There are a number of factors that can contribute to the formation of dental cavities. One fundamental that will apply to most everyone concerns the reduction of dental plaque. If you want fewer cavities, reduce your plaque levels.
Dental plaque can be defined as a complex microbial community, with greater than 10 to the 10th power bacteria per milligram. (That’s really a lot of bacteria.) Just to keep things simple, though, the problem is that these bacteria produce acids on your teeth – and the acids dissolve the enamel, leading to tooth decay.
After only a few years of practice, it became obvious to me that most people have difficulty identifying plaque. Even now, I’ll begin a dental exam or cleaning on a person and start removing large areas of plaque. If I casually ask the patient about their cleaning regimen, often I’m told “I brushed just before I came in here!”
Since that much plaque can’t form in an hour, the obvious conclusion is that the patient missed it or simply doesn’t see it. Just to be clear, plaque is the soft, sticky film that occurs on the surface of teeth – not the hard substance your dentist or hygienist has to pick away, which is tartar. Though it is basically mineralized plaque, virtually no amount of tooth brushing and flossing will remove tartar after the fact (dentists call it ‘calculus’). Once formed, calculus needs to be removed at your office visit.
It is useful to know that if you control your plaque well, calculus won’t be much of a problem. So let’s focus on that for a moment. What do you do if you feel you are brushing, but the dentist tells you he still sees plaque? Stain it!
Lately, I have been seeing more commercials advertising products for children that stain their teeth blue after they have rinsed with it. The child then brushes until all of the blue stain has been removed. What the liquid is staining is plaque. I think this is a great way to simplify the process of identifying the problem. Whether you are six or sixty, the principle is the same.
If you want to be certain you have gotten the plaque off, rinse with the stain after each meal and then brush (and floss) until you have removed the discolored areas. Barring other systemic or external contributory factors (such as medications leading to a dry mouth), you and your dentist should see a big improvement in the cleanliness of your mouth, and fewer cavities over time!
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