Dental Caries Health Article

Sealants

Because fluoride is most beneficial on the smooth surfaces of teeth, sealants were developed to protect the irregular surfaces of teeth. A sealant is a thin plastic coating that is painted over the grooves of chewing surfaces to prevent food and plaque from being trapped there. Sealant treatment is painless because none of the tooth is removed, although the tooth surface is etched with acid so that the plastic will adhere to the rough surface. Sealants are usually clear or tooth-colored, making them less noticeable than silver fillings. They cost less than fillings and can last up to 10 years, although they should be checked for wear at every dental visit. Children should get sealants on their first permanent "6-year" molars, which come in between the ages of 5 and 7, and on the second permanent "12-year" molars, which come in between the ages of 11 and 14. Sealants should be applied to the teeth shortly after they erupt, before decay can set in. Although sealants have been used in the United States for about 25 years, one survey by the National Institute of Dental Research reported that fewer than 8% of American children have them.

Diet

Choosing foods wisely and eating less often can lower the risk of tooth decay. Foods high in sugar and starch, especially when eaten between meals, increase the risk of cavities. The bacteria in the mouth use sugar and starch to produce the acid that destroys the enamel. The damage increases with more frequent and longer periods of eating. For better dental health, people should eat a variety of foods, limit the number of snacks, avoid sticky and overly sweetened foods, and brush often after eating.

Drinking water is also beneficial by rinsing food particles from the mouth. Children can be taught to "swish and swallow" if they are unable to brush after lunch at school. Similarly, saliva stimulated during eating makes it more difficult for food and bacteria to stick to tooth surfaces. Saliva also appears to have a buffering effect on the acid produced by the plaque bacteria and to act as a remineralizing agent. Older people should be made aware that some prescription medications may decrease salivary flow. Less saliva tends to increase the activity of plaque bacteria and encourage further tooth decay. Chewing sugarless gum increases salivation and thus helps to lower the risk of tooth decay.

KEY TERMS

Amalgam—A mixture (alloy) of silver and several other metals, used by dentists to make fillings for cavities.

Caries—The medical term for tooth decay.

Cavity—A hole or weak spot in the tooth surface caused by decay.

Dentin—The middle layer of a tooth, which makes up most of the tooth's mass.

Enamel—The hard, outermost surface of a tooth.

Fluoride—A chemical compound containing fluorine that is used to treat water or applied directly to teeth to prevent decay.

Mucin—A protein in saliva that combines with sugars in the mouth to form plaque.

Plaque—A thin, sticky, colorless film that forms on teeth. Plaque is composed of mucin, sugars from food, and bacteria that live in the plaque.

Pulp—The soft, innermost layer of a tooth containing blood vessels and nerves.

Sealant—A thin plastic substance that is painted over teeth as an anti-cavity measure to seal out food particles and acids produced by bacteria.

Transillumination—A technique of checking for tooth decay by shining a light behind the patient's teeth. Decayed areas show up as spots or shadows.

BOOKS

"Dental Caries and Its Complications—Tooth Decay." In The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, Robert Berkow, and Mark Burs. 17th ed. Rahway, NJ: Merck Research Laboratories, 1999.

ORGANIZATIONS

American Dental Association. 211 East Chicago Avenue, Chicago, IL 60611. (312)440-2500. <http://www.ada.org>.

American Dental Hygienists' Association. 444 North Michigan Avenue, Chicago, IL 60611. (800)847-6718.

Anna Nelson, Certified Dental Assistant, and president of the American Dental Assistants' Association. 203 N. LaSalle St., Suite 1320, Chicago, IL 60601-1225. (312) 541-1550 or for Anna Nelson direct (415) 239-3479. <www.dentalassistant.org>.

National Institute of Dental Research. 31 Center Drive, MSC 2190, Building 31, Room 5B49, Bethesda, MD 20892-2190.

OTHER

Healthtouch Online. <http://www.healthtouch.com>.

Lisette Hilton