Plaque and oral diseases - Cavities

Plaque and oral diseases - Cavities

Bacterial plaque is formed by a biofilm of bacteria and salivary components which result in a mass extremely adherent to all structures in the mouth.

What is Plaque?
At first the area is colonized by bacteria which are harmless to our health, but as it accumulates over time without being removed, it becomes more pathogenic and causes diseases.
Initially bacterial plaque builds up in areas that are difficult to access, such as inter dental spaces, pits and fissures of the teeth, braces, dental bridges, crowns and other prostheses. With time, it accumulates in any area of the oral cavity, including the tongue.

Plaque can be removed by brushing with toothpaste, the use of dental floss (or dental tape) and/or through other devices for plaque removal, suitable for each situation.
Initially plaque is not visible to the naked eye. However a plaque indicator may be used, which will stain the areas where there is plaque. With further accumulation of plaque, it may be seen without needing to use these specific dyes.
Plaque, when not removed effectively, is the cause of oral diseases, at both the periodontal (gingivitis and periodontitis) and the tooth (cavities) level.

What is a cavity?
A cavity is a tooth disease of external origin, which corresponds to a hole in the tooth. However, the cavity does not immediately begin as a "hole". The disease begins insidiously and before reaching this stage of cavitation has had to undergo multiple demineralization (wearing).

Cavities need a combination of three key factors to establish:

  • Diet (some foods and drinks, but mostly sugars)
  • Dental plaque bacteria
  • Time

How does this happen?
The bacteria in plaque use sugars from the food and produce acids that will cause a loss of tooth enamel mineral (demineralization). These successive acids attacks, if not stopped by the minerals in saliva and the presence of fluorine (remineralization), will enable the irreversible loss of tooth enamel and leads to the formation of a hole, which is the cavity.
There is an ongoing process between demineralization and remineralization in our mouths. If the demineralization periods are longer than the remineralization, the onset of cavitation is favored. Thus, if there is an excessive consumption of sugar-laden foods or drinks, the bacteria will grow and multiply more easily.

What is it that food and drink does?
Foods and drinks that are consumed over long periods, especially between meals, may alter the balance between demineralization and remineralization, favoring the formation of cavities.

Can I eat between meals?
You should not eat sticky foods such as caramels, gummy candy, raisins and other retentive sugar-laden foods between meals due to the acid attack being very intense and the fact that the saliva can not have the ability to prevent and repair. Those foods should be consumed only at mealtimes, preventing the teeth from constantly being subjected to acid attacks, thus helping to prevent the formation of cavities.

My son loves to walk around with the bottle in his mouth, is that a problem?
If children fall asleep with a bottle, or if you put him/her on liquids (including milk, fruit juices and other specially sweetened beverages), they can be used by these bacteria to produce acids, which may accelerate the formation of cavities. This type of tooth decay is commonly known as "baby bottle cavities".


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Do we all have cavities equally?
Since the formation of cavities depends on many factors, including the type of food, there are differences in oral bacteria of each person, the quantity and quality of saliva and also the oral hygiene habits are different from person to person, which causes the risk of cavity to be different amongst individuals.

Is it possible that I do not have the bacteria that causes tooth decay?
We all have this type of bacteria in the oral cavity, however the amount existing in individual oral cavities is variable. If the number of bacteria is too high, the risk of cavities can be increased.

How do the mouth and teeth affect cavities?
In many ways, from the formation, position and composition of the teeth, to the saliva, dental treatment and habits to maintain oral health.

What is the role of saliva?
Saliva neutralizes and defends the tooth, but more importantly, it contains minerals that help rebuild areas of the tooth that have been demineralized or attacked by acids. This reconstruction process is known as remineralization.

How will the saliva act?
In several ways. Saliva is very important and, for example, it can influence the reduction of mineral loss from teeth and the remineralization process. Sometimes certain infections or drugs alter the type of saliva, facilitating the process of formation of cavities in the whole oral cavity.

What are the areas of greatest risk to the onset of tooth decay?
The deep fissures and concavities existing in some teeth, such as molars, the areas between the teeth (interdental space) and roots of the teeth when they appear, are areas of increased susceptibility to decay.

Measures to prevent tooth decay:

  • A means of preventing tooth decay in fissures of the teeth is through the application, in these areas, by a dental hygienist or dental practitioner, a kind of resin, known as a crack sealant.
    The crack sealant begins to work as a protective barrier for the tooth surface, protecting it from plaque bacteria and acids.
  • Fluoride administered orally (systemic) helps strengthen teeth during their formation, the following are examples:
    • Fluoridated water
    • Fluoride supplements such as tablets or drops
  • Fluoride administered topically strengthens teeth after their formation, the following are examples:
    • Topical treatments with fluoride applied professionally or via prescription of an oral health professional, such as foams or highly concentrated toothpastes
    • Fluoride products for daily use, can be obtained in the form of toothpastes or mouthwashes
  • One of the best ways to prevent the loss of minerals or demineralization of the teeth and still contribute to the remineralization process is to use a toothpaste with fluoride. A small amount of toothpaste used during brushing can help to balance the situation. Many scientific studies over long periods have proven that this is one of the most effective ways to prevent tooth decay.

Don't forget:

  • Tooth decay is a process that involves a balance between the loss and recovery of minerals from over time, in response to daily attack of acids produced by bacteria. Cavities can be prevented by daily carrying out the oral hygiene instructions recommended by your oral hygienist or dental practitioner.
  • Eating the proper foods at the right time, during meals, and avoiding sugary foods and drinks between meals can help further reduce your risk level of tooth decay.
  • Brushing your teeth with a fluoride toothpaste at least twice a day, is a crucial step to help balance your oral health and prevent the formation of cavities.
  • The daily use of dental floss or other interproximal method is critical to sanitize the space between teeth, where a toothbrush can not reach.
  • Follow these rules and others that may be recommended to maintain your oral health for your whole life.
Dr. João Pedro Ferreira, Oral Hygienist, APHO This text was written under the new Orthographic Agreement.

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As a dentist... Still, prevention is better than cure! So follow these info and surely it will help you and your pearly whites healthy!

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very informative.. thanks!

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