nerve branches. This causes sensitivity.
Dentinal sensitivity occurs when the outer protective layers of enamel or cementum are removed, exposing the dentin. It can affect one or more teeth. Some causes of dentin exposure include:
- Brushing your teeth too hard. This wears away the enamel layer
- Poor oral hygiene. This may allow tartar to build up at the gum line
- Long-term tooth wear and untreated cavities
- An old filling with a crack or leak
- Receding gums that expose the tooth's roots. Receding gums often are caused by periodontal diseases or by brushing too hard.
- Gum surgery that exposes a tooth's roots
- Tooth whitening in people who have tooth roots that already are exposed
- Frequently eating acidic foods or drinking acidic beverages
You might be able to reduce your chances of dentinal sensitivity by:
- Brushing twice a day and flossing daily
- Using a soft or ultrasoft toothbrush and brushing gently up and down, rather than side to side
- Using a fluoride toothpaste and mouth rinse
- Using a toothpaste that provides protection against sensitivity
- Getting treatment for grinding or clenching your teeth (bruxism)
Pulpal sensitivity is a reaction of the tooth's pulp. The pulp is a mass of blood vessels and nerves in the center of each tooth. Pulpal sensitivity tends to affect only a single tooth. Some causes of Pulpal sensitivity include:
- Decay or infection
- A recent filling
- Excessive pressure from clenching or grinding
- A cracked or broken tooth
If you feel a sharp pain upon biting, you may have a broken or cracked filling. Pain when you release a bite is a sign of a cracked tooth.
If a tooth needs root canal treatment, there is no good way to prevent pulpal sensitivity other than to get the needed treatment. Delaying root canal treatment is not recommended. It may result in further problems.
Fluoride and our Teeth
You've probably heard that fluoride is a good thing for teeth. This is true. Fluoride, in moderation, is a very good thing for teeth for people of all ages.
Fluoride is a mineral that occurs naturally in many foods and water. Fluoride helps prevent tooth decay by making the tooth more resistant to acid attacks from plaque bacteria and sugars in the mouth. It also reverses early decay.
An exposure to fluoride (like that contained in toothpaste and city tap water) is probably the most effective cavity prevention treatment available today. Dental researchers have shown that just introducing fluoride into a (previously unfluoridated) city's drinking water supply can reduce its inhabitants' rate of tooth decay between 40 and 70 percent.
Enamel, the outer layer of the crown of a tooth, is made of closely packed mineral crystals. Every day, minerals are lost and gained from inside the enamel crystals. Losing minerals is called demineralization. Gaining them back is called remineralization.
Demineralization begins with the bacteria in the plaque on our teeth. They feed on sugar and other carbohydrates in our mouth and produce acids. The acids dissolve crystals in tooth enamel. The loss of enamel is balanced by remineralization. In this process, minerals in the saliva, such as fluoride, calcium and phosphate are deposited back into the enamel. Too much loss of minerals without enough replacement leads to tooth decay.