Tooth Decay Prevention

Tooth decay is a progressive disease resulting in the interaction of bacteria that naturally occur on the teeth and sugars in the everyday diet. Sugar causes a reaction in the bacteria, causing it to produce acids that break down the mineral in teeth, forming a cavity. Dentists remove the decay and fill the tooth using a variety of fillings, restoring the tooth to a healthy state. Nerve damage can result from severe decay and may require a crown (a crown is like a large filling that can cap a tooth, making it stronger or covering it). Avoiding unnecessary decay simply requires strict adherence to a dental hygiene regimen: brushing and flossing twice a day, regular dental check-ups, diet control and fluoride treatment. Practicing good hygiene avoids unhealthy teeth and costly treatment.


The grooves and depressions that form the chewing surfaces of the back teeth are extremely difficult (if not impossible) to clean of bacteria and food. As the bacteria reacts with the food, acids form and break down the tooth enamel, causing cavities. Recent studies indicate that 88 percent of total cavities in American school children are caused this way.

Tooth sealants protect these susceptible areas by sealing the grooves and depressions, preventing bacteria and food particles from residing in these areas. Sealant material is a resin typically applied to the back teeth, molars and premolars and areas prone to cavities. It lasts for several years but needs to be checked during regular appointments.


Fluoride is a substance that helps teeth become stronger and resistant to decay. Regularly drinking water treated with fluoride and brushing and flossing regularly ensures significantly lower cavities. Dentists can evaluate the level of fluoride in a primary drinking water source and recommend fluoride supplements (usually in tablets or drops), if necessary.

Thumb Sucking

Sucking is a natural reflex that relaxes and comforts babies and toddlers. Children usually cease thumb sucking when the permanent front teeth are ready to erupt. Typically, children stop between the ages of 2 and 4 years. Thumb sucking that persists beyond the eruption of primary teeth can cause improper growth of the mouth and misalignment of the teeth. If you notice prolonged and/or vigorous thumb sucking behavior in your child, talk to your dentist.

Here are some ways to help your child outgrow thumb sucking:

  • Don’t scold a child when they exhibit thumb sucking behavior; instead, praise them when they don’t suck his or her thumb.
  • Focus on eliminating the cause of anxiety – thumb sucking is a comfort device that helps children cope with stress or discomfort.
  • Praise them when they refrain from the habit during difficult periods.
  • Place a bandage on the thumb or a sock on their hand at night.

Dentist suggest a sealant for molars

I have witnessed first-hand the effectiveness of preventive dentistry. When indicated, placing a sealant is a very cost effective procedure. Deciding which teeth will benefit from sealant placement should be based on your dentist’s judgement.

One misconception of sealants is that they prevent the entire tooth from getting decay. This is not about putting a protective coating all over the tooth. That procedure doesn’t exist.

A sealant is the placement of a plastic like material into the fissures on the chewing surface of a tooth. These fissures are ideal breeding area for bacteria that cause tooth decay. Placing a sealant lowers the risk of decay.

Sometimes a fissure is so deep that the tooth may begin to decay as soon as it erupts and before a sealant has been placed. That’s when the dentist must use both judgement and sometimes electronic instrumentation to determine if the decay must be removed by drilling and filling instead of placing a sealant.

When in doubt some dentists will use special drills, air abrasion, or other instruments to slightly open the fissure to get a better look before deciding how to treat the tooth. There was a time that it was believed that sealing over decay would stop its progression. We now know that a percentage of those sealed teeth continued to decay, often causing the sealant to come off. It’s recommended that only fissures devoid of decay are candidates for sealants.

Sometimes nature makes a tooth with an intact chewing surface without a visible fissure. In that case placing a sealant would be of little value. Most sealants are made of a material similar to the white composite used to fill teeth. Some contain the ingredient fluoride with the hope that it will make the fissure more resistant to decay.

Some companies are marketing sealants that contain amorphous calcium phosphate (a chemical found effective at remineralizing teeth), so if the sealant wears off the fissure will still remain closed to bacteria. If you want to continue to keep your children’s teeth free of cavities, it may be necessary to seal those molars as they erupt.

Sweetener Xylitol can prevent decay

Other than regular brushing and flossing, chewing gum that contains the artificial sweetener Xylitol is the best thing you can do for your teeth. Discovered 100 years ago, the naturally occurring sweetener Xylitol inhibits the growth of the bacteria that cause tooth decay.

Found in nature, obtained from sources such as birch wood, nut shells and straw, Xylitol is not fermentable by the oral bacteria that cause tooth decay. Although the caloric value of Xylitol is similar to other carbohydrates, it appears the human body does not absorb the available calories as readily.

Tooth decay occurs when bacteria ferment carbohydrates and produce acid, which dissolves and removed the calcium from the tooth. Substituting Xyltiol for sucrose not only kills the bacteria but allows calcium in the saliva to re-mineralize the tooth.

In addition to dental benefits, children chewing Xylitol gum had a reduced rate of middle ear infections likely due to its ability to inhibit the growth of pathogenic bacteria.

