tooth decay / cavities / dental caries

When are people especially at risk for developing tooth decay? There are two time periods in life when humans, as a group, seem to have their greatest difficulty with the development of tooth decay. They are: Childhood: Both children and adolescents. Adulthood: Senior citizens and also those adults who have had, or have been treated for, periodontal disease (gum disease).

Tooth Decay, Cavities,    & Dental Caries : Page 1 What is tooth decay? Page 2 How does tooth decay form? Page 3 How long does it take a cavity to form? Page 4 How does fluoride help to prevent tooth decay? Page 5 Tooth decay and children. Page 6 Tooth decay and adults.

The cavity prone years: Children and Adolescents As you probably realize, children and adolescents together form a population group that often has a problem with the formation of tooth decay. These "cavity prone years" are no doubt at least partially related to the fact that young people sometimes have diets that are very high in sugar consumption. Additionally, young people can sometimes be less rigorous in their brushing and flossing habits than is really in their best interest. Beyond these factors, the contents of this page describe a few problems related to tooth decay that can occur and are unique to children. They are: Using dental sealants as a means of helping to prevent tooth decay. Baby bottle caries / Baby bottle tooth decay. Braces and the risk for developing white spot lesions.

Dental sealants as a means of preventing tooth decay. Some aspects of a tooth can be more susceptible to tooth decay formation than others, primarily related to the tooth's anatomy and the fact that a specific portion of the tooth cannot be cleaned effectively. The placement of dental sealants can be an effective way to combat these conditions. Some back teeth, especially molars, are difficult for a person to clean because the grooves in the chewing part of the tooth (the tooth's "pits and fissures") are deep and narrow. Even though the person brushes they can not clean the plaque off adequately because the bristles of their toothbrush are literally too large to gain access into the bottom of the tooth's grooves. Because some plaque is not cleaned off tooth decay can form. A solution for this problem can be the placement of dental sealants. When a dentist bonds a sealant into place over the grooves of a tooth the net result is that the surface of the tooth is somewhat flatter and smoother. There are no longer any places on the chewing part of the tooth that the bristles of a toothbrush can't reach and clean. Since plaque can be removed more easily and effectively, there is much less chance that decay will start.  [ Click this link to be forwarded to our discussion about dental sealants. ]

What is "baby bottle caries"? "Baby bottle caries" (or "nursing bottle caries") refers to a pattern of tooth decay that occurs in the teeth of infants and preschoolers who are allowed to nurse from a bottle containing a sugary beverage either frequently or for prolonged periods of time (such as while napping or sleeping at night). With this condition, typically a child's front upper teeth are most effected and have extensive decay. The child's bottom front teeth are often spared from decay (possibly related to the fact that these teeth are somewhat protected from the sugary drink by the nursing position of the tongue). Any other teeth that are present in the child's mouth are also placed at greater risk for the formation of cavities and may be extensively decayed. There is nothing special or unique about the bottle caries condition. It is simply a case of a sugar supply being present as a food source for oral bacteria (over a prolonged time period) and therefore tipping the balance between demineralization and remineralization greatly in favor of tooth decay formation. What is unique about baby bottle caries is that the responsibility for the decay lies with the adult (no matter how well meaning and inadvertently) who provided the sugar source.

What can you do to minimize the risk of baby bottle caries? Here are some things you can do to minimize your child's risk for developing the rampant decay associated with baby bottle caries: Anticipate that anything you place in a child's bottle except water is a source of sugars, unless you specifically know otherwise. Breast milk, milk, formula, and fruit juices are all sources for dietary sugars. Never allow your child to nurse for prolonged periods or fall asleep with a bottle containing a beverage that contains sugars. Never give your child a pacifier that has been dipped in honey or any sugary liquid. Baby bottle caries is observed in those infants who are breast fed frequently throughout the night.

Braces and the risk of developing "white spot lesions". It just doesn't seem possible that anything could be designed that would make it harder for someone to effectively brush and floss their teeth than braces. In light of this difficulty, it's extremely important for a person (and their parents) to stay aware of the fact that this obstacle to dental plaque removal will place them at an increased risk for developing tooth decay. And actually, even beyond normal cavity formation, there is a special complication related to the tooth decay process when braces are present. As you now know, tooth decay is caused by a demineralization of a tooth's enamel. Acids produced by oral bacteria found in dental plaque actually dissolve away the mineral content found in the tooth. Because this demineralization process changes the quantity and quality of the tooth's mineral, the appearance of the tooth's enamel will change also. In fact, dentist call the earliest stage of tooth decay formation a "white spot lesion", because the tooth's enamel takes on an opaque whitish color in the area where the cavity is forming. So, if dental plaque is allowed to persistently accumulate around a person's braces, white spot lesions will form in the tooth's enamel. The portion of the tooth that lies underneath the orthodontic brackets, however, will have been protected from the plaque and therefore this portion of the tooth's enamel will not change in appearance. When all orthodontic work has been completed and the braces are removed, a white spot lesion outlining the original position of the orthodontic bracket will become painfully obvious.