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Tooth Decay

Dr. Loretta Lanphier, ND, CN, HHP, CH

Going to the dentist is not on anyone’s list of favorite things to do, as far as I know. Yet, dental care is extremely important to our overall health, and tooth decay is one of the most common medical issues in the entire world. Part of the problem is that many people today do not eat foods that we were designed to eat, so our teeth are exposed to agents of decay that they were never intended to handle. But, like most modern health problems, tooth decay can be prevented and minimized by using some good old common sense. There are also some “treatments” that are commonly used that do not fall under the heading of common sense, and in fact can be downright dangerous.

What is Tooth Decay?

Tooth decay, officially known as dental cavities or dental caries, involves the gradual breakdown of your teeth, so that tiny openings or holes (cavities) make inroads through the hard, outer layer of the tooth (enamel). The agent of decay is primarily a bacterium that feeds on certain substances in the mouth such as sugars and starches from the foods we eat. As the decay progresses, it reaches the softer under-layers of the teeth, and begins to eat away at them progressively faster. Poor dental hygiene is the major factor that contributes to cavities in most people.

Tooth decay, or cavities, is the second most common medical problem on the planet, led only by the common cold. Succinctly put, if you have teeth, you can get cavities. That makes most of us potential victims, but as we shall see, it doesn’t have to be that way. It is estimated that 9 out of 10 Americans will have at least one cavity during their lifetime, with 75% of folks experiencing their first one by the age of 5. Young children and senior citizens have the highest incidence of tooth decay, but it can occur to anyone at any age. Next to dental hygiene, diet is the second most common contributing factor in cavities.

What Are the Signs and Symptoms of Tooth Decay?

Cavities are progressive, and once the decay has pierced the tough enamel of the outer teeth, it begins to do its dirty work faster and more effectively as time goes on. At first, you might not experience any symptoms at all. Then they may begin as minor and get steadily worse if the problem is not addressed. Typical signs that you may have a tooth decay problem include:

• Tooth sensitivity to hot or cold foods and beverages.
• Pain when eating or drinking using a certain part of the mouth.
• Pain when consuming something very sweet or chewy.
• Toothaches or tooth pain that sticks around after you have stopped eating.
• Pain when you bite down in a particular area.
• Swelling, irritation, or pus around teeth or gums.

If you have any of these symptoms, the chances are that you already have tooth decay that has progressed beyond the initial stages. I know we don’t like to go to the dentist, but the more you put off tooth decay, the more painful and expensive it can be to deal with. Delaying the reality of cavities only makes the problem worse. But it does pose somewhat of a dilemma. You don’t want decaying teeth, but you don’t want to expose yourself to some of the health issues that can be associated with mainstream dentistry. It’s a bit like being between the proverbial rock and a hard place. Maybe we can provide a few tips that will help, but first let’s take a more in depth look at the causes behind tooth decay.

What Causes Tooth Decay?

Let’s face it ladies and gentlemen, our mouths are not a very tidy place. I’ve heard it said that a dog’s mouth is cleaner than a person’s, and that may well be true. But it is a known fact that the mouth is home to many varieties of bacteria, both helpful and harmful. Some of these bacteria, the most common being a bug called Streptococcus mutans which is responsible for most tooth decay, feed and thrive on certain substances that they are exposed to via the food and drinks we consume. The biggest offenders are sugars and cooked starches, also known as fermenting carbohydrates. When bacteria are combined with fermenting carbohydrates, an acid is formed as a byproduct that begins to eat away at the protective minerals in the enamel. This can begin to happen as soon as twenty minutes after eating.  To be more precise, the bacteria are just one part of a substance called plaque that is a sticky film made up of a combination of fermenting carbohydrates, bacteria, and a protein found in saliva called mucin. When plaque comes in contact with a vulnerable tooth surface, such as the back teeth and molars that have lots of nooks and crannies, the birth of a cavity is just waiting to happen. It is no coincidence that most tooth decay takes place in the molars and premolars, although it can occur anywhere on the teeth. The reason for this is that the uneven surfaces make it easier for decay to get a foothold, and also because these teeth are typically the hardest to keep clean.

