Dental Decay (Caries)
Myths and Facts
Decay occurs as a result combined changes to our oral environment.
Myth- Dentists diagnose decay by detecting cavities (holes).
Fact- Caries is…
- a transmissible bacterial infection and….
- is a multi-factorial disease
- it reflects one or more changes to the oral environment.
Diagnosis involves recognition of those changes rather than simply noting cavities.
Myth- Placement of a restoration in a cavity is the most effective method of treating caries.
Fact- The treatment of caries requires behavioural modification (by you) and/or administering chemical agents to rectify changes to the oral environment.
Surgical intervention (‘drilling and filling’) is only required when there is a physical defect or cavitation on the tooth surface. It may be part of a comprehensive treatment plan but surgical intervention only removes the de-mineralised tissue and repairs defects. It is not a cure for caries.
Myth- There is one good treatment regime that can be applied to everyone to counter decay.
Fact- Every individual has a unique oral environment, therefore treatment must be specific for the conditions that exist in the individual’s mouth.
It is important to acknowledge that dental decay is a disease. It is a slow progressing disease caused by many interacting factors, ultimately resulting in cavities on the tooth surface. Like heart disease has many contributing factors, the end result, a heart attack, can be avoided with early intervention. Dental decay is no different. It results from a shift in the balance of natural bacteria in our mouths. For example, 200 years ago, there was little dental decay, because sugar intake was low, and our bodies natural protection kept microflora in balance. However, repeated frequent sugar intake leads to acidic plaque and an increased chance of developing cavities. The growth of bacterial species that like to live in acid is favoured because they prefer to eat sugar, and produce more acid themselves to maintain their preferred environment. The composition of plaque is thus altered by the environment in the mouth. Our oral environments may be altered by other changes, not just increased sugar in our diets. For example, a decrease in saliva flow may also change plaque into producing acid. To successfully treat decay long term, we aim to target factors that may be changing the oral environment in an unfavourable way.