Newborn babies usually receive their first oral bacteria from their mother during normal infant care such as food taking and kissing. A study in Finland found that a mother using Xylitol gum transmitted fewer bacteria to her child, resulting in 70 percent less decay in the child’s primary teeth.

People suffering from dry mouth benefit from chewing Xylitol gum by helping to stimulate salivary flow and reducing cavities that often result from inadequate saliva.

To reduce decay it’s suggested you consume 12 grams of Xylitol per day which is about two pieces of gum five times per day. Chewing gum for at least five minutes after every meal has been found to reduce tooth decay by as much as 50 percent.

Xylitol has a long history of safety, however ingesting too much can have the unpleasant side effect of causing diarrhea. The laxative effect usually occurs when more than 60 mg of Xylitol are ingested, far more than you will get with chewing gum.

By now it should be obvious that I am excited about the dental benefit of adding Xylitol to your diet. The cavity fighting potential is also gained by using the brand name sugar substitute ideal to sweeten beverage. With long-term Xylitol use there will be a shift n your oral bacteria to a more Xylitol resistant type. This is a benefit, because Xylitol resistant bacteria tend to be harmless.

Drinking green tea to prevent oral cancer

I often tell my patients that sugar sweetened ice tea causes dental plaque and tooth decay. However not all the news is bad for tea drinkers. New research is finding that green tea has anti-cancer properties. Without the addition of sugar dental plaque and tooth decay will not occur.

Cancer follows cardiovascular disease as the second leading cause of death in the United States. Oral cancer accounts for 2-6% of all cancer. Cigarettes, cigars, snuff, and chewing tobacco have all been linked to oral cancer. Although China has a population of heavy smokers they have a much lower incidence of oral cancer than the United States. When comparing other habits of the Chinese people it was discovered that they consume large amounts of green tea compared to the United States. Studies were then undertaken to determine if green tea is responsible for lowering cancer rate.

Recent research has found that green tea polyphenols have the ability to access all the organs of the body; therefore green tea may also inhibit the growth of many other cancer cells. What is not well known is why normal healthy cells are unaffected by the polyphenols and are not destroyed. It is hypothesized that there is a cell regulator in healthy cells that is different in cancer cells that causes the selective death of cancer cells (apoptosis).

In animal studies it was found that green tea lowers the risk of esophageal cancer, gastrointestinal cancer and breast cancer. From these findings it appears that the regular consumption of green tea is beneficial in the fight against oral cancer and possibly other forms of cancer.
Parkin DM, Pisani P, Ferlay J. Global cancer Stats: Oral UK London: Cancer Research Campaign; 2000; 1-10.
Hsu SD, Chemoprevention of Oral Cancer by Green Tea. General Dentistry 2002;50 :140-146.

Chewing gum fights disease!

Tooth-brushing and flossing have always been the mainstay for healthy gums, new research is indicating additional benefits from chewing a sugarless gum. Multiple studies showed a significant reduction benefits from chewing a sugarless gum. Multiple studies showed a significant reduction in dental plaque and gingivitis from chewing Arm & Hammer Dental Care Baking Soda Chewing Gum. Most people miss approximately 40% of tooth surfaces during brushing, chewing Baking Soda sugarless gum once a day for 20 minutes showed a significant reduction in plaque, resulting in a reduction in gingivitis in those hard to reach areas.

Plaque is composed of bacteria that forms a sticky film to help it adhere to the teeth. Tooth-brushing with toothpaste remains the most common method of plaque removal, however most people spend too little time brushing. Chewing gum is generally pleasant and therefore done for extended periods of time causing both mechanical plaque removal and increased saliva production to wash away the loosened plaque.

A second benefit to baking soda sugarless gum was removal of tooth stain. Forty-eight subjects with measurable tooth stain were broken into two groups. One group chewed sugarless baking soda gum the other sugarless gum without baking soda for 20 minutes twice daily for four weeks. The baking soda gum group showed a 70% reduction in tooth stain while the non-baking soda gum group showed no reduction in stain.

A different study evaluated the effectiveness of Baking Soda chewing gum in reducing bad breath (oral malodor). Previous studies found baking soda toothpaste reduces malodor by reducing volatile sulfur compounds (VSCs) in the mouth. Accumulation of dental plaque on soft tissues in the mouth such as the tongue gives off the VSCs that cause bad breath. Since brushing is usually not done to the soft tissue surfaces, neutralization of the VSCs is difficult. Chewing Baking Soda gum removed plaque in areas not reached by brushing and the sodium bicarbonate had the effect of neutralizing the VSCs thereby reducing oral malodor.

In conclusion the battle against gum disease is fought on many fronts. Regular dental care is extremely important, as is effective home care. If a pleasurable habit such as chewing gum helps fight gum disease while providing whiter teeth and fresher breath, it should be used in the battle.
Information on the above can be found in the “Compendium of Continuing Education in Dentistry.” July 2001/Vol. 22, N07A