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your teeth
Holiday Survival Guide by Dr. John F. Miller DDS
“Trick or Treat!” In my experience it’s pretty much always treat. In fact, I’m not entirely clear on the origin of the greeting and how one would satisfy the “trick” option. I know a couple of card tricks; I can only imagine my reception if I doled these out instead of high fructose corn syrup in some form or another. A good plan B either way if the candy runs out, as it always does. The fall season is upon us and to avoid sounding negative I’ll just say, “I like it.” I might add, however, that I try harder to like fall than any other season. Shouldn’t it really be called, “summer’s hangover?” It has it’s redeeming qualities however: the changing of the colors, pumpkin everything, football, and a string of holidays that bring friends and family together around the foods, treats, and indulgences we love. I have covered a variety of dental topics over the past year for this great publication. I hope that it has been an education for you. Being uninformed is no way to live. So let’s approach this holiday season together following a frank discussion on dental caries (aka cavities; aka tooth decay). 76
What more can I teach you about tooth decay? You’re going to say, “sugar rots your teeth. I already know that.” I’m going to get down to the simple science behind the creation of a tooth cavity so that my audience can make a more informed approach to the holidays with respect to their oral health. I’ll respond to your earlier comment and tell you, “sugar does not cause tooth decay any more than gasoline alone gets you to point B.” In other words, sugar needs a motor to harness its high-energy chemical bonds. Our mouths are filled with billions of little motors in the form of bacteria. Some of these bacteria are cariogenic and responsible for tooth decay. Mainly Streptococcus mutans and Lactobacilli. They ferment the available sugar and create lactic acid as a by-product; this is the direct cause of tooth decay: ACID! Right now, as you read, your teeth are under attack. Bacteria are colonizing and creating a biofilm (plaque) on your tooth surface. Cariogenic bacteria thrive in an environment devoid of oxygen. The thicker the layer of plaque, the less oxygen available at the tooth
surface, the more potent the bacteria, the more acid being produced, the greater the rate of tooth decay. Now that we have established that Acid is the direct cause of tooth decay, let’s discuss the oral pH cycle. The pH scale is a logarithmic measure of acidity. To keep things brief, the lower the pH value, the more acidic something is. Our mouths have a physiologic resting pH of approximately 7.0, or neutral. After we eat food containing fermentable carbohydrates, the pH levels within plaque drops below 5.0 rapidly as bacteria convert the available sugar into acid. Demineralization (decay) of dental enamel occurs at a pH of 5.5 or less while remineralization (repair) occurs at pH levels above 5.5 Saliva acts to neutralize the mouth and restore healthy pH levels, but this typically takes about 30 min. So every time you eat, drink, snack, etc. your teeth experience demineralization from the first bite until 30 minutes following the last bite. This should get the wheels in your head turning, you’ve been informed, and you think about your morning latte that you sip over the course of 2 hours. This equates to 2.5
hours of demineralization. Even worse, sustained periods of high acidity will eliminate healthy bacteria resulting in a higher concentration of cariogenic bacteria, lower pH levels, and more rampant decay. Halloween is upon us. Our children gain access to a bag of candy that they will devour over the space of a few days. It is not only possible, but also probable that they will have a sustained oral pH of 5.0 or less for days on end. Irreversible damage is inevitable. Thanksgiving is next, offering up bottomless supplies of pies, sweet potatoes, cranberry sauces, and cider that segue seamlessly into December’s caramels, fudge, cookies, and eggnog (Damn you eggnog you're so irresistible). It doesn’t end until midnight on New Year’s. My purpose is not to be a party pooper, but rather to inform and let the reader react accordingly. The day after Halloween I’m going to exercise my right as a father to confiscate any and all Reese’s Peanut Butter Cups and enjoy them...my way. During Thanksgiving I fully intend on consuming my weight in Pumpkin Pie, and let’s not get start-