Cosmetic Dentist - Vacaville
14 Cernon
Vacaville, CA 95688
707-448-6252

Breakthroughs

January 2005
Caries Risk Patients - New preventive Regimes
Our senior patients have long been subject to a serious problem, Root Decay. These cavities can wipe out a perfectly good and serviceable dentition in a short time. There are several factors that promote the problem. The first is a decrease in saliva. Xerostomia is defined as dry mouth resulting from reduced or absent saliva flow. Xerostomia is not a disease, but it may be a symptom of various medical conditions, a side effect of a radiation to the head and neck, or a side effect of a wide variety of medications. It may or may not be associated with decreased salivary gland function.1,2 Xerostomia is a common complaint found often among older adults, affecting approximately 20 percent of the elderly.1,3-5 However, xerotomia does not appear to be related to age itself as much as to the potential for elderly to be taking medications that cause xerostomia as a side effect.Another cause is a decrease in the ability of the patient to complete daily home care. The third is a poor diet, high in sugar or simple carbohydrates that can be broken down to sugar in the mouth. The culprits in tooth decay are acid producing bacteria. Streptococcus Mutans is the main species that causes decay. Reguardless of the cause of Xerostomia (dry mouth), the affect is an increase in the concentration of bacterial produced acid on the surface of the teeth. This acid causes fast and troubling decay on the surfaces of the teeth nearest the gums.

The most recent development to stop Root cavities and decay in general has been through the action of "probiotics". This is a replacement scheme that involves replacing the bad, acid producing bacteria with one that doesn't produce much acid. Bacteria metabolize sugar. The researchers tested several sugars to see if there was a decrease in the level of decay depending on the sugar. They found that populations of children that chew gum with xylitol as the main component, had a lot less decay, reguardless of their diet or their home care habits. What was happening was the Xylitol gum was promoting a form of bacteria with low acid production over the old acid producing bacteria. This is termed probiotics. Replacing one species with another.

Our office recommends that our patients with increase decay incidence or those at risk due to Xerostomia, orthodontics or problems with home care compliance, chew one stick , 5 minutes, three times a day. Remember that the gum must be a gum that Xylitol is the MAIN INGREDIANT, listed first in order of weight. 1: Int Dent J. 2005 Apr;55(2):81-8.

For more information about xerostomia go to http://www.oralcancerfoundation.org/dental/xerostomia.htm

Fluoride Varnish to reduce decay.
The use of a strong varnish made of fluoride has been shown to be helful in reducing decay in decay prone patients. The material is applied like paint, with a fine brush. If applied twice a yea,r the rate of decay in at-risk patients decreases to almost zero. Old cavities can even be "healed" in some cases. This process is used in Europe and Australia but has not found great support in the USA. Our office delivers this therapy to patients as a part of our efforts to keep the overall health higher using preventive care (which is usually a lot cheaper)

1: Gerodontology. 2003 Jul;20(1):9-14.
2: J Dent. 2003 Jul;31(5):313-9.
3: Caries Res. 2002 Sep-Oct;36(5):373-6.