We have all heard that if we eat sweets, that we will get cavities or holes in
our teeth. This is not exactly true, because cavities are a disease process and
not directly caused by the sugar we eat.

What is the cause of a cavity? A cavity is a bacterial infection. It’s a
contagious disease which can spread from person to person through their saliva.
It can be spread by sharing foods, drinks or kissing.

The way this happens is that there are several specific species of bacteria
that get on the surface of your teeth and start to multiply.

In a very short time a plaque forms that is a sticky substance. It adheres to
your teeth which is teaming with bacteria.

These bacteria can only survive on sugar or foods that turn into sugar, like
carbohydrates.

While these bacteria use carbohydrates to live on, they secrete an acid as
a by product of their metabolism. It dissolves the enamel or the outer covering
of the tooth.

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When you hear the term “oral health,” chances are you think about brushing, flossing, and visiting the dentist.

All play a critical role but Dr. Deborah Stymiest, a Fredericton, N.B. dentist and president of the Canadian Dental Association, says oral health means more than just healthy teeth.

“You have to have a healthy mouth to be a healthy person,” Stymiest says.

Stymiest calls the mouth “the window to the rest of the body.” She says problems there are often a warning that something is wrong elsewhere.

Bacteria thrive in warmth and moisture, and the mouth is an extremely hospitable environment. The reason dentists and hygienists insist that patients brush and floss after every meal is that those rituals prevent bacteria from building up on the teeth. Unchecked, a buildup of plaque (soft bacteria) or calculus or tartar can eat away at your gums, which will then wear down the bone that holds teeth in place.

Lose enough bone and you’re also likely to lose teeth.

Dental patients have long been warned about these issues. More recently, however, studies have shown that the bacteria in plaque can also hitch a ride in the bloodstream and travel through the body, inflicting damage along the way or at their destination.

Among the health problems linked to poor oral health are chronic obstructive pulmonary disease, low birth-weight babies, diabetes and bacterial pneumonia. The latter can occur when bacteria from the mouth moves to the lungs. This is a particular problem for the elderly in nursing homes, whose immune systems are often weak and who may not get the help they need to brush and floss properly.

Diabetics are especially susceptible to periodontal disease, partly because high glucose levels can cause the gums to become infected and inflamed. Exacerbating the problem is that diabetics (and people with auto-immune diseases) don’t heal quickly.

Stymiest notes that failure to brush and floss tonight is not likely to result in a chronic or fatal disease tomorrow. “There are likely multiple factors at play,” she says, “but there’s absolutely no question that the consequences of poor oral hygiene go much further than your mouth.”

The connection between oral and physical health isn’t entirely new, but the strong emphasis on it is. Traditionally, dentists practised independently from the rest of the medical world, but in recent years there has been an increase in communication and information sharing between the professions.

The evolution can be traced in part to an overall shift in medical care from treatment to prevention, says Brenda Leggett, an Ottawa dental hygienist and information coordinator for the Canadian Dental Hygienists.

“It isn’t just in dentistry that prevention has become more important,” she says. “We’ve talked a lot about exercise and diet over the last 10 to 20 years, and research has established how strongly oral and general health are linked. It wasn’t just about having nice white teeth and healthy gums and good breath. [Dentists and doctors] realized that any kind of infection in the mouth is likely to affect the rest of the body. It’s critical that we keep that area of the body healthy.”

People with the germiest mouths are the most likely to have heart
attacks, researchers reported at the beginning of National Oral Health
Month in April.

A study that compared heart attack victims to healthy volunteers found
the heart patients had higher numbers of bacteria in their mouths, the
researchers said.

Their findings add to a growing body of evidence linking oral hygiene
with overall health. Several studies have shown associations between
gum disease and heart disease.

“Research shows there is a connection between our oral health and our
overall health,” says Dr. Deborah Stymiest, president of the Canadian
Dental Association.

“There is a relationship between oral disease and health problems such
as diabetes and certain kinds of pneumonia,” according to Stymiest,
who has a dentistry practice in Fredericton, New Brunswick. “There may
even be a link to heart disease and stroke, as well as premature and
low birth-weight babies.

“So it makes sense to care for our mouths the way we care for our
bodies,” she says.

The national voice for dentistry believes too many Canadians give
short shrift to their oral health. “We often ignore bleeding or tender
gums, while an irritation or pain elsewhere in the body would mean a
trip to the doctor,” Stymiest says.

Failure to pay heed to our mouths can be dangerous, the CDA boss
warns. “Oral pain, missing teeth or oral infections can influence the
way a person speaks, eats and socializes. These oral health problems
can reduce a person’s quality of life by affecting their physical,
mental and social well-being.”

Worse yet, “The reality is that oral health problems could be a sign
of something serious such as oral cancer,” Stymiest cautions.

The CDA notes that approximately 3,200 Canadians are diagnosed with
oral cancer every year and 1,050 people will die of it annually.

