Oral Health :

Preventing Tooth Decay

Christiane Loell, dpa

The attack comes after consumption of food and drinks containing certain forms of sugar. If given the chance, the multitude of bacteria in the mouth feed on the sugars and form tooth-damaging acids. Little white spots appear at first, which can darken and develop into painful cavities. The diagnosis: tooth decay.

The causes of tooth decay are quite complex. "So-called genetic predisposition plays a minor role," said Dietmar Oesterreich, vice president of the German Dental Association. "The main risk factors are poor dental hygiene and an improper diet."

The acid-forming bacteria, mixed with food particles and saliva, coat the teeth with a biofilm called dental plaque. The plaque should be regularly removed.

"Preventing tooth decay depends on how effective dental hygiene is," Oesterreich noted. "Twice a day thoroughly is better than four times superficially. You can't get rid of the biofilm with oral irrigation or mouthwashes alone. You've got to brush your teeth properly."

Not smoking also helps because smoking reduces saliva flow; saliva washes away food and plaque from the teeth.

Diet-related risks of tooth decay begin in infancy. Some small children constantly have a bottle at hand from which they sip a sugar-containing juice and many convenience and kids' foods hardly require chewing.

"Chewing is a kind of dental self-cleaning. Mushy foods foster formation of dental plaque," according to Christian Hirsch, president of the German Society of Paediatric Dentistry.

How frequently sweets are eaten is more consequential than the amount, according to Hirsch. "It's not necessary to forbid children from eating sweets. My children eat sweets, too," he said, adding that it was much unhealthier to nibble on a bag of jelly babies all day than to eat an entire chocolate bar all at once. "The teeth need periods when they're not subjected to acid attacks."

Besides a low-sugar diet, fluoride is seen as providing protection against tooth decay. "Fluoride strengthens the hard surface (enamel) of the teeth and negatively affects bacterial metabolism, thereby helping to prevent tooth decay and repair incipient damage," Oesterreich said.

From the appearance of the first primary tooth until age two, parents should brush their children's teeth once a day with a dab of fluoridated children's toothpaste. After age two, it is advisable to brush them twice a day with children's toothpaste.

Paediatricians and dentists differ on the form in which fluoride is best taken, noted Hirsch. "Paediatrians favour tablets, and dentists toothpaste," he said, adding that tablets had definitely been proven to work, but not as well as toothpaste, which is applied directly to the teeth.

"Pediatricians are afraid that too much fluoride can get into the body of a child who swallows the toothpaste," Hirsch explained.

According to the German government-backed Institute for Quality and Efficiency in Health Care (IQWiG), excessive fluoride can impede the growth of children's permanent teeth. This easily occurs, it said, particularly if they swallow toothpaste or tooth gel. Hirsch, however, said that excess fluoride could indeed cause problems with the mineralization of permanent teeth, but not by swallowing toothpaste.

Eighty per cent of the tooth decay in children occurs in the grooves and pits of the back teeth (molars and premolars), Hirsch said. These surfaces can be prophylactically sealed, which is usually done with a thin coating of plastic.

Copyright 2012 dpa Deutsche Presse-Agentur GmbH

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