How frequently should I visit a dentist?
The majority of the population who have average risk for tooth decay, gum disease and mouth cancer should visit a dentist once a year. However, if you have above average risk you may need to visit a dentist more frequently.
The following are examples of factors leading to a higher risk category:
- If you consume sugars frequently, you may develop tooth decay.
- If you have poor oral hygiene, you may develop gum disease.
- If you are a regular smoker of tobacco products and you regularly consume more than the recommended number of units of alcohol, you have increased risk of developing mouth cancer.
- If you have a health condition, like gastric re-flux, that affects your oral health. The acid in the mouth from gastric re-flux causes tooth erosion.
- If you have an oral health condition that may affect your general health. Gum disease can have a negative effect on diabetes and diabetes can make gum disease worse. These are some of the risk factors a dentist will consider when recommending the frequency of your dental examinations.
How long does it take dental decay to form a cavity in adults?
In general, it takes a long time, usually several years from the time a decay process starts on a tooth to when the tooth becomes cavitated with a visible hole in the tooth. It varies from individual to individual and the rate of progression depends on the balance between risk factors and protective factors present in the mouth over a period of time.
Is it possible to stop dental decay in tooth enamel?
What is a surprise is that, at the microscopic level, many healed lesions can be observed in the tooth enamel. What this tells us is that dental decay is a dynamic process in that there are bouts when tooth enamel is under attack by bacteria producing acid from dietary sugars while at the same time healing is also taking place as fluoride is taken up into the enamel at the same time making it more
resistant to further attack.
However, this level of equilibrium can be disturbed by a range of factors which can result in the decay process continuing to go deeper into the tooth. A persistent snacking habit with frequent intake of sugars throughout the day will overpower the mouth’s defence system. Saliva is constantly bathing the teeth in a healing solution and protects and re-mineralises teeth under attack. Saliva contains several ions which have a buffering effect on acid in the mouth, it also contains fluoride ions which bind to tooth enamel making it more resistant to acid.
For saliva to be protective, it needs time between acid attacks to restore the balance in the mouth. Decay progresses when this balance cannot be achieved most of the time. Anything which hinders the production of normal amounts of saliva in the mouth will upset the balance in favour of further progress of dental decay towards cavity formation. Dry mouth is a condition caused by a lack of normal saliva in the mouth. The most common cause of this condition is prescription drugs especially tranquilizers used to treat anxiety disorders. People with dry mouth can experience a sudden deterioration in their dental decay pattern with decay spreading rapidly to multiple tooth surfaces.
How soon does a tooth with dental decay need a filling?
There is a growing trend within dentistry internationally to practice dentistry more preventively, do less fillings than previously and use minimally invasive dentistry techniques when required including
repairing existing fillings rather than removing them completely.
Dentists are monitoring decay in teeth and using preventive methods such as dietary counselling, advising patients to use topical fluorides like fluoride mouth rinses and high dose fluoride toothpastes. Dentists may also apply fluoride varnish and use sealant restorations to arrest dental decay and minimise the loss of tooth structure as much as possible. Drilling teeth is delayed as much as possible unless there is strong evidence from radiographs that tooth decay is active and progressing. The best evidence is a combination of visual evidence along with a special type of radiograph called a ‘bite-wing radiograph’.
Bite-wing radiographs usually taken every two years or more frequently if there is high risk provide powerful
evidence of the progress of dental decay in a tooth as it goes from the outside enamel to the inner softer dentin. The pulp and nerve of the tooth retreat from the advancing bacterial infection by laying down layers of protective secondary dentin. Sometimes the response of the pulp and nerve of the tooth along with dietary changes and preventive interventions will arrest the decay process completely. Sometimes these efforts will not be successful and a restoration/filling using a minimally invasive technique will be required.
Modern filling materials, because they adhere to tooth surfaces, allow for smaller fillings which minimise the loss of natural tooth substance and help prolong the life of natural teeth for as long as possible.