Winter Is Coming eep K Smiling by Dr. John F. Miller DDS
We are staring down winter folks. I pushed it out of my mind, convinced myself that it wouldn’t return. And yet, despite all my “jedi mind tricks” and appeals to the universe, October has arrived. It could snow before we flip the calendar. SNOW PEOPLE!! Let’s pull on our Sorels and tune up our snow-blowers and get through this together. We need each other’s smiles over the next six months. Not only is the weather going to get trying, we are facing down the dental and waistline guantlet. With a shotgun start on October 31st, piles of halloween cavity nuggets unfortunately transition very easily into “pumpkin pie” & “eggnog” season. Some of you might refer to this as autumn or fall. Either way, the sun is no longer bathing us in happiness so we seek out alternative savory and sweet sources. Seriously, I hope whoever invented eggnog received a Nobel Prize for their contributions to humanity. Alright, I’m obviously making an over generalization with assuming you are all as weak as me when it comes to the holidays and the treats they offer. You are all amazing examples of self control and
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are all very svelte I might add. But in anticipation of moments of weakness let’s approach this holiday season a little smarter following a frank discussion on dental caries (aka cavities; aka tooth decay). 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 you can make a more informed approach to the holidays with respect to your 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 minutes. So everytime 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, think about your morning coffee that you sip over the course of 2 hours. This equates to 2.5 hours of tooth 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 tooth 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 probable that they will have a sustained oral pH of 5.0 or less for days on end. Irreversible damage