Tooth destroyers. The main enemies of tooth enamel

Will floss prevent dental caries?

A recent New York Times article[] questioned the benefits of dental floss.

A 2011 study[] found that flossing in addition to brushing reduces the risk of gum disease. And not too much, since most people don’t floss their teeth thoroughly enough.

But in the fight against enamel destruction, thread is not a help at all. There is still no evidence that regular flossing reduces the risk of tooth decay.

Caries: general methods of prevention

1. The main reason for the development of caries is carbohydrates consumed during meals (simple carbohydrates, i.e. sugars, are especially harmful). As a rule, a person consumes these elements between main meals (for example, drinking tea with sugar or confectionery). If you give up snacking, you will reduce the risk of developing caries.
2. The use of vitamins that prevent the development of caries. In Russia, this method is not very common, although the anti-caries effect of vitamins B6 and B1 has long been proven. However, no pill, even taken on a regular basis, can prevent tooth decay if oral hygiene suffers.
3. Fluoridation. This method of caries prevention helps strengthen the strength of enamel, increase its resistance to acid, and also get rid of the pain reaction to eating too hot or cold food. In simple fluoridation, fluoride gel is applied to the tooth. Deep fluoridation involves sealing the enamel. This is a longer process in which the teeth are first dried, then deep fluoride is applied to them, followed by drying again and the use of copper-calcium hydroxide.
4. Infiltration. With this method of preventing dental caries, the stain is lubricated with an etching composition, then a drug that seals the pores is applied to the cleaned surface of the tooth. Infiltration allows you to stop the development of caries and the increase in the size of the carious spot, since the acid released by bacteria is not able to penetrate into the enamel. The method is absolutely painless, therefore it is recommended, including for children. The only condition for successful completion of the procedure is sitting still for 20 minutes, so infiltration may not be suitable for restless children.
5. Ozone therapy.
6. Laser therapy.

If a hole has already appeared in the tooth, then the above prevention options will not help: you will have to resort to surgical intervention.

Do I need a dental scan?

American dentists recommend having your teeth x-rayed every year. Austin Frakt, a health economist, reviewed[] medical studies and concluded that such reinsurance is unwarranted. Cavities in the tooth form more slowly—over 2–3 years.

In Russia, preventive x-rays are not so popular. But computed tomography is suggested to be done regularly. You should also not agree to this expensive service more often than once every couple of years.

How not to miss caries

To detect caries, sometimes a mother needs to take a brush and thoroughly brush her child’s teeth. The following points should be of concern:

• the enamel does not have a shiny appearance;
• the surface of the crowns is covered with pits;
• dark areas are visible on the front surfaces;
• there are cavities between the crowns or on the surface of the fissures;
• there are enamel defects.

Detected defects are a reason to make an appointment with a pediatric dentist. The initial stage of caries is difficult to detect on your own; it looks like a white matte spot on the enamel. Typically, parents discover a problem when the child complains of severe pain, refuses to eat, and tooth decay requires immediate treatment.

Which toothpaste is more effective?

The good news is that brushing your teeth is still beneficial. But to prevent the development of caries, the paste must contain fluoride. A study of the results of dental examinations of children aged 5 to 16 years []confirmed the effectiveness of the use of this mineral for the prevention of caries and tooth loss. Moreover, it is better to brush your teeth with fluoride paste twice, not once: the positive effect will be more noticeable.

True, fluoride paste does not help against gingivitis and plaque on teeth. But it really protects against enamel destruction.

Prevention of caries: local methods

These methods of preventing caries include:

• Remineralization is a procedure during which tooth enamel is saturated with fluoride and calcium, which has a positive effect on its strength. In addition, fluoride prophylaxis increases the resistance of enamel to microorganisms that provoke the development of caries.

When acidity drops below pH5, the concentration of calcium and a number of other elements in tooth enamel begins to rapidly decrease. It is at this moment that the greatest activity of cariogenic organisms is observed. After covering the tooth surface with fluoride varnish, fluorine begins to penetrate into the enamel, which, together with calcium, does not allow it to dissolve even in conditions of high acidity.

Remineralization can be:

1. Homemade, which consists of the most ordinary thorough brushing of teeth with toothpastes containing fluoride. There are pastes with more effective amino fluoride (they have a higher price and a faster penetration rate of fluoride into the enamel), as well as with sodium monofluorophosphate (they are a budget option). For a more professional fluoride prophylactic course, in addition to toothpastes and rinses, you will need remineralizing gels, which need to be used every 3-4 months, which does not replace brushing your teeth. If you follow these rules throughout your life, there's a good chance you'll never have to treat tooth decay.

2. Professional , for which you cannot do without visiting a doctor. Its main advantage is better efficiency due to the use of drugs characterized by a higher concentration of active substances. During the procedure, the teeth are coated with a transparent fluoride-containing varnish, which actively penetrates the enamel over the course of several hours. Gradually the film dissolves.

WHO recommends fluoride prophylaxis in two ways: using fluoride pastes at home and periodically resorting to the use of professional preparations that modern dentistry can offer.

