Some of these may be surprising to you, others not so.
Fortunately it is by now common knowledge that sugar is one of the key factors contributing to tooth decay.
However, what some people might not know is that sugar not only is derived from sugar cane (refined sugar) but also occurs naturally in many of our foods. Naturally occurring sugars – such as those in honey and fruit – are just as detrimental to teeth as the refined sugars found in sweets, etc. Frequency of intake is crucial, so it’s important to reduce your consumption of sugar and to observe good oral hygiene (brushing and flossing).
Increasingly, dentists and oral health professionals are seeing patients with evidence of acid wear, or erosion, on their teeth. Again frequency of exposure plays an important role. Patients who are frequently exposed to acid in the oral environment – whether it be through diet (i.e. lemon juice, wine, soft drink) or through biological factors (usually acid reflux) – are slowly wearing down and eroding the surface of their teeth. Sparkling water (soda water) is acidic in nature and could also be contributing to acid wear. Acid wear cannot be reversed because it is not possible to rebuild lost enamel. Adding insult to injury, an acidic oral environment is one in which oral bacteria thrive, and this can lead to other dental problems.
Tooth grinding is common and doesn’t discriminate according to age. Children are just as likely to grind their teeth as adults, but in adults stress is often an influencing factor. From a dental point of view, it is very difficult to prevent tooth grinding itself. However, where the majority of the damage occurs at night, your dentist can provide you with a grinding guard to wear to bed.
In severe cases of tooth grinding, patients can crack their teeth, fracture existing restorations and wear down the surfaces of the teeth that come into contact with teeth on the opposing arch. Damage from tooth grinding can therefore become very expensive for patients. It makes sense to try to identify the source of any tension that leads to grinding, and to address that tension.
Smoking doesn’t directly cause tooth decay. However, it greatly affects the oral environment by introducing toxins, affecting the mouth’s ability to fight infection and increasing the risk of oral cancer. It is the soft tissues that bear the brunt of the affects of smoking.
Smokers should expect to experience high rates of very severe gum disease, which, over time, can result in tooth loss – not to mention the aesthetic damage that years of smoking can bring about.
5. Dry mouth
Dry mouth can be a very serious issue for some people, mainly because it increases the risk of tooth decay and gum disease. It can also be very uncomfortable for sufferers.
There are many different causes of dry mouth – some preventable, others less so. Anatomical issues such as blocked nasal passages (when the person affected has to predominantly breathe through their mouth) or “incompetent lip seals” (whereby people cannot close their lips unless forced to do so) can be the cause. Other influencing factors might be a person’s hydration levels, or the side-effects of some medications.
Having a dry mouth can make oral bacteria more virulent and the saliva more acidic. This can lead to a higher risk of tooth decay and gum disease. If you feel you may be experiencing dry mouth, it is worth discussing with your dentist or hygienist some of the ways in which you can try to manage the problem.
6. Poor oral hygiene
People who lack the ability or motivation to achieve a good level of oral hygiene will be at higher risk of gum disease or tooth decay. And remember: your perception of “good oral hygiene” may not match that of your hygienist. Your dental hygienist will take the trouble to run through some different approaches only if they feel they can suggest some improvements to your oral hygiene, with you being the beneficiary of this advice.
7. Neglecting the gums
It is sometimes the case that a dental patient is at extremely low risk of tooth decay but extremely high risk of gum disease. A person’s susceptibility can have a lot to do with their inflammatory response and immune systems. Regardless, there is no point in having healthy teeth if they are wobbling about in the bone because the gum and supporting structures of the teeth are diseased. Your gum health should be checked at every checkup appointment.
8. Heavy brushing
Have you ever felt confused in the toothbrush section of the supermarket when you are faced with dozens of different toothbrushes to choose from?
The only strength of toothbrush bristle that you should purchase is “soft” or even “extra soft”. (The reason the big oral care brands offer “medium” and “hard” toothbrushes is that people buy them!) Heavy brushing over a long period of time (particularly with a medium or hard brush) can contribute to considerable recession of the gums and can wear the surface of the roots of the teeth themselves. This damage cannot be reversed!
So often patients mention that their teeth don’t feel clean when they have used a soft or extra-soft brush. This is probably because they are not using the correct technique or brushing for long enough. Have a discussion with your oral health professional about which toothbrush to purchase. Also, consider buying an electric toothbrush, and ask your hygienist how to use it.
9. Waiting for pain
It’s not a good idea to wait for pain before intervening. Tooth pain usually occurs when the tooth is severely affected by infection or decay, and by the time the pain is felt, the infection or decay is deep within the tooth. This can mean treatment needs to be more severe or the prognosis is less positive.
Generally we like to see you regularly for checkups, so we can catch problems early, before they give you pain. This way we can intervene with a treatment that is less invasive and more likely to be successful. Also, patients who come to the dentist only when they have pain are less likely to have a good experience, often associating dental treatment with suffering. Regular attenders, who often don’t need any treatment at all, tend to associate visiting the dentist with having a good experience.
10. Ignoring pain
If you are experiencing discomfort or pain from any of your teeth and this is not normal for you, it is best to seek the opinion of your dentist. Even if no underlying cause is found, it is best to be certain. I have seen patients present with a raging abscess on one of their teeth when the ostensible purpose of their visit was for a regular six-monthly hygiene appointment. They typically mention that the tooth has been painful for some time but they weren’t sure about the cause.
The longer your pain is left untreated, the poorer the prognosis might be. We encourage you to have a good understanding of how your mouth and teeth feel when healthy, as distinct from unhealthy, so you can identify when something is not right and seek the appropriate care.