In my professional experience, it’s become clear that the disease of tooth decay is out of control and getting worse. Forty percent of children entering kindergarten have dental decay. It’s the single most common disease in children. In most cases, decay starts in the first molars, which come into the mouth at about age six. I use sealants on the first molars of kids that age and urge my colleagues to do the same. If we accept that practice as a first line of defense against decay, we can begin to defeat this epidemic and make a major contribution to the health of the human race.
Prevention has to start with the little ones, but believe it or not, adults have more tooth decay than children. Government studies show that nine out of every ten adults up to age sixty-four have had decay in their permanent teeth.
My colleague and friend Dr. Kim Kutsch has made it his life’s work to disrupt the upward trend of tooth decay. You’ll hear more from him later in this chapter. We both believe it’s our challenge as dentists to stop the growing presence of decay in its tracks. We do that in a supporting role. You, the patient, are on the front line. It’s your mouth, your child’s, or your partner’s.
Where do you start? The first step is to understand what decay is, how to prevent it, and of course, how to stop it once it begins. The second step is to determine your personal risk for decay, and we’ll get to that shortly. But first, the basics. What is tooth decay and what causes it?
Dental decay is a breakdown of the tooth as the result of bacteria that produce long periods of low pH (acid conditions) in the mouth.
The letters pH stand for “potential hydrogen.” It’s a common measure of acidity in the human body, expressed as a number on a scale of 1–14. The higher your pH, the more oxygen rich your oral environment is, which is good. The lower your pH, the more acidic and oxygen-deprived your mouth is, which is very bad for teeth.
Let’s simplify matters: For oral health, higher pH (over 6) is good; lower pH (under 6) is bad.
When your mouth is acidic day in and day out, your saliva is unable to counter the tendency. Saliva’s main job is to bathe the teeth and flush bacteria away. When saliva is overwhelmed, acid eats away the enamel of your tooth, creating a hole or cavity. We know that teeth start to decay at an acidity of 5.5. So the goal is to keep your oral pH above 6.