Many of us have heard that dental disease is epidemic today, but what does that really mean in terms of your family’s oral health? Should you do more than simply brush and floss daily? And how can you protect your children—especially those of school age, who are away from home for several hours each day—from cavities and gum disease?

One key to protecting yourself from infectious oral disease is to understand the processes that cause it. So, how does tooth decay occur?

Tooth decay is caused by certain types of bacteria (Streptococcus mutans and Lactobacillus) that live in your mouth. When these bacteria attach to the teeth and multiply in dental plaque (a sticky film that constantly forms on teeth and gums), they can cause damage to your teeth.

The bacteria feed on what you eat—especially sugars (including fruit sugars) and cooked starch (cookies, crackers, chips, breads, potatoes, rice, pasta, candy, and so forth). Within minutes of consuming these sugars and starches, the bacteria begin producing acids as a by-product of digesting food. These acids penetrate the enamel surfaces of teeth and dissolve their minerals, calcium and phosphorus.

If the bacterial acid attacks are infrequent and of short duration, your saliva can help repair the damage by neutralizing the acids and replacing lost minerals. If there is a great deal of bacteria in your mouth, however, saliva alone cannot counter the loss of minerals due to the bacteria-caused acid attacks. This is the start of tooth decay, and it leads to cavities.

Methods of Controlling Tooth Decay

There are several effective methods of controlling tooth decay. Most can be performed at home, as part of your daily health routine. Some require a prescription or a visit to the dentist.

Diet: Reduce the amount and frequency of sugary and starchy foods, snacks and drinks that you consume—particularly between meals.

Plaque Removal: Daily removal of plaque from your teeth is an essential part of controlling tooth decay. Be sure to remove appliances such as orthodontic retainers and partial dentures prior to brushing and flossing, and remember to brush all surfaces of the appliance, as well.

Xylitol: When used frequently throughout the day (especially after meals and snacks), xylitol is very effective in controlling tooth decay. It works in three important ways:

• Unlike table sugar, xylitol cannot be converted to harmful, acid-producing food by bacteria.
• Xylitol inhibits bacteria’s ability to adhere to teeth, gums and the tongue. This reduces the amount of plaque formation.
• Xylitol increases salivary flow, providing further protection against harmful bacteria.

Fluoride: Fluoride can help your teeth become more resistant to bacterial acids. Fluoride is available in many forms, such as over-the-counter toothpastes and rinses, prescription products such as creams or gels that are used at home, and foams or varnishes that are applied in the dental office. Follow the advice of your doctor with the use of fluoride products.

Antibacterial Oral Rinse: If you are at a high risk for tooth decay, your dentist may prescribe temporary use of an oral rinse to reduce the amount of decay-causing bacteria in your mouth.

Sealants: These plastic coatings bonded to the biting surfaces of molars protect the deep grooves from decay. Sometimes grooves on the surface of teeth are too narrow and deep to be cleaned with a toothbrush, and decay may result in spite of good oral health practices. Sealants are an excellent measure for children and young adults at risk for this type of decay.