What Is Tooth Decay?
Caries is a chronic -degenerative infectious disease of the teeth. In the initial phase, the enamel (the external surface of the tooth) is destroyed by the dental plaque (demineralization process), formed by bacteria born from food residues: these bacteria can produce acids that erode the tooth, for this reason, caries, if not treated promptly, it can also affect the deeper layers of the tooth (dentine and pulp) causing extreme, sometimes excruciating pain. According to the Ministry of Health, data relating to carious disease, measured with the DMFT index (Decayed Missing, Filled, Teeth), show that:
- At four years, this is equal to 0.81, with a significant component of carious lesions in place (20.61%);
- At 12 years, 43.99% of subjects are affected by caries, with a DMFT of 1.09.
Caries Of Milk Teeth
The structure of milk and permanent teeth differs only in the thickness of the hard tissues (enamel) and the soft tissues (pulp) extension.
- Milk teeth are characterized by thinner and less resistant enamel than that of permanent teeth. Also, the layer of dentin (the most tender and delicate part of the tooth that forms the root, inside which the pulp is located) is finer. In contrast, the pulp is more extensive, with the pulp horns (portions of the pulp that extend towards the enamel) more superficial.
- Therefore, caries affecting a milk tooth in children, if not treated in time, progresses much more rapidly, affecting the pulp, than caries affecting a permanent tooth in adults.
Causes Of Tooth Decay
The grooves and occlusal dimples of the molars and premolars are the hollow areas of the teeth where bacterial plaque accumulates and “stagnates” more easily. This is where caries begin, which, if not adequately treated, progressively affects the deeper dental layers up to involving the pulp. The latter becomes inflamed in an irreversible way (phlogosis), causing the death of its cellular elements ( necrosis ). Necrosis affects the dental pulp, tooth apices, and roots and often triggers acute (e.g., abscesses) or chronic (granulomas) inflammatory immune reactions. The underlying causes of caries are complex and only partially known; some of the most frequent are:
- Microbial factors, as in the typical microbial flora present in the mouth, some microbes favor the deposit of dental plaque;
- Hygienic aspects and poor oral hygiene predisposes to the formation of dental plaque;
- dietary factors, especially excessive consumption of sugary foods and beverages ;
- constitutional factors, such as insufficient structural strength of the tooth;
- Reduction of salivation.
Symptoms Of Tooth Decay
Symptoms of caries vary depending on the extent and location of the lesion. First-degree caries (which have only affected the enamel) generally do not cause any symptoms: the parent needs to have the child undergo regular dental visits, even when he does not feel any pain. Already starting from the second stage of caries (nicking of the dentin), inflammation of the pulp tissue can manifest itself through:
- Severe toothache
- Bad breath
- Tooth sensitivity
- Presence of visible holes or pits (usually black) between the teeth
- Dull white spots or small halos on the tooth
- Periradicular alveolar bone abscess (apical periodontitis)
- Gum swellings
- Facial swelling (in more severe cases)
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Caries Diagnosis And Treatment
To diagnose caries, the child must undergo a dental examination. Usually, the dentist quickly detects the presence of caries thanks to special instruments (mainly) used to verify any holes in the enamel. In these cases, the dentist may prescribe specific radiographs of the dental arches capable of highlighting the degree of severity of the carious lesion. Caries are treated by removing the necrotic parts and restoring the residual cavity of the tooth with a filling; in any case.
The therapy depends on the severity of the lesion (in the most severe cases, tooth extraction is resorted to). Deciduous teeth (commonly called “milk”) should never be removed since their early loss could reduce the space destined for the respective permanent tooth and, subsequently, the establishment of potential malocclusions. Expect your children’s teeth to fall out independently at their own pace.
General Dietary Recommendations
Limit as much as possible the consumption of foods and drinks containing simple sugars. The bacteria responsible for caries formation use the sugars we introduce with food to increase and produce acids capable of damaging the dental enamel. Furthermore, excessive consumption of especially added sugars predisposes to obesity, type 2 diabetes mellitus, and cardiovascular disease. Do you want to know how much sugar your son or daughter eats every day and how much should he consume? Calculate it for free with the sugar meter and discover substitute foods with less or no sugar.
- Avoid consuming sticky foods, which are more difficult to remove, even with a toothbrush.
- Limit acidic foods as they can damage tooth enamel.