The dentists’ group points out that the disease has a low survival
rate because it is often diagnosed very late. “With early detection,
the survival rate of oral cancer can be greatly improved,” Stymiest
says. “This means going to your dentist for regular checkups. Your
dentist has the training and experience to detect oral cancer early.”

As well, the overhead light dentists use to examine patients is
several times brighter than a doctor’s office so dentists may be more
able to detect signs of oral cancer.

The CDA suggests that, as part of a healthy lifestyle and to help
reduce the risk of oral disease, you should follow these five steps:

1. See your dentist regularly: Regular checkups and professional
cleanings are the best way to prevent problems or to stop small
problems from getting worse.

Your dentist will look for signs of oral disease. Oral diseases often
go unnoticed and may lead to or be a sign of serious health problems
in other parts of the body.

2. Keep your mouth clean: Using a soft-bristle toothbrush, brush your
teeth and tongue at least twice a day with fluoride toothpaste to
remove plaque and bacteria that cause cavities and periodontal or gum
disease.

Floss every day. If you don’t floss, you’re missing more than a third
of your tooth surface.

Your dentist may also recommend that you use a fluoride or
antimicrobial mouthrinse to help prevent cavities or gum disease.

When choosing oral care products, look for the Canadian Dental
Association (CDA) Seal of Recognition. Oral care products that have
earned the Seal of Recognition have been reviewed by the CDA and will
effectively contribute to your oral health.

3. Eat, drink, but be wary:

Healthy food is good for your general health and your oral health. The
nutrients that come from healthy foods help you fight cavities and gum
disease.

Limit how much and how often you consume foods and beverages that
contain sugar. Sugar is one of the main causes of dental problems.

Limit your consumption of foods and beverages that are high in acid.
The acid may play a part in causing dental erosion.

4. Check your mouth regularly:

Look for warning signs of gum disease, one of the main reasons why
adults lose their teeth. The warning signs include red, shiny, puffy,
sore or sensitive gums: bleeding when you brush or floss; bad breath
that won’t go away; loose or sensitive teeth; change in the colour of
your gums; and receding gums.

Watch for signs of oral cancer. The three most common sites for oral
cancer are the sides and bottom of your tongue and the floor of your
mouth. The warning signs include bleeding that you can’t explain; open
sores that don’t heal within seven to 10 days; white or red patches;
numbness or tingling; small lumps and thickening on the sides or
bottom of your tongue, the floor or roof of your mouth, the inside of
your cheeks or on your gums; dry mouth, a sore mouth or burning mouth
syndrome.

Report any of these warning signs to your dentist.

5. Avoid all tobacco products: Stained and missing teeth,

infected gums and bad breath are just some of the ways smoking can
affect your oral health. Besides ruining your smile, smoking can cause
oral cancer, heart disease and a variety of other cancers, all of
which can kill you.

All forms of tobacco are dangerous to your oral health and your
overall health, not just cigarettes. Smokeless tobacco such as chewing
tobacco, snuff and snus can cause mouth, tongue and lip cancer and can
be more addictive than cigarettes.

If you use tobacco products, ask your dentist and your family doctor
for advice on how to quit.

The CDA says that, if you take care of your teeth and gums and visit
your dentist regularly, “your smile should last you a lifetime. Your
oral health is good for life.”

Sun Media news services

The days of whining drills and shrieking patients that can make a trip
to the dentist an experience to dread may be numbered. Scientists
claim they may have found a way to regrow rotting teeth.

Researchers studying tooth development have singled out a gene that
controls the growth of enamel, the hard outer layer of teeth, which
cannot grow back naturally once it is damaged by tooth decay.

The discovery sheds fresh light on the way teeth form and could pave
the way for dental treatments that heal decayed teeth by regenerating
a layer of enamel, making traditional drilling and filling obsolete.

Scientists at Oregon State University found the gene after noticing
that mice born without it grew teeth with no enamel covering.

Tooth enamel is the hardest tissue in the body and begins to form when
humans are still embryos. Specialised cells called ameloblasts in the
tooth bud make enamel by releasing calcium phosphate minerals into a
protein “scaffold” that shapes them into tightly packed rods of
enamel.

When our teeth are fully formed, they erupt from the gums and the
enamel-forming cells die, making it impossible for our teeth to grow
new enamel later.

For most animals this is not a problem, but in humans the large amount
of sugar and starch in our diet is turned into acid by bacteria living
on our teeth, which slowly dissolve the enamel to make a hole in the
tooth. If untreated, cavities can cause life-threatening infections in
the body.

In the latest research, published in Proceedings Of The National
Academy Of Sciences, a team led by Chrissa Kioussi and Mark Leid bred
mice that lacked a gene known as Ctip2. They found that the gene was
crucial for the enamel-producing cells to form and work properly.

