Even in the 21st century, cavity control or tooth decay still remains one of the most prevalent diseases or infections of mankind. Cavity control or tooth decay still affects, depending on the study, 85-95% of the population, even after the introduction of fluoridated water, which according to the World Health Organization, next to the polio vaccine was the most effective health measure taken in the 20th century.
So why do we still have dental caries(tooth decay)? Research tells us this is a multifaceted problem. The primary causative bacteria, streptococcus mutans, is unfortunately, very common and lives with all of us. As infants, we are easily infected and very early on by our family members. So if we are all infected why are some patients more decay prone than others? The answer lies we believe in the quality and quantity of one’s saliva. Those patients with a more acidic, thicker and lower flow rate saliva will be far more caries prone than those patients with a more basic, thinner and heavier flow rate saliva. So if we can’t alter our saliva what can we do? Now we can talk about factors that we can control, diet and oral hygiene come to the forefront. If we can reduce the complex sugars that feed the bacteria we can reduce their numbers. What we don’t realize is that complex sugars don’t only mean candy. Any food heavy with carbohydrates, such as pasta, potatoes, rice, bread etc. can supply these complex sugars. Since it seems almost impossible to remove sugar from our diet what can we do? Well we can choose a substitute that actually works by reducing the growth of these bacteria, Xylitol. Xylitol is totally derived from plant materials, birch trees, berries, mushrooms etc. Alcohol sugars like xylitol actually work against the bacteria multiplying and growing and at the same time help to re-mineralize areas that are decalcified (weakened) in our teeth. This makes Xylitol an excellent sugar substitute to protect our dentition. Nowadays we can find Xylitol in some gums, mints and it can be purchased in bulk as a powdered sugar substitute.
Other plant extract sugar substitutes, like Agave and Stevia do not offer the same benefits. Xylitol, like most plant extracts, however, can be difficult for some patients to digest, so like Grandma said, “Moderation is key in most things we eat and do”.
So what else can we do besides improve our diet to help control decay? Now we come to something we truly can control, our own oral hygiene. If we can reduce the number of bacteria in contact with our teeth on a daily basis by good interproximal (between the teeth) cleaning, with flossing and brushing , we will reduce our decay potential. Add to this topical fluoride rinses or gels and occasionally disinfectant mouth washes (like chlorohexidene, for adults only) and we go a long way to knocking out the high levels of decay causing bacteria in our mouths. This all goes hand in hand with good regular cleanings and checkups in the dental office between 3 and 6 months being the most ideal time line for the majority of patients.