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Let’s get technical – this is how you get tooth decay

This blog is for people who want to get into the nitty gritty details of how you get tooth decay. And good on you for wanting to educate yourself. I’ve tried to simplify it as best as possible. If you have any questions or you need a local family dentist, give my team a call at Riverstone Family Dental on 8678 3538.

Teeth are made of three layers. The outer layer is called enamel. Enamel is harder than bone and is designed to be very strong to prevent your teeth breaking when you chew. A key ingredient in tooth enamel is something known as hydroxyapatite. It makes the enamel nice and strong. Tooth enamel may be strong but it is susceptible to demineralisation where mineral such as hydroxyapatite is dissolved due to the effect of acid on the teeth. As mineral gets dissolved, it causes sensitivity and eventually creates a physical cavity. Acid can come into contact with your teeth in several ways:

  • through the build up of plaque which is broken down by bacteria which in turn gives off acid
  • internal acidic environment due to acid reflux or a gastrointestinal ulcer
  • when eating a highly acidic diet


Diet: the most important factor in tooth decay

Many foods contain hidden sugars so the best advice I can give you is to read the labels of your food products. Sugar can easily add up and before you know it, your diet becomes high in sugar. Some of my tips:

  • frequency of sugar intake is more important than overall quality – avoid constantly snacking or sipping on sugary foods and drinks
  • discourage your kids from ‘grazing’ between meals
  • avoid altogether: soft drinks, fruit juices, sports drinks because they are both sugary and acidic
  • limit sweets to mealtimes
  • beware, even though something may be labelled as having ‘no added sugar’ it still might contain “natural” sugars
  • chewing sugar-free gum helps to increase saliva flow and buffers acids in your mouth


Your health: look after your #1 asset

Many general health problems can cause oral health problems.

Heart conditions and diabetes are the main culprits. If you look after your overall health, your teeth and gums are less likely to have problems. Quit smoking and control your blood sugar levels and you are less likely to have periodontitis (an infection of your gums and jaw bone).

If you take medications, make sure your saliva flow and quality are top notch. How do you do that? Before starting any new medication, ask your GP if it will have an effect on your saliva flow. For example, most medications that are “anti-” something will cause a dry mouth, think anti-depressants, anti-nausea medications etc. If you need to take them please ensure you increase your water intake, chew sugar-free chewing gum in between meals and use products such as those from the Biotene range as a saliva replacement. Another point about medications is some have sugars in them, especially kids syrups. So please check this and if using them, make sure your child drinks plenty of water and wait 30 minutes before brushing their teeth.

Pregnancy is a time to look after your oral health. Studies have shown that antibiotics and an unwell mother may contribute to some enamel defects in kids’ teeth. So please look after yourself during pregnancy and if you are planning to get pregnant, visit your dentist beforehand to ensure your dental health is under control.

Fluoride, calcium and phosphate: supplements

Fluoride works best when it is on the surfaces of your teeth, as it sits there, it remineralises the surfaces of your teeth. This means, it has the opposite effect of acid and sugar on your teeth. Calcium and phosphate roam around in your mouth via your saliva. They are also important players in remineralising your tooth enamel. Milk-derived proteins which contain calcium and phosphate (CPP-APP) are now used to help prevent tooth decay in kids and at-risk people, this product is known as GC Tooth Mousse.

Sealing and cleaning: this is what works

Fissure sealants have been shown in countless studies to have an incredible effect on preventing decay in your back teeth. The pits and fissures of back teeth are very susceptible to getting food suck in them, leading to tooth decay.
When it comes to cleaning your teeth, brushing your teeth should be done twice a day for 2 minutes and flossing once a day. Every 6 months, a visit to your dentist will ensure your oral hygiene is up to scratch and problems are diagnosed early.

Here are some of my tips:

  • the mechanical action of tooth brushing helps to remove plaque which causes tooth decay
  • start your kids early with developing their tooth brushing habits – as soon as their first tooth appears at about 6 months. At Riverstone Family Dental, I have a Toothbrushing Chart which kids tick off when they have brushed their teeth. Remember to make it fun and consistent.
  • flossing – find what works for you. Gone are the days where you only use a piece of string. You have a choice of using piksters, floss holders, interdental brushes, superfloss and many more products to clean in between your teeth.


I hope you have found this blog helpful. As always if you have any feedback, questions or would like to book in, then give my team at Riverstone Family Dental a call on 8678 3538.