• What causes tooth decay?
• How long after a meal can the decay process start?
• How do we prevent tooth decay?
• How does fluoride prevent tooth decay?
• How do sealants prevent decay?
• Nursing & Baby Bottle Tooth Decay?
• HOW DOES NURSING DECAY DEVELOP?
• WHY ARE BABY TEETH IMPORTANT?
• WHAT CAN I DO TO PREVENT NURSING DECAY?
• DETECT NURSING DECAY EARLY

What causes tooth decay?

Your teeth are covered with a sticky film of bacteria, called plaque. Within this film, there are thousands of different types of bacteria. Of all these many different types of bacteria, only one causes tooth decay. That bacterium is called Strep Mutans. It is impossible to rid oneself of all these germs, and it would be unfavorable to do so. You see, all the other bacteria in your mouth are constantly fighting a war, preventing the Step Mutans from taking over.

After eating a meal, there are small crumbs of food in our mouths, just like those that you may see on your kitchen table. The Strep Mutans bacteria eat these crumbs and produce harmful acid. This acid can attack tooth enamel for as long as 20 minutes or more. Repeated acid attacks cause the enamel of the teeth to break down, resulting in tooth decay.  

 If left untreated, the decay will continue to progress through the tooth structure until it reaches the pulp.  The pulp chamber houses the nerve and blood supply for the tooth.  When decay reaches the pulp, an abscess ensues which is associated with tremendous pain.  Once the decay is in the chamber, the only choice of treatments are Root Canal Therapy or Extraction of the tooth.

       

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How long after a meal does it take for this acid to be produced?

This depends on the person, the frequency of snacking, and the amount of available sugar present. Studies have shown that an acid environment can be created as quickly as 30 minutes after a meal and could last for hours.

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How do we prevent tooth decay?

The best way to prevent decay from forming is by cleaning our mouths, thus removing all the stray bits of food. This can be accomplished by brushing and flossing your teeth. If there is no food for the bacteria to digest, then they cannot create the acid needed to cause decay. Also repeated fluoride treatments and protective sealants have been shown to decrease the effects of the harmful acid that causes decay.

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How does fluoride prevent decay?

Fluoride helps prevent decay by making our teeth more resistant to the acid that is produced. If we brush regularly with fluoridated toothpaste and receive fluoride treatments, more fluoride will get incorporated into the structure of our teeth, and the bacteria will have to produce much more acid.

The best time to introduce fluoride to the teeth is when they are still forming in the jaws. This can be accomplished quite simply by allowing children to consume properly fluoridated water (7 parts per million), or a fluoride supplement (for children growing up in non-fluoridated communities).

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How do sealants prevent decay?

Typically, posterior teeth have deep grooves that are impossible to keep clean, despite how often you brush. This is because, these grooves become microscopically small and the bristles of a tooth brush cannot reach them. As you eat, food and bacteria get stuck in these grooves. The bacteria then produce the harmful acid which in turn cause cavities to form. After being placed on the chewing surfaces of a tooth, the sealant hermetically seals these grooves, thus preventing food and bacteria from getting into the grooves. Also the sealant material makes the tooth more resistant to the harmful acid that can form cavities.

     

Toothbrush Bristle                    Before                          After       can not fit in grooves

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Nursing & Baby Bottle Tooth Decay?

Proper dental care is a lifelong commitment that starts even before your baby�s first tooth forms.  While daily cleanings and fluoride are important, they alone may not prevent Nursing Decay a major cause of tooth decay in infants.  Nursing Decay is costly to treat.  If left untreated, however, it can quickly destroy the teeth involved.  It also can lead to pain, infection, early loss of baby teeth, crooked permanent teeth, and an increased risk of decay in permanent teeth.  When you consider the possible dental problems that can result from Nursing Decay and the cost of treating those problems, it is best to prevent Nursing Decay from developing in the first place. 

 

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HOW DOES NURSING DECAY DEVELOP?

Nursing Decay can develop if your child�s teeth and gums are in prolonged contact with almost any liquid other than water.  This can happen from putting your child to bed with a bottle of formula, milk, juice, soft drinks, sugar water, sugared drinks, etc.  Allowing your baby to suck on a bottle or breastfeed for longer than a mealtime, either when awake or asleep, also can cause Nursing Decay.

 When liquid from a baby bottle builds up in the mouth, the natural or added sugars found in the liquid are changed to acid by germs in the mouth.  This acid then starts to dissolve the teeth (mainly the upper front teeth), causing them to decay.  Nursing Decay can lead to severe damage to your child�s teeth and also can cause dental problems that affect your child�s permanent teeth. 

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 WHY ARE BABY TEETH IMPORTANT?

 Many parents assume that decay does not matter in baby teeth because the teeth will fall out anyway, but decay in baby teeth poses risks.  If your child loses his baby teeth too early because of decay or infection, the permanent teeth will not be ready to replace them yet.  Baby teeth act as a guide for the permanent teeth.  If baby teeth are lost too early, the teeth that are left may shift position to fill in the gaps.  This may not leave any room for the permanent teeth to come in.

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 WHAT CAN I DO TO PREVENT NURSING DECAY?

• Never put your child to bed with a bottle.  By 7 or 8 months of age, most children no longer need feedings during the night.  Children who drink bottles while lying down also may be more prone to getting ear infection.
• Only give your baby a bottle during meals.  Do not use the bottle as a pacifier, do not allow your child to walk around with it or to drink it for extended periods.  These practices not only may lead to Nursing Decay, but children can suffer tooth injuries if they fall while sucking on a bottle.

• Teach your child to drink from a cup as soon as possible, usually by 1 year of age.  Drinking from a cup does not cause the liquid to collect around the teeth, and a cup cannot be taken to bed.  If you are concerned that a cup may be messier than a bottle, especially when you are away from home, use one that has a snap-on lid with a straw or a special valve to prevent spilling.

• If your child must have a bottle for long periods, fill it only with water. 

Keeping your baby�s mouth clean is also important in preventing tooth decay.  After feedings, gently brush your baby�s gums and any baby teeth with a soft infant toothbrush.

Start using water and a soft child sized toothbrush for daily cleanings once your child has seven to eight teeth.  By the time your toddler is 2 years of age, you should be brushing her teeth once or twice a day, preferable after breakfast and before bedtime. Begin using fluoride toothpaste when you are sure the toothpaste will not be swallowed (usually when your child is around 3 years of age).  Use a pea-sized amount of toothpaste to limit the amount your child can swallow.  Too much fluoride can be harmful to a child.

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DETECT NURSING DECAY EARLY

Nursing Decay first shows up as white spots on the front teeth.  These spots are hard to see at first-even for a pediatrician or dentist- without proper equipment.  A child with tooth decay needs to get treatment early to stop the decay from spreading and to prevent lasting damage to the teeth. If you are concerned that your child may have Nursing Decay, your pediatrician can refer you to a pediatric dentist who will carefully examine your child�s teeth for signs of decay. With the right balance of proper home and professional dental care, your child can grow up to have healthy teeth for a lifetime of smiles. 

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The above is an oversimplified discussion on tooth decay. If you have any questions please feel free to contact Dr. Bialik at, 246 Federal Road, Suite D-13, Brookfield, CT 06804, (203) 791 – 2771.

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