Sure, we care a lot about our bodily health and mental health — but how often do you prioritize your dental health? (Illustration: Erik Mace for Yahoo Health)
Unless you’re a dentist, chances are you don’t give that much thought to cavities. Along with chickenpox and ear infections, it’s a health issue we tend to associate with the Dora the Explorer set. So the results of a new report from the Centers for Disease Control and Prevention may leave you open-mouthed: One in four of us is walking around with an untreated cavity, and nearly all adults will suffer from tooth decay at some point in their lives.
“We tend to associate cavities with early childhood, but adults actually have the same rate of tooth decay as kids,” says Bruce Dye, DDS, dental epidemiology officer at the National Institute of Dental and Craniofacial Research, who helped to conduct the survey. “It can affect you at any time during your lifespan.”
Considering that tooth care has been programmed into our brains for practically forever — brush twice a day for two minutes, floss daily, and visit the dentist every six months — why are so many adults orally challenged? We get to the root of the problem and reveal surprising ways to keep your pearly whites in peak condition.
Certain populations are more cavity-prone
According to the CDC report, some ethnic groups have higher rates of untreated tooth decay than others. It’s more prevalent among African-Americans (46 percent) and Hispanics (36 percent), than Caucasians (22 percent) and Asians (17 percent). What’s causing the disparity?
“That’s the billion-dollar question,” Dye tells Yahoo Health. “We’ve been trying to tease out the source of the difference, but it’s a complex issue.” He explains that there are three overarching factors that contribute to oral health: biology, social conditions, and behavior.
In terms of biology, some people were blessed with genes that give their chiclets a better chance to shine, like bulletproof enamel, bacteria-bashing saliva, and a robust immune system. And according to the American Academy of Periodontology, it’s possible that certain clusters of the population are genetically susceptible to oral disease.
“A new study found that a small percentage of African-Americans are missing a variant form of salivary protein that wards off cavity-causing bacteria,” David Silverstrom, DDS, at the Silverstrom Group, tells Yahoo Health. (That being said, stellar oral care can help you overcome a less-than-ideal gene pool. And even strong DNA won’t totally protect you if you neglect your chompers.)
Then there’s the social element. “Lower socioeconomic groups tend to have greater levels of untreated cavities,” pediatric dentist Jonathan Shenkin, DDS, vice president and spokesperson for the American Dental Association, tells Yahoo Health. “And access to health care plays a major role.” Medicaid coverage varies greatly from state to state, with some states offering no dental benefits, or only limited benefits for emergency care. What’s more, even if a patient has decent coverage, he or she may not have access to transportation to get to the dentist’s office in the first place.
Finally, lifestyle contributes to the quality of your pearly whites. Research has found that disadvantaged social groups are more likely to smoke (which dramatically increases the risk of gum disease and tooth loss) and to consume diets high in added sugar, creating the perfect breeding ground for bacteria. “In addition, there may be a lack of education about proper tooth care among people in poverty or near-poverty,” says Shenkin.
Sneaky habits can sabotage your smile
Cultural background aside, you may be wondering why cavities persistently pop up in some oral hygiene devotees, while, on the other hand, a slacker who does the bare minimum may still maintain a gorgeous grill.
Here’s the deal: The idea of “soft teeth” is a myth. However, genes do play a role in how cavity-prone your teeth are. “Certain DNA strands lay down teeth that are better able to absorb fluoride and create a hard enamel surface,” Dye explains. Plus, some people are born with particularly bountiful saliva, which provides a moist environment for healthy bacteria to thrive, bathes your ivories in essential minerals like calcium and phosphates, and neutralizes your mouth’s pH. (Too much acid eats away at enamel.) Having a naturally hardy immune response makes you better at fighting infections of any kind, from the flu to gum disease. Finally, the shape of your mouth has an impact: “Crowding makes it more difficult to floss and remove bacteria,” Shenkin points out.
But there are also hidden triggers. Bottled water guzzlers are missing out on the benefits of fluorinated municipal drinking water. (The same is true if you grew up sipping unfluorinated water, such as well water.) Snorers have dry mouths, an environment in which cavity-creating bacteria thrive. Teeth grinders wear down their enamel, making them more vulnerable to decay. Frequent snackers are exposed to a near-constant stream of sugar throughout the day.
On that note, you might also be unwittingly consuming cavity bombs. “Acidic foods like citrus and soda lowers the pH levels in your mouth, causing demineralization,” says Dye. If you consume sugary beverages (yes, that includes juice!) he suggests alternating with water to restore a healthy pH balance.
“And anything sticky gets caught in your teeth and lingers longer in your mouth,” adds Shenkin. That includes even healthy choices like dried fruit and nut butters. His fix: Chew sugar-free gum after meals to stimulate saliva flow, which will help clear away sugars.
Cutting corners might cost you more
Even people lucky enough to score dental benefits through work are starting to feel the financial costs. “Employers are covering less and less — in fact, there has been no increase in the maximum billable amounts in the last 30 years,” says Shenkin. “There are fewer in-network dentists to choose from, and out-of-pocket costs are rising. As a result, we’re seeing a dramatic drop in dental visits among adults with private insurance.”
But skimping on oral care until a toothache hits can backfire, big-time. “A cavity is like an iceberg,” explains Shenkin. “If you wait until you see a hole or feel pain to go to the dentist, it’s a sign that you probably have an enormous cavity brewing underneath.”
That’s right: There are rarely any noticeable signs or symptoms when decay first sets in, meaning that waiting to self-diagnose is risky. “That’s why we take X-rays,” says Shenkin. “You can’t view small cavities with the naked eye, but in an X-ray, they appear as dark triangles on the surface of the tooth.”
These tiny pits can often be easily treated with a program that promotes remineralization, such as avoiding sweet drinks and using toothpaste with a high fluoride concentration to strengthen your enamel and prevent the crater from reaching the inner layer of your tooth, or dentin. (Once it penetrates the dentin, game over — the drill comes out.) It can be hard to wrap your head around handing over a hefty sum for a cleaning when you feel totally fine, but “just because nothing hurts, that doesn’t necessarily mean things are good,” Shenkin says.
What if you do nada? If you’re lucky, your untreated cavity might remain stable, staying the same size year after year. Or it might get serious fast, triggering an infection that could potentially lead to hospitalization. “It’s similar to ignoring a rattling sound in your car,” says Shenkin. “Disregarding the problem will require much more expensive work in the long run.”
And it’s not only your teeth that are in danger. “Oral health impacts your overall well-being — when in balance, the complex community of billions of bacteria in your mouth actually protect and support your body’s ability to live,” says Silverstrom. “However, when disturbed, it produces bad bacteria that lead to gum disease and cause a decrease in our immune response. If you don’t take care of your teeth, you could get cancer, heart disease, diabetes, or Alzheimer’s.”
Best to play it safe, and put your money where your mouth is.
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