Tooth killer caries
As the godmother of a dentist's child, you are soon warned about gifts that cause tooth decay. At the latest when the first tooth breaks through. And so the one-kilo jar of Nutella was the first and the last - even if it made the little one very happy. Because sugar damages teeth. «Bacteria form an acid from certain carbohydrates that attacks the tooth enamel,» says Florian Wegehaupt, Head of Cariology at the Zurich Centre for Dental Medicine. When the four factors of teeth, sugar, time and bacteria (especially streptococci and lactobacilli, which are part of the normal oral flora) come together, caries, also known as tooth decay, develops. According to Hubertus van Waes, head of the school dental service in the city of Zurich, various age groups are at risk of tooth decay: First and foremost are kindergarteners and first-graders, because this is the age at which the first permanent molars erupt. «Their shape and position in the dentition makes it difficult to clean them properly,» he says. However, toddlers under the age of four are also at risk because dental prophylaxis programmes only start at kindergarten. Other risk groups include adolescents, who sometimes neglect personal hygiene, and young adults who are suddenly responsible for themselves after leaving school and have other priorities due to their apprenticeship, studies or social life.
The higher the level of education in families, the fewer children have tooth decay.
Switzerland is regarded as a pioneer of dental prophylaxis. The first prevention programmes were launched here in the 1960s. And they were a great success: in 1964, an average of eight decayed teeth were found in twelve-year-olds in Zurich, whereas in 2009 only one tooth per child was affected. According to Giorgio Menghini, an expert in oral epidemiology at the Centre for Dental Medicine at the University of Zurich, around 60 per cent of 12-year-olds are now caries-free. Generally speaking, the higher the level of education in families, the fewer children have tooth decay. This can be observed in all countries worldwide, confirm Wegehaupt and van Waes, to whom all Zurich school dental clinics report. While preventive measures in terms of oral hygiene have been effective in many countries, sweet drinks are a major problem nowadays, says Wegehaupt. Even small children often suffer from milk tooth decay because they drink sweetened teas, fruit juices or other soft drinks around the clock from a bottle. In the worst case, caries can already destroy milk teeth.
Treat holes
In simple caries cases, a fluoride varnish is applied. For cavities that cause pain, the dentist drills and places fillings. In the worst case, a decayed tooth has to be extracted. If a caries remains untreated, the problem germs increase, which further promotes tooth decay. This is why milk teeth are also treated. Children should go to the dentist as soon as their first tooth erupts, says Florian Wegehaupt. «Parents can simply bring their toddlers to their dentist appointment.» And this is also when brushing teeth after every meal begins. Wegehaupt refers to the guidelines of the Swiss Dental Association (SSO) and recommends special children's tooth
pasta that contains fluoride according to age. This protects the tooth enamel. As soon as the first permanent tooth is out, normal toothpaste can be used. From the age of 6 - especially for children with an increased risk of tooth decay - it is recommended to use a fluoride jelly once a week or to rinse the mouth daily with a fluoride solution. The daily use of fluoridated table salt is also advisable. According to Wegehaupt, research into caries treatment is being carried out on several levels: the longevity of fillings, a possible vaccination against caries, treatment approaches without drilling or in the area of enamel damage caused by acids that are not produced by bacteria and are found in food. The new approaches are promising, but are still in their infancy.
Brush and protect your teeth
«The be-all and end-all is and remains prevention - i.e. brushing teeth and fluoride,» says Dr van Waes. «The school dental clinics already offer prevention programmes for young children, where parents in particular are educated.» From kindergarten onwards, school dental care instructors visit all classes several times a year. In the Swiss school dental clinics, children are examined once a year and the correct tooth brushing technique is practised again. «In Zurich, school dentists and school doctors work together and have published joint recommendations for healthy eating,» adds van Waes. The main issue here is the ubiquitous sweet drinks, which are also harmful to teeth due to their acid content. Although sugar-free alternatives are better for teeth, they are still far from healthy. Swiss children currently have very little tooth decay. However, this will only remain the case if prophylaxis is not slackened, says van Waes and warns: «Caries is simply underestimated.» That's why it's still important to brush, use fluoride and eat a low-sugar diet. Otherwise tooth decay will strike again.
Picture: Fotolia
How does tooth decay develop?
If teeth are not brushed sufficiently, a coating of bacteria forms that feed on sugar, among other things. The bacteria ferment the low-molecular carbohydrates into acids. These penetrate the tooth enamel and decalcify it. The areas become brittle and chalky white. If the surface then cracks, this is known as a carious «hole». Caries begins at the contact points of two neighbouring teeth or in the pits of the chewing surfaces.
3 tips for caries-free teeth
- Brush teeth after every meal to prevent plaque build-up
Thorough but gentle cleaning of teeth and interdental spaces so that the gums do not suffer, fluoridated table salt age-appropriate fluoride application - Healthy diet with few sweet drinks
Do not constantly expose teeth to acids and sugar - Regular check-ups at the dentist
Caries usually begins in invisible areas, which is why an X-ray is often needed to make a diagnosis.
Further information and sources
www.schulzahnpflege.ch%C2%A0
www.sso.ch > Patients > Prophylaxis
www.generation-kariesfrei.ch - Brochure «Dental damage is avoidable»
