The number one problem in dentistry, by far, is dental decay or “holes in teeth”. Dentists all over the world are filling holes every single day and 99.9% of all people would have at least one hole in their life time. So, it’s no surprise that the million dollar question is “ what causes dental decay?”
I’ve heard a lot of my patients said, “my teeth have always been weak.” True weakness in teeth from conditions where teeth didn’t form properly when we were young do exist, but they are very rare. Certainly, it doesn’t happen on mass to the extent that a large number of people (basically everyone) with tooth decay suggested.
Everyday I have been asked about the cause of dental decay, but this is not a new information. We knew about this for decades as I’ll point out later on. It’s by and large habitual and it’s completely preventable. The most common things patients heard from dentists are “you need to clean your teeth” and “don’t have too much sweets”. That is because the causes are BACTERIA and SUGAR.
Bacteria and sugar cause tooth decay
Another common thing I heard from my patients is, “But I brush my teeth everyday. Why am I getting holes?” From my own observation, a lot of my patients didn’t clean their teeth as well as they thought they did (You can find out how well you brush here) but I agree that some of the mouths I’ve seen with decay were completely spotless. This led me to believe that the “sugar” part of this equation is the more significant one.
I mentioned that we knew about sugar as a cause of tooth decay for many years. There were a few studies done in the 50’s which clearly demonstrated this fact.
The “Hopewood House Study”, done here in NSW, Australia during 1948 – 1963 showed that children (at the children’s home) living on diet with low amount of refined sugar or carbohydrates had significantly less decay than the average Australians.
Another study conducted in Sweden during 1945 – 1953, “The Vipeholm Study”, carried out the experiment on the mentally-deficient patients at the VIpeholm Mental Hospital. Different types of sugary diet were fed to the patients to induce dental decay. This experiment, proposed today, would not pass the medical ethic approval, but it gave us a clear insight to the causal link between sugar and tooth decay.
With this information, I can simply put my patients into 4 typical categories as shown below.
- The patients that clean their teeth well and have little sugar are the ones with excellent teeth and minimal decay in their life time.
- The patients with poor oral hygiene but have little sugar in their diet tend to have more problem with their gum but not their teeth.
- The patients who clean well but consume a lot of sweets have no gum disease but do have tooth decay.
- And lastly, there are patients who don’t clean their teeth and have a lot of sweets. This is a recipe for an absolute disaster.
Dental problems in relation to amount of sugar consumed and bacteria
Dentists knew about this fact for a long time and most people knew deep down they need to clean their teeth well and are not supposed to eat a lot of sugar. What I believe we failed to do as dentists is to explain why this is the case. In the next blog, we’ll dive deeper into the process and how we can fight the problem.
To your healthy smile.
Supa Dental, Melton.