As the outer layer (enamel) is worn down, tiny holes and cracks (cavities) appear that allow the factors of decay to reach deeper into the softer layers of the teeth (dentin) where the tooth decay is able to be even more destructive. As the decay progresses, it finally reaches the pulp layer, which contains nerves and blood vessels. This advanced stage of tooth decay can cause very painful symptoms, including pus that is the response of the immune system to the infection. The result is called an abscessed tooth, and can lead to serious systemic infections that can spread throughout the body via the bloodstream. A common treatment to repair tooth decay at this stage is called a root canal. If root canals are not performed properly, it can lead to progression of the infection and cause serious side effects. Be very careful, and get a second opinion if any dentist recommends a root canal, especially if the patient is a child. They are often not necessary, but can be very profitable for some unscrupulous dentists.

Other than the obvious factor of proper dental hygiene that can drastically reduce the incidence of tooth decay, there are certain other situations and behaviors that can affect your risk for cavities:

• Diet is, of course, a big one. Limit or eliminate certain foods and drinks that are high in fermentable carbohydrates, and/or stick to your teeth for a long time after eating. If you do eat these, make sure you brush or at least rinse with water as soon as possible after eating. Some of the most common culprits are: milk, table sugar, raisins, soda pop, hard candy, raisins, cookies, cakes, dried fruit, bread, and snack chips. Believe it or not, a food like potato chips can be worse for tooth health than something sugar-laden like a candy bar. Why? Because potato chips cling to the teeth, and are harder for saliva to naturally wash away. Even brushing and flossing can miss them.
• Snacking and sipping:  Sometimes its not so much what you eat, but when and how you eat it. For example, sipping soda or fruit juice on and off gives almost constant fuel to form the acids that erode your enamel. Its kind of like soaking your teeth in the stuff all day long. Coffee drinkers are guilty of this too, especially if they like café au lait. It’s amazing how much milk you can consume in a day if you are a heavy coffee drinker.
• Receding gums:  If you are prone to this condition, the roots of your teeth are at greater risk of being exposed to the factors of decay than if you have normal gums. Your dentin is much more susceptible to tooth decay, so it may be a faster process for you if your gums recede.
• Age:  Most folks are at greater risk for tooth decay as they get older, especially if they have not taken care of their mouth over the years. If you have existing fillings or other dental work, your risk for additional decay is also increased.
• Dry mouth:  If you have abnormally low amounts of saliva in your mouth, you may get tooth decay easier as well. Saliva is a natural cleansing agent for the teeth and mouth. Certain medications or conditions can cause dry mouth and low saliva levels.
• GERD:  If you have this condition that causes chronic heartburn and acid reflux (stomach acid backing up into the mouth) your mouth can become a highly acidic place that is a welcoming environment for the agents of tooth decay.

What About the Dentist…?
Don’t get me wrong. I am not anti-dentist or anti-dental care. It is just that you need to be aware that going to a modern dentist can be “fraught with imminent peril,” as W.C. Fields might have put it. For years the standard material used to repair cavities with fillings had dangerous amounts of mercury, nickel, and other toxic metals in it. Mercury is a very dangerous element that can cause serious damage to your neurological system, among other threats. There are alternatives available today that are less dangerous, but even some of these can expose your system to unwanted chemicals that can be very harmful, especially if one has an allergic sensitivity to any of these substances.

Be careful too if you are considering getting mercury fillings removed. Be sure you go to a dental care practitioner that specializes in this kind of work. If the person is not competent, removal of the fillings can cause more harm than good by spreading the mercury throughout your system.

And don’t fall for the fluoride scam either. Despite what you might hear in the mass media and from mainstream dentists, there is hard evidence that proves that the type of fluoride that is used in topical treatments and municipal water supplies is a toxic chemical that you do not want to expose yourself or your children to.

The bottom line with dental care is to brush your teeth after every meal (using natural toothpaste that does not expose you to harsh and dangerous chemicals), floss once a day before bed, and rinse your mouth with clean, filtered water after eating or snacking. If you do need to have a cavity filled, find an alternative dentist who uses safe materials and procedures. As far as the dietary factor goes, most of the stuff that contributes to tooth decay is things we should not be eating anyway. This is not rocket science folks. Take care of your body, and it will take care of you.