Your Teeth—Love 'em or Lose 'em

In a society that seems to be so concerned about personal appearance why are so many losing this essential component of a beautiful smile?


AMONG North Americans more than 20 million adults have no natural teeth, an additional nine percent of the population have teeth only in one jaw. As a result one person out of every four has some false teeth in his mouth either a whole or partial set. In a society that seems to be so concerned about personal appearance why are so many losing this essential component of a beautiful smile? A surprising number of people lose their teeth just as others lose their hair. And, they will add, "if my father and mother were wearing dentures when they were 40, undoubtedly I will be too." Fortunately this idea is largely fallacious. Only a very few people lose their teeth from unavoidable hereditary causes. Most are lost for reasons that are directly under your control. The purpose of this article is to point out these reasons and to tell what can be done to control them.

The main cause of tooth loss in children and young people is tooth decay. Five percent of the population is affected by this disease, and approximately 800 million cavities are still unfilled. By the time a person has reached adulthood he usually has had most of this cared for and the teeth filled, or else he has lost the teeth that were involved. It is more significant that most people are unaware that 10 per cent of the 5-year-olds in our country have eight or more cavities.

When tooth decay is left untreated it soon goes beyond the hard enamel, where it originally entered. It passes through the soft dentin, which separates the enamel from the pulp, and enters the pulp chamber itself, where the toxins from the bacteria involved in this invasion destroy the delicate nerves and blood vessels supplying the tooth.

From here the infection goes out the end of the root and forms an abscess in the bone. At this time, or before, the victim usually presents himself to the dentist complaining of a severe toothache. Even at this late stage in the process the tooth can be saved by a delicate procedure in which the dead and infected tissue is removed from the tiny pulp canal, and it is cleaned, filled, and capped with a gold crown.

This, however, is costly and time consuming, and many people simply elect to have the tooth extracted. The cheap est and easiest method of saving the tooth is, however, to prevent the dis ease from starting.

In order for decay to occur three factors must be present: an appropriate bacteria, a proper environment for the bacteria to live in, and a susceptible host for the bacteria to invade. The absence of any one of these factors eliminates the possibility for decay.

The bacteria are present in the normal flora of the mouth, and we have not yet discovered a way to selectively eliminate only the harmful ones.

The proper environment for decay consists of the food that is necessary for the bacteria to metabolize in order to form the acids that attack the tooth. This food consists of sugars and other refined carbohydrates. To remedy this we must, first, cut out of the diet as much refined carbohydrate as possible and, second, after eating, immediately brush off all the food material remaining on the teeth.

Even if the above precautions are fol lowed, some people have pits and grooves in their teeth, which are so narrow that they are virtually impossible to keep clean with normal methods. So checkups at the dentist are necessary to halt decay in these areas before it threatens the tooth.

After age 35 the most common cause of tooth loss is pyorrhea, or periodontal disease. About 75 per cent of the adult population with one or more natural teeth are afflicted with this disease. Al though the prevalence increases with age, it is by no means a natural part of growing old.

Periodontal disease is a spreading infection, similar to tooth decay in this respect, which affects the apparatus that attaches the tooth to the gums and bone. It begins as a sticky bacterial colony attached to the tooth surface and is known as plaque. Soon the toxins produced by this plaque begin to irritate the gums, causing inflammation to be gin. This is noticed by you as reddening, puffiness, bleeding, and tenderness.

The infection then begins to spread down the side of the tooth, destroying the attachment fibers as it goes. Soon it reaches the bone and begins to destroy the real support of the tooth. This is noticed by you as loose teeth. After a time, if left untreated, there will be nothing left to hold the tooth in place, and it will fall out along with the plaque that is coating it. Then with the irritant gone, the inflammation will clear up.

A better way to remove the irritant, and also to save the tooth, is by removing the plaque when it first forms on the teeth. This is usually about 24 hours after a meal, and at this time it can be removed easily by careful brushing and flossing. If it is allowed to remain longer it begins to react with the minerals in the saliva to form a bony scale on the teeth known as tartar or calculus. This substance is not damaging by itself, but it serves as an attachment point for more plaque and as a shield for plaque that is already down in the crevice be tween the tooth and the gums. Thus it becomes very difficult for you to remove the plaque yourself, and you should go to the dentist for a professional cleaning.

Just a final word about a factor that is often overlooked when considering causes of preventable tooth loss, and that is trauma. Especially in children, and in boys more than girls, oral and facial injuries are responsible for a large number of lost teeth. In adults also this problem is significant in connection with sports and automobile accidents. Safer playing equipment and emphasis on care and caution in playing are the principal means of prevention in the young. For adults the two main causes can be almost totally eliminated by the use of mouth guards while engaged in contact sports, and seat belts with shoulder harnesses while traveling in an automobile.

Our natural teeth were designed to be permanent. The main reason they are not is owing to carelessness or neglect on our part. Furthermore, artificial teeth can never perfectly restore the beauty and function or the comfort and convenience of the original set. So wouldn't it be worth taking time now to ensure a lifetime of natural smiles to come?

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January 1976

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