If given the right tools, we
all have the ability to become dentally fit. These tools don’t
simply involve cleaning aids, but—much more importantly—adequate
education. It really falls on each of our individual shoulders to take
charge. As a dentist, I can give you the knowledge to be healthy but
what you do with that knowledge is up to you.
Simply, dental
disease can be attributed to two factors that account for 99% of all
dental problems. If these two factors are controlled, most dental
disease will be controlled.
The first of
these, of course, is plaque. Even if your mouth could be sterilized,
in 24 hours you would still develop plaque. Plaque is basically an
invisible biofilm that, over time, mixes with food particles and turns
white. Plaque is not the same thing as calculus, which is a mineral
deposit that is more a function of our body’s general acid level.
Plaque is the
cause of the two of the three major dental diseases: gum disease and
decay. Plaque mixes with sugar to produce an acid that demineralizes
tooth structure—what we call decay. You don’t get decay from
sugar; you get decay from sugar plus plaque. Further, just as
important as the amount of sugar ingested is the frequency and length
of time that teeth are exposed to acid. Decay-causing acid forms while
sugar is being ingested and will continue for roughly 30 minutes after
that ingestion stops. For example, drinking a sugar soda for five
minutes will result in 35 minutes of acid production. Sipping a sugar
soda for 90 minutes results in two hours of acid production. Quite a
difference!
The two basic
principles of decay control are thus minimizing plaque levels as well
as the frequency of sugar ingestion. Your hygienist should be spending
as much time on helping you to understand this as he or she does
cleaning your teeth.
Plaque also is
the primary cause of periodontal or gum disease. If left unattended,
plaque first causes the gums to become inflamed; we call this
gingivitis. These gums appear red and swollen and bleed easily. With
plaque control this condition will heal itself. The condition
sometimes progresses to the next phase of disease in which the
teeth’s supporting structures (the gum and eventually even the bone)
begin to break down. This can progress to a point of irreversibility
and even tooth loss.
The treatment
for this problem is first and foremost plaque control. And the
treatment for plaque control is very specific patient awareness! This
can be provided by your dentist and hygienist, and should address
exactly where the pocket areas are that you need to address and how to
most effectively maintain them. In advanced situations, the services
of a gum specialist may be needed. However, remember this: no one is
more important in the treatment of gum disease than you, the patient.
The second
factor that causes dental disease is a problem with your occlusion or
bite. Occlusion means how your teeth come together when you close down
and actually chew and speak. Unfortunately, most of us were born
with occlusions that lend themselves to tooth grinding and clenching,
tooth wear, and tooth cracking and fracturing. Occlusions even play a
major role in most gum diseases. The list of problems caused by bad
occlusions includes the vast majority of temporomandibular joint (TMJ)
diseases, ear pain or ringing, and headaches of many varieties. A
bite problem can also contribute to migraines, problems with
dizziness, and neck pain and tightness. (For more on this, see the
three-part series “Bioesthetic Dentistry” at the Alaska Wellness
archives, http://www.alaskawellness.com/Holistic%20Dentistry%20Archive.htm.)
Unfortunately,
the problem of occlusion can only be treated by a properly trained
dentist. It is not something that a patient can control for him or
herself like gum disease. Treatment of bite related problems requires
the use of a very precisely designed splint that allows the correct
seating of the jaw joint. It is only from this correct joint position
that an accurate diagnosis of the entire chewing system can be
achieved. The good news is that excellent dentistry performed in
a mouth with great plaque control and controlled occlusal forces will
last for years and years.
Dr.
Bill Gerace, D. D. S.,
of Anchorage, serves on Alaska’s Board of Dental Examiners, is an
Adjunct Professor at UAA’s medical program, and has lectured
extensively as a faculty member of Oragnathic Bioesthetics, Int.
