Prophylactic dentistry

Notes from a talk given by Professor Ernest Hausmann- from the State of New York University at Buffalo.

Do you really want the pain and expense of dental treatment for you and your children? At least 98% of gum and teeth disease can be avoided by adequate preventive care.

Clumps made up of two kinds of bacteria settle on the surface of the teeth. They can transform sugar (sucrose) into a stickly glue which enables them to stick to the teeth. The sugar is also broken down to produce acids strong enough to eventually corrode the enamel of the teeth and allow the bacteria access to the more vulnerable inner parts of the tooth.

The alkaline nature of the saliva acts as a buffer against the acid produced from the sugar. At night our saliva production is at its lowest, making the teeth more vulnerable. Some of the worst cases of caries in children were caused by prolonged sucking on sweet milk bottles.

Some parts of the teeth are more vulnerable than others. Cavities are most often found on the adjacent surfaces of teeth, in the valleys on the biting surfaces of molars and premolars (chewing teeth) and at or close to the gum line on the front and back of the teeth.

Teeth are most susceptible to dental caries within one year of eruption of the tooth. This is one reason why the problem is so common amongst children.

Teeth cleaning should be methodical, all five surfaces of each teeth should be cleaned and should take about three minutes, including flossing. It's a good idea to use a watch or egg timer as this period cannot be easily judged subjectively.

A soft brush is fine for brushing, (and sometimes recommended in the case of gum disease). Much vigorous brushing with a hard brush can cause problems, esp. with the canines (eye teeth) which are usually most overbrushed. Teeth should also be flossed, even in children from about three to four years of age. When flossing, one should take care to rub against the sides of both adjacent teeth. It does not matter if the floss is waxed or not waxed from a dental health point of view.

Many schools offer a sealing treatment for our children's teeth. This provides excellent protection, and is best done as soon as the teeth emerge. Fluoride also decreases susceptibility to caries. Water in Israel is partly fluoridated, (though much of this will be lost if you filter your water) Fluoride drops and dental treatments are all available with the advice of your dentist.

Gum disease is a serious problem which can cause the loss of healthy teeth if we don't take time and effort to prevent it. The two main types of gum disease are gingivitis and periodontitis, the latter being a much more serious and extensive infection. It is very important to clean the teeth thoroughly and gently at the gum line, even below the gum line if you can carefully and thoroughly brush that crevice.The bacteria in serious chronic periodontal disease can enter the blood stream and cause problems elsewhere.

Today it is thought that serious periodontal infection contributes to heart disease just as much as obesity and hypertension. (Genco, Zambon, Herzberg)

(This is NOT the same as Focal Disease and NICO . Back in the twenties some dentists believed that infection from tooth abscesses could caused widespread damage. There are still some dentists today that advise removing teeth with root canal treatment based on the suspicion that they harbour infection which could damage other organs (NICO) , but this is outside mainstream dentistry. Only in very rare extreme cases - in chronic alcoholics for example, do we know for sure that a tooth abscess can threaten other organs)

Professor Hausmann kindly took the time to look over my notes and approve them, and also discuss some of the points raised.

Copyright © 1999 Gila Atwood

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