No matter your age, if you’ve been to a dentist, you probably know the feeling – butterflies in your stomach as you wait for the verdict from your oral health professional. Fillings, or no fillings today?
New insight into the disease of dental caries, more commonly known as tooth decay, has come to light, and the news is good. It seems that the progression of tooth decay can not only be stopped, it can be reversed.
Previously, it was believed that caries was a rapidly progressive disease in need of “drilling and filling.” But recent insights show that with correct treatment, not only does tooth decay not always progress, more often than not, it can stop naturally, and even regress so long as the tooth does not yet have a cavity.
The regression is due to remineralisation of the demineralised, or decayed, tooth surface. The minerals involved in the natural repair of decayed tooth surfaces come from saliva.
Remineralisation occurs naturally, but the rate of remineralisation is significantly boosted on exposure to fluoride. As well as fluoride from water and toothpaste, dentists can paint high-concentration fluoride varnish directly onto the white patches to accelerate their remineralisation.
If, and when caries goes into remission (that is, when the disease process stops), teeth can be completely remineralised and the white patches fade, and later disappear. In other cases, when caries are in remission, remineralisation may not be complete, in which case the white scars remain, or only partially fade.
This is vital information when you consider that in Australia, tooth decay is the most common chronic disease. It is currently estimated that around 26% of people aged 15 and over have untreated tooth decay. 27% of people aged 5 to 10-years have untreated decay in their primary (baby) teeth, and 11% of children aged 6-14-years have untreated decay in their permanent teeth.
There are two main protective factors against tooth decay – saliva and fluoride.
Saliva is rich in calcium and phosphate, and is the source of tooth minerals needed for remineralisation. Saliva also has many other significant purposes, including:
- Managing acid levels in the mouth;
- Protecting against bacterial and fungal infections;
- Transporting nutrients, enzymes and minerals.