Causes and Prevention of Dental Disease

Dentists primarily treat the effects of periodontal disease and dental caries (cavities) at a cost of billions of dollars per year in the U.S. Given that these two diseases are nearly 100% preventable by simple, inexpensive methods, this is ludicrous. Prevention makes more sense.
Periodontal disease and dental caries are both caused by dental plaque, the sticky film full of bacteria that forms continuously on teeth. Because plaque is sticky it holds the bacteria and their toxins in contact with both teeth and gum tissue and, given time, leads to one or both diseases.

The good news is that this process can be controlled by disrupting the plaque so that it no longer adheres to the teeth. This is easily done by using dental floss and toothbrushing to clean the teeth. The bad news is that plaque begins to re-form on the teeth almost immediately.

On average, plaque re-forms in about 24 hours for most people. At that point plaque can again produce enough toxins to begin the disease process. Cleaning your teeth with dental floss and toothbrush at least once a day will prevent these two dental diseases for most of us.

Those people who have dry mouth often have plaque that re-forms in much less than 24 hours. For example, if plaque re-forms in 6 hours due to dry mouth you can only control it by flossing and brushing every 6 hours.
Some people are fortunate in that their plaque re-forms at longer intervals. If that is the case for you, flossing and brushing every 24 hours is still your best bet since it’s easier to develop a once-a-day habit.

This is not a contest. To control plaque both are needed. Brushing cleans only those areas where the bristles can reach. Toothbrush bristles cannot reach between the teeth. Only floss can clean between the teeth. Thus, even if you brush daily and effectively you will never remove plaque from between the teeth and will eventually develop either periodontal disease, caries or both. Not surprisingly, most of the dental treatment people need is performed to correct the effects of disease that started between the teeth. That’s right, where only floss can clean.

Brushing after meals has been recommended for many years. The American Dental Association recommends brushing your teeth twice a day and flossing once a day. Some recommend flossing in the evening so your teeth will be clean while you sleep. In my opinion this does not make sense, given what is known about the physiology of dental plaque.
What we do know is that if plaque is present on the teeth when you eat, toxins are released within a matter of seconds. If there is no plaque present or the plaque is immature, little or no disease producing toxins are released. For flossing and brushing after eating to do any good you would literally have to floss and brush between bites. The same is true for snacks between meals.
Flossing and brushing are most beneficial if done in the morning before eating or drinking anything. Your teeth will then be free from disease-causing plaque no matter what you eat all day. The time when your plaque is most mature and most likely to cause disease occurs during the night when you are not eating.

Brushing, flossing, and mouthwash are frequently discussed as methods for removing food particles. Nobody wants food particles on their teeth so removing them is a fine idea. But ask yourself this: do food particles cause dental disease if there is no plaque present? The answer is ‘no’. Plaque is the culprit in causing disease, not food particles.

Flossing and brushing will not remove your wisdom teeth, straighten crowded teeth, treat decay in natural pits in biting surfaces, correct damage from accidents or replace missing teeth. What they will do is give you a chance to avoid up to 85% of the disease that can be treated by dentists.

Establishing any habit is difficult. What you choose to do about your personal oral hygiene depends on your knowledge, your motivation and your commitment to attain the best dental health. Learning the technique of flossing and applying what you know consistently until it becomes a permanent habit holds great benefits for you. Your dental health will be better, your general health will be better and, especially if started at an early age, your costs for dental care can be greatly reduced.

These thoughts are Dr. Clark’s opinions, based on scientific education and over 50 years’ experience as a dentist.

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