Tooth decay syndromes.
At different points in their life a person may find themselves vulnerable to experiencing a decay rate or pattern that's shared with other members of their population group.
This page provides descriptions of the following common tooth decay syndromes.
A) Children and adolescents.
- Baby-bottle tooth decay (baby-bottle caries).
- White-spot lesions (often a problem for children wearing braces).
B) Adults (especially seniors).
The decay pattern typically displayed with baby-bottle caries syndrome.
Baby-bottle tooth decay.
Baby-bottle caries refers to a pattern of tooth decay that occurs in infants and preschoolers who are allowed to nurse from a bottle containing a sugary beverage, either frequently, or else for prolonged periods of time (i.e. napping, sleeping), or both.
Other names for this syndrome are: Early Childhood Caries (ECC), nursing bottle caries, or just nursing caries.
a) Only specific teeth are affected.
In most cases, this condition displays a characteristic decay pattern.
- The upper front teeth are affected the most. These teeth may have very extensive decay.
- The child's back teeth are frequently affected too.
- The lower front teeth are usually spared from cavity formation. That's because they are protected somewhat from exposure to the sugary drink by the nursing position of the child's tongue.
b) Why does the decay form?
There is nothing special or unique about baby-bottle syndrome. It's simply a case of cause and effect.
- A sugar supply (the drink) is available to the child's oral bacteria frequently, or else over extended time periods.
- This excessive exposure simply tips the tug of war between demineralization and remineralization in favor of the former, and therefore a syndrome of cavity formation.
c) What can you do to prevent baby-bottle tooth decay?
Here are some of the things that you can do to reduce your child's risk for experiencing this problem:
- Anticipate (unless you specifically know otherwise) that anything you place in a child's bottle could be a sugar source. Breast milk, milk, formula, and fruit juices are all sources of dietary sugars.
- Never allow your child to nurse for long periods of time, or fall asleep with, a bottle that contains a sugary beverage.
- Never give your child a pacifier that has been dipped in honey or any other type of sugary liquid.
- Frequent breast feeding can lead to baby bottle caries syndrome too.
Root caries / Gum-line tooth decay.
Root caries is a decay syndrome that takes place with people who have a receded gum line.
a) Dental anatomy as it pertains to this problem.
A tooth's enamel covering ends right at its gum line. This enamel-covered portion of the tooth is termed its "crown."
The remaining portion of a tooth, the part that lies below the gum line, is its root.
b) A tooth's root is "softer" than its crown.
The root portion of a tooth is not covered by enamel. Instead, it's primarily composed of another mineralized tissue called dentin.
Gum recession exposes root surfaces. As a result, the roots are placed at greater risk for cavities.
c) How gum recession can increase your risk for decay.
When gum recession occurs, a tooth's root becomes "exposed" (meaning it's no longer fully covered over by a protective layer of gum tissue and bone).
This change can put a person through a new set of cavity-prone years (similar to when they were a teenager). Here's why:
- Root surfaces are relatively "soft," at least when compared to enamel, and therefore decay more readily.
- Teeth with receded gums can be a challenge to clean thoroughly. As a result, dental plaque (a major factor in the formation of tooth decay) may remain on their surface for extended periods of time.
d) Seniors are especially at risk for this syndrome.
Gum recession frequently accompanies advanced age, which means that seniors are especially likely to experience root caries.
As an added factors, seniors often experience a decrease in oral moisture, which also increases their risk for decay. (See next section.) They also frequently have diminished dexterity, which makes brushing and flossing effectively more difficult. (The use of an electric toothbrush may be beneficial.)
e) The treatment of root caries can be difficult.
Successfully treating this syndrome can be a challenge.
- Just as cleaning a tooth's nooks and crannies that have become exposed when its gum tissue recedes, your dentist will have difficulty in identifying, accessing and treating the cavities that have formed on these surfaces too.
- To make matters worse, the decay involves comparatively softer tooth dentin, as opposed to enamel. That means the rate at which cavities start and advance is accelerated.
All of these factors combined lead to an outcome where experiencing this syndrome frequently results in tooth loss.
f) What can you do to minimize your potential for gum recession?
- Brushing too forcefully, or brushing back and forth with a "sawing" motion, can cause gum tissue to recede. So can brushing with a toothbrush whose bristles are too stiff.
- Gum disease (periodontal disease), as well as those procedures required for its treatment, typically result in some amount of gum recession. Be diligent with your oral home care so you don't develop this condition.
- Bruxism (a habit of tooth clenching and grinding) can create changes with teeth that result in gum-line recession.
Xerostomia / Chronic dry mouth.
Xerostomia refers to a state of diminished salivary flow (reduced saliva), the result of which is a chronically dry mouth.
One problem associated with this condition is that a lack of saliva can tip the balance between demineralization and remineralization in favor of the former, and therefore create a syndrome of cavity formation.
a) What role does saliva play in cavity prevention?
Saliva plays a very important role in fighting tooth decay. Here is a list of some of the benefits that it provides:
- It contains buffering agents that help to neutralize the acids that cause tooth demineralization.
- It contains the minerals that must be present for the tooth remineralization process to occur.
- It contains antibacterial agents that can help to inhibit the growth of oral bacteria.
As these protections are lost, the decay rate of the person can be expected to rise, possibly significantly.
b) What causes xerostomia?
A person's salivary glands tend to work less effectively as they age. And as a result, the quantity (and composition) of their saliva may change.
Oral dryness can be a side effect of some types of medication. This includes: Antihistamines (allergy and cold medications), blood pressure agents, diuretics, urinary incontinance drugs, narcotics as wellas antidepressant, antipsychotic and anti-anxiety medications.
This cause can be especially troublesome for seniors since it's so common for them to be taking a regimen of multiple medications.
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