Just as prevention is increasingly emphasised in health care, such as teaching healthy habits rather than treating the consequences of bad habits, prevention has also become commonplace in dentistry.
Whereas in treatment used to be mainly reactive when people developed dental complaints, nowadays more preventive work is done through regular dental check-ups and follow-up X-rays. Normally, we advise people to come for a check-up (periodic oral examination) twice a year. We can then detect the most common problems, such as cavities, poor or worn restorations and gum disease, at an early stage.
Because of this early diagnosis, we can usually limit the scope and number of treatments, rather than acting only when the patient experiences pain or discomfort. This can also lead to early diagnosis and treatment of dental wear, the cause of some headaches (clenching/grinding), cracks around grey fillings and dormant inflammation at root tips.
The dental hygienist and prevention assistant complement the dentist by teaching the patient good oral hygiene and periodically cleaning the teeth as needed. The younger a patient is when they are taught this properly, the fewer problems we see during their lives.
Obviously to stay pain-free, but also to be able to eat well, look well cared for
and not suffer from bad breath. However, it is often forgotten that a diseased mouth can have implications for overall health because of relationships with cardiovascular disease, diabetes and rheumatoid arthritis, for example.
It is often said:
‘A healthy mind in a healthy body’
‘A healthy mouth in a healthy body’ also applies.
Here, prevention plays the biggest role.
Sugary foods are the main cause of tooth decay, i.e. getting cavities or caries. Everyone has bacteria in the mouth and that is actually a good thing. They provide defences in your mouth; the good bacteria make it less likely for harmful bacteria to gain the upper hand. However, when certain bacteria sit undisturbed in the mouth for a long time, a rough white layer forms on the teeth; this is called plaque. If plaque is given a chance to develop for several days, sugars and other carbohydrates are converted into acids, which can cause cavities.
Brushing twice daily and using a tooth pick or floss once daily prevents cavities. Of course, cavities usually occur in the hard-to-brush areas, where plaque can grow undisturbed for extended periods of time. Such as between the molars and in deeper grooves.
Plaque left unbrushed for long periods of time can also cause gum disease(gingivitis). This is usually red and bleeds easily when touched lightly. If plaque remains even longer, it slowly calcifies into tartar under the influence of saliva. This (hardened) population of bacteria can no longer be removed by brushing or using a toothpick. Tartar can cause inflamed gums and eventually bone loss around teeth. This gum disease is called periodontitis. You can read more about this under the heading ‘dental hygienist’.
Acid in food and drink, or what comes back from the stomach (reflux), can also cause wear on tooth enamel. This is called tooth erosion. The tooth enamel then dissolves (decalcifies or demineralises). It is important to allow the teeth to recover for a while after a meal or drink: saliva neutralises the acid and helps to protect the teeth. Therefore, do not brush your teeth for the first hour after eating acidic products. But also do not brush your teeth an hour before eating acidic products. This is because there is always a protein-rich layer (pellicle) on your teeth that protects against erosion. Immediately after brushing, that layer is gone for a while and your teeth are so clean that they are temporarily more susceptible to erosion. In the hours after brushing, this protein-rich layer re-forms. Erosion is a growing problem. Soft drinks and fruit juices are erosive. Frequency is important, as is whether you drink quickly or not (better to drink it all at once). Patients in whom erosion has played a role for several years may have developed so much tooth wear that the teeth need to be restored.