Halloween, Hollow Teeth, Hallowed Be Thy Name

October 2007

By: Dr. Scott R. Harden

As we face Halloween and all that despicable candy, I feel it only fitting to dedicate this article to the fundamental topic of dental cavities.

We all know sugar is bad for teeth, but why? It’s really pretty simple. Tooth decay is caused by certain bacteria in our mouths that produce acid in the presence of carbohydrates such as sucrose, fructose and glucose. Thus if it tastes sweet, it’s probably bad for your teeth.

Is it Important to Brush My Teeth Every Day?
There are more than 100 species of bacteria, and hundreds of species of fungi, protozoa, and viruses that live in our mouths. Microbiologists estimate that, in addition to these known species, there are up to 500 other living, breathing organisms inhabiting our mouths, although only 50 have been identified and named. The sheer number of these creatures is astronomical, considering the fact that our mouths contain more bacteria than the entire world’s population. These bacteria constantly accumulate on our teeth every day in the form of plaque, a sticky white film.

Plaque tends to accumulate in areas that are undisturbed, such as in the grooves and on the biting surfaces of the back teeth, between the teeth, and next to the gum line. Thus, plaque removal is vital to avoid the effects of tooth destruction from the acid it produces.

How Will I Know if I Have a Cavity?
This may sound a bit surprising to most people, but the large majority of cavities are completely painless. This is because the outer enamel has no nerves. It is only when the cavity enters the underlying dentin that the cavity may begin to feel sensitive. The most common symptoms are an increased sensation to cold and/or sweet foods or beverages. A cavity is often responsible for a tooth that breaks. The cavity weakens the tooth, especially when it forms under a filling or a tooth cusp, and can easily cause a fracture when biting down.

Patients are sometimes surprised or even in denial when they learn that they have a few cavities – especially when they don’t have any symptoms. It is far better to treat a small cavity than to wait until they have symptoms (like pain). By the time there are symptoms, the cavity may have spread to infect the dental pulp, necessitating a root canal procedure or an extraction to eliminate the infection. Decay is gradual and the body is amazing at adapting to and thus tolerating such problems. Regular dental examinations, at least twice a year, will greatly reduce the likelihood that a dental cavity will go undetected and spread to a more serious condition. Remember, dental decay is an infectious disease.

How do Dentists Detect Cavities?
Cavities are detected a number of ways. Traditionally, the dentist uses a hand held instrument called an explorer to probe the tooth surface for cavities, and if it “catches”, that means the instrument has found a soft area or cavity. Recent technology utilizes a Diagnodent ultrasonic devise that is far more accurate than an explorer, and can identify cavities forming deep down in grooves before they appear at the surface. Dentists can also use a visual examination to detect cavities, and with technology again introducing telescopic lenses that work like a microscope, allows amazing us to see amazing detail as never before. Cavities can be seen initially as white demineralization areas, that progress to brown or black spots. Dental x-rays, especially check-up or bitewing x-rays, are very useful in finding cavities that are hidden between teeth, or under the gum-line. An example of such an elusive cavity is shown. Note this large cavity would be covered by gum tissue and if not for x-rays, it might remain undiagnosed completely.

Though cavities can obviously be repaired by fillings, try to avoid them by taking care of your teeth. Here’s how:

  • Limit sweets and sodas as much as possible. Drink water more often; it’s better for you.
  • Relative to Halloween, if your child has dental sealants, tell them to be selective in what type of candy they eat. Sticky candy can remove sealants off their teeth and then permit the candy to lodge down in the grooves.
  • Brush your teeth with fluoride toothpaste after each time you eat or at least twice a day. Bedtime is an important time to brush.
  • Brush up and down in a circular motion.
  • Gently brush your gums as well to keep them healthy.
  • Floss your teeth once a day to remove plaque and food that’s stuck between your teeth.
  • See your dentist twice a year for regular checkups.

Good luck with your teeth and the welcomed phrase, “no cavities”.