Tooth decaySoon after tooth brushing, a thin, sticky layer of bacteria forms on the surface of all the teeth. This layer of bacteria is called plaque.
When we eat anything sugary, the plaque bacteria turn the sugar into the energy they need, producing acid at the same time. The acid removes minerals from the hard tooth surface (enamel) in a process called demineralisation. This softens the enamel, and may lead to tooth decay.
Saliva is a watery fluid that helps to wash away and neutralise the acid. It also contains minerals to replace those lost from the enamel during acid attack (remineralisation).
Demineralisation and remineralisation are repeated every time we eat or drink something sugary. It is an ongoing battle between the acid and our saliva. If sugary food or drinks are consumed too often, the saliva doesn't get long enough to fully remineralise the teeth. The enamel gradually weakens, and eventually a decayed hole (cavity) forms. This can be painful.
Dental erosion is gradual wear of the surfaces of the teeth. It is caused by acid attacking the surfaces of the teeth, but this time the acids are not made by bacteria. Instead, the acids usually come from drinks such as fruit juices, fizzy drinks and squashes - even the sugar-free varieties.
These drinks are so popular that nearly half of the children in the UK have some dental erosion by the age of six.
Dental erosion is irreversible and can result in sensitivity and pain.
Erosion can be prevented by drinking acidic drinks less often. Babies and toddlers should not drink juice or fizzy drinks from bottles, as this can lead to severe erosion. Older children and adults may be able to reduce the amount of contact acidic drinks have with their teeth by drinking through a straw, placed towards the back of the mouth.
Maintaining good oral hygiene is an important part of preventing tooth decay and gum disease. This means cleaning your teeth twice a day with fluoride toothpaste, visiting the dentist and hygienist regularly and controlling how often you consume sugar.
Brushing is the most effective way of removing plaque. Here are some tips for getting the most benefit out of tooth brushing:
Children's teeth should be brushed by their parents from the time their teeth come through until they are able to do it properly by themselves (usually at about seven years of age).
If your child is less than two years old, only use a smear of toothpaste. Then, use an amount about the size of a small pea until they are seven years old. You must make sure that they spit the toothpaste out after brushing. However, fluoride needs to be in contact with the teeth in order to have an effect, so you should not ask your child to rinse their mouth out with water after tooth brushing.
Some people prefer an electric toothbrush. There is some evidence that certain types of electric toothbrush are more efficient at removing plaque than brushing by hand.
Dental floss or inter-dental brushes remove plaque and particles of food from between the teeth and under the gumline. These are areas that a toothbrush cannot reach. Correct technique is important, so ask for advice from your dentist or hygienist.
Fluoride mouthwashes can help to remineralise the enamel. Some antiseptic mouthwashes reduce the number of plaque bacteria. Those containing chlorhexidine (eg Corsodyl) are very effective, but can stain the teeth and affect the sense of taste in the long-term. Always follow your dentist's advice and read the instructions on the box or bottle.
These are small pills that, if crunched for 30 seconds, turn plaque a bright colour - usually pink. This can help you to see any areas that you have missed.
Chewing sugar-free gum after a meal stimulates the production of saliva, which helps to neutralise plaque acid. Some chewing gums contain a sugar-free sweetener called xylitol, which suppresses certain types of plaque bacteria. Research is currently looking at whether this prevents decay.
There is a clear link between sugary food and drinks and tooth decay. Some types of sugar are worse than others. The biggest offenders are those added to food during manufacturing (refined sugars).
It is how often these sugars are eaten - rather than the amount - that is important. Avoiding refined sugars between meals gives your teeth a chance to be remineralised by saliva.
Fruit, vegetables, cheese and milk all contain natural sugars that are much less likely to cause decay. This makes them good alternatives to sweets, and suitable for snacks between meals.
Smoking stains the teeth and increases the risk of gum disease and tooth loss.4 Alcoholic drinks, and the mixers used with them, often contain lots of sugar, increasing the risk of tooth decay.
Drinking alcohol and smoking or chewing tobacco are also associated with an increased risk of developing mouth cancer.
In the UK, about 2,800 people are diagnosed with mouth (oral) cancer each year. Most of these people are over the age of 40, and it affects more men than women. In recent years there has been a rise in the number of younger people affected.
Mouth cancer is one of a group of cancers called head and neck cancers. Mouth cancer can occur in many different areas, including your lips, tongue, gums, floor of the mouth (under the tongue), inside the cheeks and on the palate (roof of the mouth). The floor of the mouth is the most commonly affected area.
Visit your doctor or dentist as soon as you can if you notice any of these symptoms. However, many of these symptoms can be caused by other conditions. They do not necessarily mean that you have mouth cancer.
It's not fully understood why some people get cancer and others do not. But there are certain factors that make mouth cancer more likely. The main risk factors are:
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