I have Caries. What is that?
Caries is a disease caused by germs that infect the hard tissues of the teeth. The entire inner portion of a tooth may be affected before any outward signs, such as a "cavity", sensitivity, or pain become evident. This is why early detection is important.
A person's susceptibility to decay is determined by numerous factors, four of which are major: 1) the strain of germs in their mouths, 2) the type and amount of saliva, 3) acid exposure 4) and oral hygiene. These factors occur in varying degrees and in endless combinations to make each person different.
All caries is caused by a specific germ named Streptococcus Mutans (SM). Just as all colds are caused by a specific virus, the Rhinovirus. But just as some colds are nastier than others, and no two colds the same, some strains of SM are nastier than others. We call this virulence, with some germs being more virulent, or nastier than others. Research has shown that a person keeps the same 5-6 strains of SM through out their lives.
Saliva is important in controlling oral disease. It contains two important things, antibodies that kill germs, and buffers that neutralize acids. If a person suffers from a dry mouth, called Xerostomia, they may not have enough of these two factors. Many factors affect saliva such as age, habits such as smoking, and many medications.
Acid exposure, both amount and duration, is a big factor in caries. There are three sources of acid in one's mouth, acid produced by plaque, acid from the stomach (which may be elevated in those with Reflux Disease or chronic heartburn) and dietary acid from our food and drink. Few beverages, for instance, other than water are not acidic.
Last, but not least is oral hygiene. Proper oral hygiene helps prevent the accumulation of acid producing germs on teeth that occurs in the form of plaque.
If these factors combine to make a patient susceptible to decay certain things can be done to control the disease. Home Fluoride supplements are prescribed. Special fluoride releasing restorative materials, called Glass Ionomers, are used where possible. Ways to reduce acid exposure are discussed. Gum that contains Xyletol, which helps control SM, is often recommended. Oral hygiene is reviewed and reinforced. And frequent check-ups are scheduled to detect any problem areas at their earliest stages.
It is important to understand that dental restorations, such as fillings or crowns, do not "cure" caries. They only repair the damage caused by the caries up to that point. If the original cause is not corrected the problem will reoccur. This is why it is important for the dentist and the patient to identify and address those factors that increase a person's susceptibility to caries.
Most people who have suffered a life of battling decay think that they must not be brushing well enough and are often embarrassed at the dental office. But caries is not that simple. Many of the factors that make them susceptible to decay are beyond their control, but with proper care the disease can be controlled.
