Prevention

If totally successful, this would mean you never need treatment, but the chances of that are slight over a lifetime. However prevention helps to keep your teeth for the whole of your life. At the age of 90 they won't appear as they did at the age of 18 because of wear and tear, but they can still look very good. So what do you need to avoid and what do you need to do to keep them for life?

There are two common diseases which will stop you achieving the goal of keeping your teeth. They are tooth decay and gum disease. Both are caused by harmful bacteria, usually passed from parents and family soon after birth, and if conditions are suitable they grow into harmful masses perhaps many years later. Prevention involves keeping the conditions unsuitable for their growth into mature films of plaque, or where this is impossible to limit the damage they cause.

Preventing loss of teeth due to gum disease

The main way to do this is to disrupt the growth of bacterial films around all teeth by brushing and flossing every day. Should there be sufficient space between teeth use of an interdental brush may be better than floss. If you don't clean along the gum-line every day the film sticks more tightly and often becomes harder every day until a toothbrush or floss just won't get it off. These are the conditions the harmful bacteria like, and begin to grow, soon wreaking havoc with your gums causing them to swell and soften. If you spit out blood-stained saliva after brushing, or worse, spit out blood when you haven't brushed get professional advice. If you smoke these tell-tale signs of gum disease may be absent and the first you become aware of is severe gum problems. Gum disease rarely causes pain, so you can't rely on that to warn you.

Preventing loss of teeth due to tooth decay

Tooth decay usually starts at inaccessible sites around a tooth, so you can't rely on regular brushing to prevent decay, but it will be worse and more widespread if you don't. The main method of preventing tooth decay is to starve the harmful bacteria of their food, refined sugars. Unfortunately most people also enjoy the same kind of food, so to reduce intake is difficult, and you need to be single-minded to achieve it. Our ancestors, 10,000 years ago, didn't have access to refined sugars and tooth decay was not a problem for them. As human diet changed so did their bacterial inhabitants, so that now almost everyone eating a western diet is infected with them. They have to compete with protective bacteria to find a home around teeth and we can help them by drinking acid drinks, which kill off protective bacteria as well as dissolving the surface of teeth to produce erosion, which causes tooth wear and sensitivity.

A way of controlling the rate of decay is by using toothpastes containing fluoride. This slowing down process helps give us time to see what's happening so that professional preventive measures can be taken. Those who don't brush lose this benefit and decay can destroy a tooth in less than six months, even teeth that are slowly erupting and can't be reached by toothbrush bristles may, by the time they are fully erupted, be destroyed. This can be very traumatic for 6 year old children (and their parents) when they may need to be given a general anaesthetic to remove them. Such children may find it difficult to accept dental treatment later in their lives.

Warning..fillings may harm your health!

Fillings in teeth don't stop teeth decaying, they merely restore the damaged tooth to keep it functional, and if the materials are tooth coloured they maintain the aesthetic appearance. A good filling or other restoration will not promote tooth decay or gum disease by leaving inaccessible places for bacteria to grow. A good filling takes time to place, while a rushed job may promote new disease. The NHS system encourages jobs to be rushed so that more people can be seen. An NHS dentist is rewarded no more for a good filling than a bad one. Generally, the quality of a filling is proportional to the cost. Choosing the provider of a filling on the basis of cheapness may turn out to be a false economy. You may be lucky, but you are gambling with your health and ultimately your lifespan.

FAQ about prevention

How long and how often should I brush each day and when is the best time?

The important thing is quality. One very effective brush each day is better than 20 flicks round. If you do the job quickly then you will take short-cuts, and as the habit develops, you miss the same places leaving these as havens for bacterial growth. The general advice is to brush for at least 2 minutes twice each day before breakfast and last thing at night.

What toothpaste should I use?

What you like the taste of so long as it contains fluoride. Anti-plaque formulas can be useful, but only if you brush effectively taking the paste to all the cracks and crevices.

Is an electric brush better than a manual one?

Trials often show electric brushes have the edge, but trials are not the real world where the novelty has worn off. In practise either can give excellent results if you use them properly. Electric brushes tend to give the user a false sense of security, because the sensation of movement may not translate to contacting the right places.

What foods and drinks harm teeth?

Most processed foods have this potential. So-called healthy smoothies and fruit juices contain high levels of sugar. Many manufactured foodstuffs have added sugars to make them more palatable. Perhaps we should turn this round and give an idea of what are safe foods. These turn out to be the foods that our ancestors could have collected or caught 10-15,000 years ago. As you go round the supermarket ask yourself is this something those ancestors would have had available to eat or drink, if so they are safe with one exception, honey. They rarely had access to honey, so it didn't cause problems. They didn't have 'energy' drinks despite being as active as modern athletes, instead water was their main drink.

I play sport, how can I prevent injury to my teeth?

If you play contact sports, or activities where there is risk of facial trauma, it is advisable to have a properly fitted mouthguard, which is comfortable to wear for the required time.

What kind of drinks are acidic?

Other than water, tea, coffee and milk, all drinks are sufficiently acidic to kill protective bacteria. All non-sugar, so-called diet drinks are acidic, while liquid meal substitutes making up part of slimming regimes are likely to be high in refined sugar.

Refined sugars and acids are bad. Sugars locked up in fruits are good...unless you suck and suck and suck at them.