Tooth decay
Soon after tooth brushing, a thin, sticky layer of
bacteria forms on the surface of all the teeth. This layer of bacteria is called plaque.
When we eat anything sugary, the plaque bacteria turn the sugar into the
energy they need, producing acid at the same time. The acid removes minerals
from the hard tooth surface (enamel) in a process called demineralization. This
softens the enamel, and may lead to tooth decay.
Saliva is a watery fluid that helps to wash away and neutralize the acid. It
also contains minerals to replace those lost from the enamel during acid attack
(remineralization).
Demineralization and remineralization are repeated every time we eat or drink
something sugary. It is an ongoing battle between the acid and our saliva. If
sugary food or drinks are consumed too often, the saliva doesn't get long enough
to fully remineralize the teeth. The enamel gradually weakens, and eventually a
decayed hole (cavity) forms. This can be painful.
Dental erosionDental erosion is gradual wear of the surfaces of the
teeth. It is caused by acid attacking the surfaces of the teeth, but this time the acids are not made
by bacteria. Instead, the acids usually come from drinks such as fruit juices,
fizzy drinks and squashes - even the sugar-free varieties.
These drinks are so popular that nearly half of the children in the UK have
some dental erosion by the age of six.
Dental erosion is irreversible and can result in sensitivity and pain.
Erosion can be prevented by drinking acidic drinks less often. Babies and
toddlers should not drink juice or fizzy drinks from bottles, as this can lead
to severe erosion. Older children and adults may be able to reduce the amount of
contact acidic drinks have with their teeth by drinking through a straw, placed
towards the back of the mouth.
How to look after your teeth
Maintaining good oral hygiene is an important part of preventing tooth decay
and gum disease. This means cleaning your teeth twice a day with fluoride
toothpaste, visiting the dentist and hygienist regularly and controlling how
often you consume sugar.
Brush your teeth
Brushing is the most effective way of removing plaque. Here are some tips for
getting the most benefit out of tooth brushing:
- brush at least twice a day
- use fluoride toothpaste to protect against decay
- use a toothbrush with a small head and soft or medium synthetic bristles
- start at one side of your mouth and move round to the other side, brushing
all the tooth surfaces thoroughly
- use a gentle circular action
- pay particular attention to the gum line, angling the bristles into the
crevice where the gums meet the teeth
- don't rinse your mouth with water after brushing
- replace your toothbrush at least every three months
Children's teeth should be brushed by their parents from the time their teeth
come through until they are able to do it properly by themselves (usually at
about seven years of age).
If your child is less than two years old, only use a smear of toothpaste.
Then, use an amount about the size of a small pea until they are seven years
old. You must make sure that they spit the toothpaste out after brushing.
However, fluoride needs to be in contact with the teeth in order to have an
effect, so you should not ask your child to rinse their mouth out with water
after tooth brushing.
Some people prefer an electric toothbrush. There is some evidence that
certain types of electric toothbrush are more efficient at removing plaque than
brushing by hand.
Clean between your teethDental floss or inter-dental brushes remove plaque
and particles of food from between the teeth and under the gumline. These are areas that a toothbrush
cannot reach. Correct technique is important, so ask for advice from your
dentist or hygienist.
Use mouthwash
Fluoride mouthwashes can help to remineralize the enamel. Some antiseptic
mouthwashes reduce the number of plaque bacteria. Those containing chlorhexidine
(eg Peridex) are very effective, but can stain the teeth and affect the sense of
taste in the long-term. Always follow your dentist's advice and read the
instructions on the box or bottle.
Try disclosing tablets
These are small pills that, if crunched for 30 seconds, turn plaque a bright
color - usually pink. This can help you to see any areas that you have missed.
Chew gum
Chewing sugar-free gum after a meal stimulates the production of saliva,
which helps to neutralize plaque acid. Some chewing gums contain a sugar-free
sweetener called Xylitol, which suppresses certain types of plaque bacteria.
Research is currently looking at whether this prevents decay.
Control sugar in your diet
There is a clear link between sugary food and drinks and tooth decay. Some
types of sugar are worse than others. The biggest offenders are those added to
food during manufacturing (refined sugars).
It is how often these sugars are eaten - rather than the amount - that is
important. Avoiding refined sugars between meals gives your teeth a chance to be
remineralized by saliva.
Fruit, vegetables, cheese and milk all contain natural sugars that are much
less likely to cause decay. This makes them good alternatives to sweets, and
suitable for snacks between meals.
Alcohol and tobacco
Smoking stains the teeth and increases the risk of gum disease and tooth
loss. 4 Alcoholic drinks, and the mixers used with them, often contain lots of
sugar, increasing the risk of tooth decay.
Drinking alcohol and smoking or chewing tobacco are also associated with an
increased risk of developing mouth cancer.
Mouth cancer
In the UK, about 2,800 people are diagnosed
with mouth (oral) cancer each year. Most of these
people are over the age of 40, and it affects more men than women.
In recent years there has been a rise in the number of younger
people affected.
Mouth cancer is one of a group of cancers called head and neck cancers. Mouth
cancer can occur in many different areas, including your lips, tongue, gums,
floor of the mouth (under the tongue), inside the cheeks and on the palate (roof
of the mouth). The floor of the mouth is the most commonly affected area.
Visit your doctor or dentist as soon as you can if you notice any of these
symptoms. However, many of these symptoms can be caused by other conditions.
They do not necessarily mean that you have mouth cancer.
Causes
It's not fully understood why some people get cancer and others do not. But
there are certain factors that make mouth cancer more likely. The main risk
factors are:
- smoking tobacco -- any form of smoking can increase your risk of getting
mouth cancer including cigarettes,
- cigars and pipes, as well as Asian bidis or hand-rolled cigarettes
containing cannabis
- chewing tobacco, such as betel quid, gutkha and paan - this tobacco
accounts for the high level of mouth cancer found in countries like India
- drinking excessive alcohol, especially at the same time as smoking
- having already had cancer of the head and neck - if you've already had
this type of cancer, you are at risk of developing it again
- spending a long time in the sun or under UV light -a risk factor for lip
cancer, particularly in pale skin
Other risk factors may include:
- poor diet, lacking vitamins A, C and E and iron, selenium and zinc
- other infections in the mouth including Candida (the yeast infection that
causes thrush) - one type of long-lasting candida infection (chronic
hyperplastic candidiasis) can develop into mouth cancer
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