Why do we get tooth decay?

Tooth decay is a disease. It is caused by specific bacteria that live in our mouths, called Streptcoccus mutans. Strep mutans lives in microscopic colonies on the surface of the teeth, and is able to produce such concentrated acid as its waste product that it can dissolve the tooth enamel. In other words, these germs burn holes in teeth, and all they need is their favorite fuel – sugar!

Tooth + Bacteria + Sugar = Tooth Decay

Unfortunately, Strep mutans is a very common resident in people’s mouths, so most people have been susceptible to tooth decay. Those lucky people who never get cavities don’t have those germs in their mouths.

Why is my little kid getting cavities?

Even if you carefully control your child’s diet and snacks, some kids turn out to have Strep mutans in their mouths and get cavities. Where does it come from? It’s not genetic, but it does tend to run in families. Babies get their oral germs from the family around them. By age 2 or 3 their mouth bacteria closely resembles their mother’s and other family members. The best way to break this “chain of transmission” is for young adults to have their teeth in the healthiest condition before becoming parents. That way they have much less tooth decay bacteria to pass on to the next generation.

How can we prevent tooth decay?

Tooth + Bacteria + Sugar = Tooth Decay

To keep the teeth intact, we can kill the germs, and we can reduce their food supply by reducing how much sugar we eat, and how often we eat it. The same applies to all the simple “fermentable” carbohydrates.

Brushing and flossing is important, but they’re not always enough to get at the microscopic colonies the germs live in. Most dentists recommend topical fluoride, in toothpaste, in mouthwash, and applied in the office, as a preventive measure. It can be useful as a prescription medicine, but it’s not the only thing that works. There are non-fluoride methods of controlling the Strep mutans germs, including topically applied iodine, baking soda/peroxide tooth paste to keep the mouth alkaline, and various ozone preparations. Ask your IAOMT dentist and hygienist.

Doesn’t fluoride in the water protect us?

Community water fluoridation is promoted by many health authorities as a way to reduce tooth decay in the general population. The IAOMT, along with many other health-conscious organizations, opposes this practice. The science on water fluoridation has proven that it is ineffective, expensive, and poses clear health hazards.

Further Reading

What's a filling, what's a crown?

crownsIt all starts with tooth decay, damage caused to a tooth by bacterial action. A cavity is the hole left in the tooth after the dentist cleans out the decay. The dentist recommends the type of “restoration” based on how much healthy tooth is left, and how strong it is.

A filling is a “direct restoration.” It is a paste put directly in the cavity and hardened in place.

An inlay, onlay and crown are “indirect restorations.” Most of the time, they are made outside the dentist’s office, and require a second visit to be cemented into place. Many dentists today have computerized “cad-cam” machines in the office, which allow indirect restorations to be made in one appointment.

How do I know if I need a crown?

Crowns are used to fix a tooth when the tooth is too weak to hold a filling. It can be because there is a visible crack in the tooth, or if corners of the tooth have already broken away.

Sometimes a tooth is sensitive to bite on, with no obvious reason. That usually means there is a hidden crack, and a crown is used to strengthen the tooth and hold it together.

Teeth that have had root canal treatment are known to be weaker, and are usually finished with a crown for strength.

The need for a crown, and what type of crown, is a decision for your dentist to determine. As always, the dentist must discuss the treatment plan, and it must make sense to you.

What kind of crown is best?

The classic standard crown material in times past was cast gold. Gold crowns are very durable, proven for centuries. However, they look like gold, and not everyone likes that.

The standard tooth colored crown for many years has been the “porcelain-fused-to-metal” crown. Most of the time the metal part would be gold, but many other metals were used.

It is important to avoid “non-precious metals” for crowns. They tend to be toxic and allergenic.

In more recent years, dental technology has perfected ceramic and composite-ceramic materials for crowns. They are completely non-metallic, they are tooth colored and look very natural, and they tend to be very biocompatible. There are many brand names, but some of the categories are: zirconia, lithium disilicate, zirconia blended composite.

If you are chemically sensitive, an important consideration is to use materials that are tested safe for you. Another consideration: the dentist should use materials they are familiar with.

How do I know if I need a root canal treatment?

Diseased-treatedRoot canal treatments are used to preserve teeth that would otherwise need to be extracted.

A tooth that is too painful, or is actually infected, can often be treated so that the pain and infection goes away. The inflamed or infected nerve tissue deep inside the tooth is cleaned out, and the whole root is filled.

Millions of root canal treatments are done every year, and most of them end up making the teeth comfortable. However, it may take several months for a treated tooth to fully settle down.

Aren’t root canals bad for you?

This is a difficult question. On the one hand, a root treated tooth is dead. There are many reasons to think that they hide bacteria in microscopic spaces – low grade infections that stay as long as the tooth is there. Some dentists feel that all root treated teeth are a health hazard. They say there is no reason to keep dead parts in your body, and they should be extracted.

On the other hand, extracting the tooth is the only alternative to having a root canal treatment. Keeping your own teeth is a great value. It can be a lot easier and less expensive to keep a tooth that is comfortable and functional – chewing and smiling – than to extract it and replace it. Millions of teeth get root canal treatments every year, because people choose to try keeping the teeth rather than losing them.

We don’t have a good test to find out if a root treated tooth is hurting your health. If you are concerned about whether your health is good enough for you to tolerate root canal treatments, you must have the discussion with your dentist and your medical doctor.

Further Reading

Should I have my old fillings replaced?

amalgam-fillings-300x200Sometimes filling replacement is done for routine maintenance. They get old and corroded, or they break, and should be replaced to keep doing their job.

The harder question is should they be replaced by choice, to eliminate mercury exposure? It is a personal decision that only you can make for yourself. If you have studied the issue, and you decide that you do not want mercury fillings in your mouth, it’s your right to ask your dentist to replace them. Some dentists will be reluctant to do this for you, while others will understand and accept your request.

Some people with health problems are told by their doctors that they have mercury toxicity, and are given a prescription to replace mercury fillings.

If you choose to have old mercury fillings replaced, don’t forget the basic precautions.

  • Find a dentist familiar with mercury-safe procedures.
  • Make sure the dentist will protect you from breathing and swallowing the debris that comes off when drilling out the old fillings.
  • If you are chemically sensitive, the dentist can test the new fillings to make sure they’re safe for you.
  • If you are pregnant, or think you might be, or nursing: we do