• Proper oral hygiene , which is both a simple and very important step in caries prevention, prevents the appearance of carious areas.

A considerable part of people believe that their oral hygiene is absolutely fine. However, if this were true, the disease would not be so common.

Which toothbrush is better

Electric toothbrushes are many times more expensive than regular ones. But it does seem to make sense in terms of plaque and gingivitis control.

Researchers compared the teeth of adults and children who used electric and regular toothbrushes. Within a month, it turned out that among representatives of the first group, plaque formation decreased by 11%, and after three months - by 21%. After a month of using electric toothbrushes, the incidence of gingivitis decreased by 6%, and after 3 months - by 11%.

Models with a rotating head cope best with plaque.

The role of nutrition in preventing dental caries

One of the effective measures to combat caries is the correct approach to nutrition. The tissues of the oral cavity are sensitive to the lack of certain food components. In particular, a lack of protein in the diet prevents the accumulation of calcium and disrupts the structure and strength of enamel. At the same time, foods that are too fatty increase the permeability of the enamel, which increases the likelihood of the formation of carious lesions.

An excess of refined carbohydrates (sweets, flour products, sugar) in the diet not only reduces the resistance of teeth to the development of caries, but also weakens the immune defense, which is also a risk factor.

To prevent caries, it is important to adhere to the following dietary recommendations:

• A sufficient amount of protein must be present in the daily diet;
• eat foods containing vitamins C, D and group B;
• be sure to eat foods rich in calcium and phosphorus (milk, cheese, eggs, fish, broccoli, legumes), as well as fluoride-containing foods (sea fish, Georgian tea);
• it is necessary to limit the consumption of foods rich in “fast” carbohydrates, eat as little sweets, cakes and refined sugar as possible;
• Avoid sticky products: they can remain on the surface of tooth enamel for up to an hour, contributing to its demineralization for a long time.

The nature of your diet directly affects the condition of your teeth. A rational, fortified, balanced diet is an effective method of non-drug prevention of caries.

Is professional teeth cleaning necessary?

Some dentists recommend polishing and grinding your teeth, or professional cleaning, twice a year. However, this procedure has a number of contraindications: allergic reactions to the medications used, enamel sensitivity, bleeding gums.

In 2005, eight studies[] were conducted on the effects of professional dental cleanings on dental health. None of them even confirmed the safety of this procedure, let alone the need to do it regularly.

What to give up from food to prevent tooth decay

If you like to eat a lot of sweets, then the issue of preventing tooth decay may be more difficult than it seems. Everyone knows that pathogenic microflora feels very comfortable when a person eats sweets. It is the excessive, regular consumption of buns, sweets, cakes, chocolate that not only spoils the figure, but also the teeth.

Regular consumption of fried, too spicy or salty foods also has an adverse effect on teeth. Too acidic also negatively affects tooth enamel. Gradually destroying its structure, promoting the development of caries.

Particular attention should be paid to the following products:

• Various greens;
• fresh vegetables;
• fresh fruits.

It is better to eat food that has been subjected to gentle heat treatment; eating apples, carrots and similar products is very useful. If you are a fan of canned foods, then keep in mind that marinades also have a bad effect on tooth enamel.

Why do you need interdental brushes?

In 2015, a review of seven studies was published in which 354 patients brushed their teeth in three ways:

• only with a brush;
• brush and floss;
• brush and brushes.

Only once did scientists note that additional cleaning with a brush had advantages over brushing. But the evidence cannot be considered rigorous, since we are talking about a superficial study: the effect has not been analyzed in the long term. The same goes for comparing brushes and dental floss.

There is not enough data yet to draw conclusions about the benefits of brushes for interdental spaces.

How often should you visit the dentist?

In 2013, scientists analyzed[] data from medical examinations of 36,000 children. With regular preventive examinations, the likelihood of subsequent requests for treatment was indeed lower. But preventive examinations are economically justified no more than once a year.

Further research showed[] that it was not preventive examinations as such that had a positive effect, but the use of dental sealants. Dental sealants are coatings that are applied to the chewing surfaces of teeth to protect them. This procedure is most effective for children when the teeth are not yet damaged.

But sealants, when applied correctly, last from three to five years. Therefore, in this case, you can get by with fewer visits to the dentist.

There are also separate types of caries:

1. Cervical caries.

   Tooth damage occurs in the neck of the tooth. Treatment is complicated by the proximity of the gums to the site of inflammation.

2. Milk caries.

   This disease can develop on children's baby teeth as a result of insufficient hygiene and care of the teeth and oral cavity. Children's teeth are easily exposed to bacteria, especially if the child consumes foods high in carbohydrates: sweets, carbonated drinks. Some parents do not attach much importance to the disease of baby teeth, believing that there is no need to treat teeth that will soon be replaced by permanent ones. However, one should take into account the fact that milk caries is a source of bacteria that can provoke diseases of the ENT organs, the digestive system, and also provoke infection during the eruption of permanent teeth.