By understanding the genetics of tooth development, Ms Kioussi said it
might be possible to repair damaged enamel and even produce new teeth
in the laboratory.

Some groups have already succeeded in growing the soft tissues inside
teeth, but they do not have the hard enamel covering needed to
withstand chewing and biting.

“Enamel is one of the hardest coatings found in nature. It evolved to
give carnivores the tough and long-lasting teeth they needed to
survive,” she said. “A lot of work would still be needed to bring this
to human applications, but it should work. It could be really cool; a
whole new approach to dental health.”

If scientists can perfect a way of regrowing teeth and replacing the
drill in the dentist’s surgery, it could have important knock-on
effects for patients.

In 2005 a survey by researchers at the University of Toronto found
that 5 per cent of patients were extremely anxious about visiting the
dentist, and half were so afraid that they either cancelled their
appointment or failed to show up. By missing appointments, patients
risk turning a fairly minor dental problem into a serious risk to
their health.

Last year a poll by the Irish Dental Association found that parents
passed on their fear of dentists to their children by telling them
they were being brave or had nothing to fear from a visit.

Despite rates of dental cavities falling for the past 30 years, almost
half of children and adolescents and more than 55 per cent of adults
in Britain are still affected by holes in their teeth.

Paul Sharpe, an expert on tooth development at the Dental Institute at
King’s College London, said: “If you could find some way of growing
ameloblasts that make enamel, you could find a way to repair teeth.

“Any gene like this is worth understanding. The more we learn about
it, the more we can use the information to make biological models of
tooth repair.”

Professor Sharpe’s own work focuses on using stem cells to regenerate
teeth, but he said the introduction of the Human Tissue Act had made
it difficult to obtain teeth from patients on which to do the work.

“We’ve probably lost a year because we’ve not been able to get hold of
the right cells, and often these are from wisdom teeth that people are
choosing to have removed,” the professor said.

Guardian News & Media

Researchers are delving into extracted human teeth, filling them with a calcium and phosphate-containing solution in attempt to remineralize the tooth, said Sally Marshall, researcher and professor in the Division of Biomaterials and Bioengineering at UCSF.

“What we want to do is restore properties as they were in the original tooth,” Marshall said.

And they’re 60 percent of the way there, she said.

“(Sixty percent is) not good enough, but it’s a step in the right direction,” she said.

Marshall said she is not working to literally re-grow teeth, but to retain and preserve the tooth structure that’s already present.

“Anything you can do that helps eliminate the removal of that structure is good,” Marshall said.

Marshall said the goal of remineralization (restoring lost minerals) is to use the mechanical properties of the tissue to restore the enamel. Small dental caries, or cavities, are relatively easy to remineralize because collagen fibrils and apatite crystals on the outside of the tooth are primarily mineral, Marshall said.

As Marshall’s research grant ends its second year, she said she doesn’t know how much longer it will take to fully remineralize a cavity-stricken tooth. But she said she eventually sees tooth remineralization as common practice in dentists’ offices.

“The goal is to make something that is useful to anyone,” Marshall said.

Daniel Bures, adjunct assistant clinical professor in Marquette’s School of Dentistry who also practices privately in Milwaukee, said there is probably a chance patients will see remineralization sooner rather than later.

“Frankly, the field is moving so quickly that it could be a few years,” Bures said.

Bures added that the destruction of human teeth is quite common, and said once decay gets past the enamel, it can progress quickly.

“Tooth decay is the most prevalent disease on the face of the earth,” Bures said.

Natural bacteria that aid in digestion process sugary foods into an acidic environment in the mouth. This can eat away at the tooth structure and cause decay, Bures said. The decay generally begins with the demineralization of the enamel, the protective outer-most layer of the tooth.

“Most people think that bones are the strongest (structure in the body), but it actually is the enamel,” Bures said.

The decay can then progresses into the dentin layer below. If the carie is not detected and eliminated with a filling, it can progress deeper into the pulp of the tooth, Bures said.

Dental pulp is the soft connective tissue made up of blood vessels and nerve endings that brings nutrients to the tooth, said Gary Stafford, professor in the School of Dentistry. Cavities that reach this deep into the tooth require root canal therapy, he said.

Stafford said because it is possible to remineralize the enamel but not the dentin or pulp, early intervention is key.

“(The) whole purpose is to catch a lesion early, thereby alleviating necessity for a filling,” he said.

Stafford said dentistry has always been about prevention, and remineralization will help to slow down the process of decay.

“In the last years there’s been a paradigm shift to focus more on remineralization versus the restoring process,” he said.

As added benefits, the calcium and phosphate used in remineralization are known to help strengthen tooth enamel, buffer plaque acid, reduce sensitivity and reverse white spot lesions such as those left after braces, he said.

“We can be less invasive if we can help strengthen, be as conservative as possible and preserve enamel that is there,” Stafford said. “That’s the best thing that can happen.”