How does tooth decay occur?
In the first of five blogs, Steve Lomas (Practice Partner at Old Surgery Dental Practice) shares an article he recently wrote for his doctor so he could advise his patients on how to look after their children’s teeth. Part 1 deals with the circumstances during which tooth decay occurs, along with guidelines so that your children can still enjoy treats without putting their teeth at risk!
Understanding the decay cycle really helps with applying the preventive rules. There are three factors necessary for a tooth to decay. Plaque, sugar and time. These three factors can work together to damage the hard enamel outer shell of the tooth. Plaque is the transparent thin film that attaches to our teeth every day, consisting of bacteria and food debris. When we eat or drink the bacteria in the plaque help turn sugars into acid. The acid produced can damage the enamel surface, resulting in a small cavity in the enamel. At this stage no pain is felt and progression of the cavity can be stopped. If the bacteria are given sugary food and drinks too frequently, the cavity will break through the enamel into the inner dentine layer of the tooth. At this stage it is common to feel sensitivity and a dental filling is required to stop the bacteria damaging the dentine and to prevent the cavity reaching the nerve in the inside of the tooth when an abscess can occur.
If you follow a few simple guidelines these three factors can be controlled so that your children can still enjoy a few sweet treats without putting their teeth at any great risk.
Plaque management – tooth brushing, fluoride and mouthwashes
- The first teeth will start to come into your child’s mouth at about six months old. Start with a small soft tooth brush and a tiny smear of adult strength toothpaste
- Look at your tube of toothpaste. On the ingredients list it will always tell you how much fluoride is in the toothpaste in units of ppm (parts per million). For under twos it should be a minimum of 1000ppm, after that a minimum 1350ppm (which is adult strength toothpaste). A smear is fine for toddlers, and a small pea sized amount is fine after that and for adults. There is no need to place a huge line on the toothbrush head, that’s just advertising tricks to encourage you to use more product
- Fluoride helps repair and strengthen the enamel surface
- Brush for two minutes every morning and night. Oral B and Aquafresh regularly provide us with little two minute egg timers to give to children, so look out for these
- Do not rinse the mouth out after brushing, especially at night. Leave the toothpaste on the teeth so that the fluoride can help strengthen the enamel overnight. Most of us rinse out because our mums taught us to do so
- Brush before bed and go to sleep. Do not take a drink immediately after brushing and only let your child take water to bed, not juice or similar. We produce less saliva when we sleep so we do not wash off the toothpaste as quickly as in the morning
- Try and use an electric toothbrush from as young an age as possible, usually around the age of three. I usually recommend a basic inexpensive Oral B model, frequently on offer in the supermarkets, Boots and Argos. These can be battery powered or better still rechargeable. Oral B make smaller softer children’s heads for these brushes, so one toothbrush body could work for the whole family if you swap the head for each person. We have tried out some of the really cheap ones made by other manufacturers available in the supermarkets, and some have been amazingly poor at removing plaque even when I have used them, so I stay with the Oral B brushes
- If you like to use a mouthwash, that is fine. Look for a fluoride containing one, Colgate do one especially for children. It is not a substitute for good brushing, but can help kill bacteria in the rest of the mouth and rinse food debris from the cheeks. If using at night remember to use before brushing, not after, as I want the toothpaste to be the last product applied to the teeth
- Disclosing tablets. These are little tablets available from your dentist or pharmacy that stain the plaque on the teeth. I think these are so important I that I will give them their own paragraph in a future blog post!
