Always getting cavities? You don’t have to and the solution is simple. The concept that dental decay is an infectious disease is a foreign notion for most patients. However biological manipulation of dental disease risk, and the ability to treat that infection, is here.
One of the first questions I ask a patient on our first visit is “Tell me about your dental history?”
The response is commonly ”Well, I’ve got lots of fillings and no matter how well I brush my teeth I’ve always got something to do when I go to the dentist.”
Typically, on review of their mouths, the picture looks like this:
A relatively clean, well maintained mouth.
- Lots of fillings
- New decay
- Root fillings
- Possibly missing teeth
The traditional response in the dental industry has been to take a surgical approach to the problem, cutting out decay and filling a hole, with little emphasis on treating the underlying infectious disease.
Enlightened dentists have been treating the cause of decay for some years, with a global view that dental decay (caries) is a bacterial infection or imbalance. New, fast and cost effective screening tools, and treatment regimes have been developed to eliminate decay. For the the first time, patients discover that their customary experience of dental care can change.
To understand more about the modern concept of dental decay as an infectious disease, watch this You Tube clip from Carie Free…
Future proofing your mouth is real… imagine knowing that this might be the last filling you require, apart from simple repair and replacement as old fillings wear out. Even better, imagine knowing through a simple bacterial screen that you are at risk of developing decay before you have decay.
The latter concept is hard to get one’s head around. It means that when environmental influences are in balance (mostly what we eat and drink) the chance of expressing decay is lower, even with a high bacterial risk. However, as soon as the patient becomes exposed to different environmental selection pressures, the decay process begins rapidly and the results can be costly and destructive.
Take this example:
The teenager who has attended the dentist diligently through school years with parental insistence and guidance, completing orthodontics and arriving at 18 with no more than a few fissure sealants. Mum or Dad have been shopping and cooking and eating habits have been moderated by parental influence.
Returning home in November after a year at university, Mum organises a visit to the dentist. Both parent and student are shocked to discover that 6-8 fillings are needed at a substantial cost. Parents often face disbelief or worse – mistrust in the dentist making the diagnosis. A dentist who has failed to diagnose the bacterial risk is placed in a difficult position of defending a diagnosis that seems contrary to past observations.
So what happened here? Our student adopted a diet and lifestyle that created selection pressures that tipped the bacterial balance into the danger zone, creating so much loss of tooth mineral on a consistent basis that multiple cavities formed. Those changes can be quite subtle. In the presence of a cariogenic biofilm even small changes such as increased caffeine intake, producing a drier mouth with less saliva, will be enough to tip the balance in a high risk individual.
We know that the dominance of a cariogenic biofilm (bad bacteria) is inherited. Children are infected in infancy by oral contact with a parent, typically the mother. This transmission of infection is called vertical transmission. We have mixed evidence to support horizontal transmission – the transfer of bacteria from genetically dissimilar individuals such as partners. Intimate contact invariably involves transfer of saliva and there are case reports of specific strains of bacteria being transferred between spouses with a resultant increase in decay rates.
Current treatment modalities involve a regime of high pH mouthrinses to manipulate the biofilm content, allowing dominance of good bacteria. Regular screening and monitoring is an important part of decay prevention, as well as lifestyle awareness on the part of the patient.
Find out how you can measure your risk and future proof your mouth with us here
