Other Factors In The Decay Process

In this first of a series of info bites regarding dental and orthodontic topics I thought it appropriate to review the tooth decay process and some of the many factors which ultimately contribute to an individual’s susceptibility to decay.

In a recent article in the Journal of Clinical Pediatric Dentistry it was very interesting to note that even though the prevention of the dental decay (caries) has been an objective of our profession for many decades it has yet a very prevalent disease in our population.

In fact a stunning statistic is that only ten-percent of our adolescents in the U.S. enter adulthood decay free. This is an astonishing fact in spite of the many preventive measures the profession has instituted such as hygiene instructions, professional cleanings, communal fluoridation programs, topical fluoride applications, and sealants.

There are many factors that contribute to the different decay rates that exist in our population from individual to individual and even from sibling to sibling. Some of these factors are:

  • the protection elements of an individual’s saliva,
  • the balance between an individual’s decay producing and non-decay producing bacteria,
  • and the physical-chemical composition of an individual’s enamel.

These factors are very important influencing an individual’s resistance to the tooth decay process.

In order to understand the influence of these factors let’s review the tooth decay process.

Relatively innocuous bacteria reside in the oral cavity and prevent the overgrowth of more adverse inhabitants such as yeast and fungi. The normal bacteria utilize the residual food particles left from poor hygiene for their own metabolism and excrete their waste products which are acidic in chemical composition. These acids then have the ability, if not removed or neutralized, to dissolve the enamel creating a cavity. If not treated this process will penetrate the enamel then penetrate the next hard layer of the tooth, the dentin, and then begin to invade the soft tissue of the tooth known as the pulp or the nerve. When this occurs the tooth may become very uncomfortable and may require more difficult procedures in order to resolve the problem.

One of the protective factors which helps insulate an individual from decay is the characteristic of their saliva. Saliva functions as a lubricant for swallowing, possesses protective proteins to fight bacteria, fungi, and viruses, contains enzymes to help in the digestion of starches, and moderates the acidic environment of the oral cavity. This acidic neutralization capacity of saliva is very important in limiting the effect of the acid -releasing bacteria as discussed previously. Knowing these factors, it is important to note that the flow of saliva is increased upon the introduction of food into the oral cavity and is also reduced when the individual is sleeping or if the patient is on long- term medications such as antihistamines. This is one of the primary reasons to meticulously brush your child’s teeth before bedtime when the flow of saliva is reduced.

The next topic we will discuss in our dental information page will be the topic of dental plaque and its relationship to the decay process. If you have any questions regarding your child’s dental health, please contact our office.