Dental caries or tooth decay, according to the United States Surgeon General report on Oral Health in America, is one of the most common chronic diseases among five to seventeen year olds[i]. In their study, it was more common than asthma, hay fever or chronic bronchitis. Although we do not have this type of data available in Canada, one can assume that dental caries is extremely prevalent in the population. A great deal of a general dental practitioner’s time is spent treating dental caries. The dental profession’s understanding of caries and treatment approach has been evolving as new diagnostic devices and preventive techniques are introduced to our practices. In 2001, the National Institute of Health’s (NIH) Consensus Conference on the Diagnosis and Management of Dental Caries throughout Life concluded:
“Dental caries is an infectious, communicable disease resulting in destruction of tooth structure by acid-forming bacteria found in dental plaque, an intraoral biofilm, in the presence of sugar. The infection results in the loss of tooth minerals that begins with the outer surface of the tooth and can progress through the dentin to the pulp, ultimately compromising the vitality of the tooth.”[ii]
This statement combines a number of new components from the traditional approach taught over the last twenty years in dental schools. Our patients assume that tooth decay is caused by eating sugary foods, not that dental caries is an infectious communicable disease caused by acid forming bacteria. One can place a number of restorations in a mouth, without treating the underlying disease. The bacteria remain in the plaque biofilm on the remainder of the teeth capable of creating new areas of decalcification and cavitation. Patients are beginning to expect that we can treat this disease or at least provide them with a reason as to why they or their children continue to develop carious lesions.
Over the next few blogs, I hope to provide you with some information on tooth decay, methods for detection and things patients and dentists can do to prevent decay or minimize the destruction of the tooth.
[i] Department of Health and Human Services, “Oral Health in America: A Report of the Surgeon General”, National Institute of Dental and Craniofacial Research, 2000, page 63
[ii] “NIH Consensus Development Conference on Diagnosis and Management of Dental Caries Throughout Life March 26 – 28 2001”, Journal of Dental Education, Volume 65, # 10, 2001, page 1162