Oral hygiene
Personal hygiene care consists of proper brushing and flossing daily.[6] The purpose of oral hygiene is to minimize any etiologic agents of disease in the mouth. The primary focus of brushing and flossing is to remove and prevent the formation of plaque. Plaque consists mostly of bacteria.[71] As the amount of bacterial plaque increases, the tooth is more vulnerable to dental caries when carbohydrates in the food are left on teeth after every meal or snack. A toothbrush can be used to remove plaque on accessible surfaces, but not between teeth or inside pits and fissures on chewing surfaces. When used correctly, dental floss removes plaque from areas which could otherwise develop proximal caries. Other adjunct hygiene aids include interdental brushes, water picks, and mouthwashes.However oral hygiene is probably more effective at preventing gum disease than tooth decay. Food is forced inside pits and fissures under chewing pressure, leading to carbohydrate fueled acid demineralisation where the brush, fluoride toothpaste and saliva have no access to remove trapped food, neutralise acid or remineralise demineralised tooth like on other more accessible tooth surfaces food to be trapped. (Occlusal caries accounts for between 80 and 90 percent of caries in children (Weintraub, 2001). Chewing fibre like celery after eating, forces saliva inside trapped food to dilute any carbohydrate like sugar, neutralise acid and remineralise demineralised tooth. (The teeth at highest risk for carious lesions are the first and second permanent molars.)
Professional hygiene care consists of regular dental examinations and cleanings. Sometimes, complete plaque removal is difficult, and a dentist or dental hygienist may be needed. Along with oral hygiene, radiographs may be taken at dental visits to detect possible dental caries Dietary modification
For dental health, frequency of sugar intake is more important than the amount of sugar consumed.[33] In the presence of sugar and other carbohydrates, bacteria in the mouth produce acids which can demineralize enamel, dentin, and cementum. The more frequently teeth are exposed to this environment, the more likely dental caries are to occur. Therefore, minimizing snacking is recommended, since snacking creates a continual supply of nutrition for acid-creating bacteria in the mouth. Also, chewy and sticky foods (such as dried fruit or candy) tend to adhere to teeth longer, and consequently are best eaten as part of a meal. Brushing the teeth after meals is recommended. For children, the American Dental Association and the European Academy of Paediatric Dentistry recommend limiting the frequency of consumption of drinks with sugar, and not giving baby bottles to infants during sleep.[72][73] Mothers are also recommended to avoid sharing utensils and cups with their infants to prevent transferring bacteria from the mother's mouth.[74]
It has been found that milk and certain kinds of cheese like Cheddar can help counter tooth decay if eaten soon after the consumption of foods potentially harmful to teeth.[33] Also, chewing gum containing xylitol (a sugar alcohol) is widely used to protect teeth in some countries, being especially popular in the Finnish candy industry.[75] Xylitol's effect on reducing plaque is probably due to bacteria's inability to utilize it like other sugars.[76] Chewing and stimulation of flavour receptors on the tongue are also known to increase the production and release of saliva, which contains natural buffers to prevent the lowering of pH in the mouth to the point where enamel may become demineralised.[77]
Other preventive measures
The use of dental sealants is a means of prevention. A sealant is a thin plastic-like coating applied to the chewing surfaces of the molars. This coating prevents food being trapped inside pits and fissures in grooves under chewing pressure so resident plaque bacteria are deprived of carbohydrate that they change to acid demineralisation and thus prevents the formation of pit and fissure caries, the most common form of dental caries. Sealants are usually applied on the teeth of children, shortly after the molars erupt. Older people may also benefit from the use of tooth sealants, but their dental history and likelihood of caries formation are usually taken into consideration.Calcium, as found in food such as milk and green vegetables, are often recommended to protect against dental caries. It has been demonstrated that calcium and fluoride supplements decrease the incidence of dental caries. Fluoride helps prevent decay of a tooth by binding to the hydroxyapatite crystals in enamel.[78] The incorporated calcium makes enamel more resistant to demineralization and, thus, resistant to decay.[79] Topical fluoride is also recommended to protect the surface of the teeth. This may include a fluoride toothpaste or mouthwash. Many dentists include application of topical fluoride solutions as part of routine visits.
Other products with little or less supportive scientific evidence for effectiveness for the purpose of remineralization include DCPD, ACP, calcium compounds, fluoride, and Enamelon.
Remineralization can also be performed professionally at the dentist.
Furthermore, recent research shows that low intensity laser radiation of argon ion lasers may prevent the susceptibility for enamel caries and white spot lesions.[80]
As bacteria are a major factor contributing to poor oral health, there is currently research to find a vaccine for dental caries. As of 2004, such a vaccine has been successfully tested on animals,[81] and is in clinical trials for humans as of May 2006.[82]
Chewing gum after eating promotes the flow of saliva which naturally reduces the acidic pH environment and promotes remineralization.
Xylitol lollies and gum also inhibit the growth of Streptococcus mutans.
