So you’ve had a cavity or a few in your lifetime. Who hasn’t? By the ripe old age of 2 1/2, almost all American kids show some decay on the surfaces of their teeth. Adults, for whom dentures were almost inevitable not long ago, are keeping their own teeth more often, but those teeth are showing an increased incidence of root decay.
A cavity is your mouth’s way of telling you that you have an active case of dental caries, a bacterial disease. Some 200 to 300 kinds of bacteria reside in your mouth, many providing worthwhile services like digesting food or producing vitamins. But other get their kicks ganging up in a sticky substance called plaque and looking for innocent teeth to beat up on. Usually invisible, plaque may briefly reveal itself as a slimy whitish film on your teeth first thing in the morning, because the glands that produce saliva, a natural mouthwash, are turned off while you sleep.
Plaque gobbles up sugars in the foods you eat and forms acids that attack your tooth enamel. Acid is produced within moments after you’ve ingested sugar and does its worst damage within 20 minutes’ time. Your teeth are pretty tough, though: A year or two of recurrent acid attacks against a tooth can occur before the first signs of cavity appear in the form of an opaque white or brown spot on the surface enamel. After that, the enamel’s outer layers slowly break down, becoming rough and stained, and the bacteria invade the dentin underneath and spread, creating a large cavity.
Your cavity starts to cause pain as bacteria and acid seep inside your tooth down to the root through tiny tubes in the dentin. Worse yet, the bacteria dig into the pulp tissue near the center of your tooth. And then—talk about excruciating—the pulp becomes swollen, infection spreads, blood supplies are cut off, and the pulp can die. Then the pain subsides…until perhaps a few years later, when an abscess can form due to bacteria working their way from the root canal into the nearby bone and tissue, leaving them inflamed and infected.
Fortunately, cavities are anything but inevitable if you’re careful about what you eat and how you care for your teeth.
Brush up. Proper cleaning of your teeth can virtually eliminate decay. Forget the old “brush twice a day” rule. Brush your teeth after every meal and snack. If you eat six times a day, brush your teeth six times.
No more than a minute or two is required for a good brushing. Just make sure you’re doing it properly. Use a soft toothbrush that effectively removes plaque without damaging tooth enamel or irritating gums.
Buy a fluoride toothpaste. It has been shown to reduce decay. Angle the brush at about 45 degrees against your gum line and move it up and down with a slight circular motion. Brush the fronts of your teeth, the backs, and the flat chewing surfaces. Then massage your gums with the bristles in a gentle circular motion to stimulate blood flow and eject plaque from beneath the gum line.
Brush your bacteria-laden tongue, too. You can buy a tongue-scraper at your drugstore for this exact purpose, but a toothbrush will do just fine in about 5 seconds.
Toss your old toothbrush. A toothbrush lasts for only three or four months. The bristles get worn out and stop doing a good job. Toss it and get a new one. You may want to replace it more often: Those old bristles are chock-full of food particles and water that provide the perfect breeding ground for germs, say researchers at the University of Oklahoma, who found that people with chronic sore throats or gum infections recovered sooner when they began replacing their toothbrush every two weeks.
Throw plaque a curve. Curved toothbrushes improve plaque removal by 63 percent compared with straight-bristle brushes, according to a study in the Journal of the American Dental Association. Choose your toothbrush on its ability to reach every one of your teeth. A dentist uses angled instruments to get into your mouth, so why shouldn’t you? Get whatever type of brush you feel most comfortable using, whatever you’ll use most often.
Floss out plaque. Flossing can take as little as a minute, but remember that you’re not trying to remove food particles. You’re trying to remove plaque from the surface of teeth. Just putting the floss between the teeth does not necessarily do the proper job. To do it right, break off about 18 inches of floss, waxed or unwaxed, wind it around your middle fingers, slide it between your teeth and curl it around them, scraping the sides of your teeth from the gum line.
Save money and time on mouthwashes. You’ve probably seen ads galore about mouthwashes that are supposed to fight plaque. But any such rinse is generally unnecessary—and time-consuming—if you’re doing a good job brushing and flossing. What’s more, the effectiveness of most of these so-called antiplaque rinses remains unproven. One exception is Peridex, a prescription-only plaque-loosening rinse approved by the American Dental Association. Most doctors often prescribe it for people whose poor eyesight or handgrip problems prevent them from cleaning their teeth well. Rinse at least twice a day for about 30 seconds, then brush and floss.
Check in for a checkup. The hour or so that you spend with your dentist twice a year in a checkup can save you from many a time-consuming dental problem in the future. Your dentist will examine your teeth and gums for cavities and disease. He may also take X-rays, than every three years. He should also inquire about health problems you might have and medications you take, all of which can have an effect on your dental health.
Seal your mouth. An hour at your dentist’s office can seal off your molars from bacteria. Plastic sealants, which go on in a liquid form and dry into an invisible but strong coating, have been shown to effectively prevent plaque formation and cut tooth decay in half. A single application of sealant can last up to several years.
Take the table test. Train yourself to get everything squeaky-clean by occasionally testing yourself with disclosing tablets available at any drugstore. After you brush and floss, dissolve one of these tables in your mouth. Any leftover plaque will almost immediately turn a garish red. Brush and floss again to remove as much of the color as you can. Any remaining color will disappear in a day or so.
Have a piece of fruit. Plaque bacteria are like kids in ca candy store: You can’t give them everything they want. Instead, selectively satisfy their voracious appetite for sweets. Worst are sticky candy bars, raisins and other dried fruits, and lingering sweets like honey. Fibrous fresh fruits like apples, as well as raw vegetables, are actually good for your teeth, massaging your gums and stimulating the production of mouth-rinsing saliva.
Go ahead and eat dessert. Limit sweets to meals instead of between them. Plaque’s acids start attacking your teeth only minutes after you ingest sugar and go on for at least 20 minutes. The few times you consume sugar, the few opportunities acids get to consume your teeth.
Say “cheese.” Eating a piece of cheddar cheese after a meal seems to take the bite out of destructive acid. In a study conducted at the University of Toronto’s Department of Preventive Dentistry, subjects who swished their teeth with a sugar solution showed significantly less tooth enamel damage if they chewed on one-half ounce of “extra-old” cheddar for 1 minute immediately afterward.
Pop some gum. Chewing on gum made with xylitol can help bust bacteria. Subjects in one study showed reduced plaque buildup after chewing ten pieces of xylitol gum daily for two weeks. A natural sweetener found in fruits and vegetables, xylitol interferes with the growth of microorganisms that form plaque. You’ll get best results, another study suggests, by popping sugarless gum into your mouth within 5 minutes after you’ve finished eating, and chewing if for at least 15 minutes. Check the label when you buy your next pack of sugarless gum to see that it contains xylitol.