Departments
Health Matters
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Week of 26 February 1999 |
Vol. II, No. 25 |
Health Matters
Biting off decay at the roots: keeping teeth and gums healthy
Both of my parents have had severe problems with their teeth and gums. What can I do to keep my teeth and gums healthy, and why is it important to do so?
Tooth decay and gum diseases are among the most common dental problems affecting Americans. According to the Crest Dental ResourceNet, nearly 97 percent of the U.S. population has tooth decay. Gingivitis, a form of gum disease, is the most common dental problem faced by people older than 18.
Healthy teeth and gums are important in terms of looking good, speaking well, eating comfortably, and preventing other health problems, says Raul Garcia, D.M.D., professor and chairman of the Department of Health Policy and Health Services Research at Boston University's Goldman School of Dental Medicine.
"For many people, a good, healthy mouth is more of a quality-of-life issue than a health issue," says Garcia. "Most people want to have good teeth, a pleasant smile, and nice breath. Healthy teeth and gums contribute to all of these."
Along with increasing quality of life, healthy teeth and gums may prevent systemic diseases. Recent research conducted at the Goldman School of Dental Medicine has shown that mouth infections increase a person's risk for cardiovascular diseases. Garcia says there is mounting evidence that chronic mouth infections, left untreated, can lead to other serious health problems as well.
More commonly known as cavities, tooth decay is most prevalent during childhood and adolescence. By the time the average child has reached age 17, he has 9 teeth (out of a full complement of 28) decayed, missing, or filled. The damage occurs in the mouth when bacteria and food debris accumulate and remain undisturbed. Bacteria react with carbohydrates in the food debris to produce an acid that dissolves tooth enamel, causing decay. Diet, genetics, and poor dental hygiene are among the most common causes.
Decay usually starts in one spot, widening and deepening until a noticeable and sometimes painful cavity is seen. Treatment involves removing the decay completely to stop the process from advancing, then filling the cavity to restore the original shape and contour of the natural tooth to maintain its function. Gold or silver fillings are common in back teeth because of their strength, while porcelain or plastic is used in front teeth for a more natural look.
According to Garcia, tooth decay can largely be prevented by keeping the mouth clean to control the bacteria in the mouth, strengthening the teeth by using fluorides and sealants, modifying diet to restrict the amount of sugar intake, and having periodic dental exams to detect and treat existing decay.
Periodontal disease is the primary cause of tooth extraction in people over age 35. Gingivitis, the most common form, is an inflammation of the gum along the teeth. Periodontitis occurs when gum tissue gradually separates from the tooth and a soft pocket forms between soft gum tissue and hard tooth surfaces. Because both are generally painless, many people don't become aware of either gingivitis or periodontitis until the condition has progressed and damage to the gums has been done. The treatment for both forms of gum disease includes the removal of tartar (solidified mineral deposits that irritate gums and underlying bone) by a dentist or dental hygienist, who will use special instruments to remove tartar (called scaling) and polishing devices to clean the surface. If tooth cleaning does not prevent or cure periodontal disease, surgical removal of gum tissue that has separated from the tooth, called a gingivectomy, may be required. According to Garcia, good oral hygiene is the most important preventive measure to ward off periodontal disease.
"A very thorough mouth cleaning -- including flossing between teeth and under the gum line -- at least once a day combined with regular professional cleaning should be sufficient to prevent most tooth and gums problems," says Garcia. In addition, the use of fluoridated toothpaste and fluoridated drinking water, which makes teeth more resistant to bacteria and acids, is helpful in keeping teeth and gums healthy.
"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on dental hygiene or other health issues, call 638-6767.