- Prefer fresh and fibrous foods as they stimulate chewing and carry out a natural cleaning of the oral cavity, which is beneficial for our mouth.
- Prefer foods containing calcium, fluorine, phosphate, and minerals essential for dental health. Grana Padano DOP, in particular, is the cheese richest in calcium among those commonly consumed and also contains phosphorus which, together with calcium, represents most of the “basic elements” that form teeth and bones. You can use a teaspoon of grated cheese daily to season first courses, soups, and vegetable purées, even instead of salt.
- Eat seasonal fruit and vegetables with every meal.
- Hydrate yourself sufficiently, preferring plain water, unsweetened infusions, or herbal teas. Read this article to find out how much your child should drink and which drinks to prefer.
- Consume foods rich in antioxidants, as these molecules limit the action of free radicals, which are also harmful to the mouth’s health. Anthocyanins, in particular, can prevent bacterial plaque from adhering to teeth, while polyphenols can perform an antibacterial action, preventing gum disease, tooth decay, and bad breath. Do you want to receive four tasty menus for free, one for each season, made up of foods rich in antioxidants and protective substances that help you fight premature aging and dental cavities? Subscribe to the Anti-Aging Diet: a food plan for your daily calories and a physical activity plan for your motor skills and possibilities.
- Choose foods that are beneficial for intestinal and oral bacterial flora.
Food Not Allowed
- Sugary drinks such as cola, orange soda, and iced teas but also fruit juices since, even if they bear the wording “no added sugar” on the packaging, they naturally contain fructose (fruit sugar). These drinks also increase the child’s thirst and do not hydrate.
- Foods are rich in simple sugars such as candies (tricky and sticky ones, such as toffees), lollipops, fruit chewing gum, nougat, caramelized dried fruit, honey, and caramel due to their stickiness to the teeth, raisins, candied fruit, but also industrial packaged sweets (e.g., snacks, biscuits, wafers, chocolate bars, etc.), jams and sweetened fruit chutneys.
- Lemon juice and vinegar for their high acidity.
- Tough foods, such as coconut, nougat, ice, etc., can ruin the enamel.
- Junk food and salty snacks such as chips, popcorn, tortillas, peanuts, etc.
Foods Allowed In Moderation
Possibly unprocessed homemade sweets such as simple cakes, dry biscuits or shortbread biscuits, fruit ice cream, pudding, etc. Classically these foods would be avoided in case of tooth decay, but common sense prevents us from being so inflexible with children and adolescents. Sweets and, in particular, ice cream often characterize important moments of childhood socialization, so it is reasonable to allow the occasional consumption of these foods (for example, at a birthday party), always followed by correct dental hygiene. Furthermore, the homemade preparation will enable you to control the doses of sugar: remember that up to 2 years of age, it is advisable to avoid consuming sugar and salt altogether.
Fruit as it is rich in simple sugars (fructose). The consumption of fruit should not be avoided because it contains many vitamins, minerals, and antioxidants essential for development, especially if eaten raw and with the peel (if edible and well washed, in small children without peel, seeds, and blended). Limit more sugary fruits such as bananas, figs, grapes, tangerines, and dates to occasional consumption, and prefer berries, grapefruit, oranges, watermelon, strawberries, kiwis, apples, and nectarines.
Salt. It is an excellent rule to reduce the amount added to dishes during and after cooking and to avoid consuming foods that naturally contain large quantities of it (canned foods or brine, stock cubes, meat extracts, soy-type sauces, etc.). Use a teaspoon of grated Grana Padano DOP to flavor dishes instead of salt or aromatic herbs and spices (rich in antioxidants).
Allowed And Recommended Foods
Seasonal vegetables for their high content of vitamins, minerals, antioxidants, and fibers. Prefer stringy raw vegetables such as carrots, celery, fennel, radishes, etc.: chewing these foods cleans the teeth because it removes part of the bacteria on the enamel and increases the tone of the gums, exerts a slight pressure on them, which massages and stimulates blood circulation. Consuming these vegetables also increases saliva production, which cleans the teeth and improves the mouth’s acidity.
Natural oligomineral water . Drinks such as herbal teas, infusions, or chamomile tea can also be consumed without sugar to ensure proper hydration for the child.
Cereals as they are indispensable for the correct intake of complex carbohydrates. I prefer whole grains because they are rich in magnesium, valid for the absorption of calcium and phosphorus, it also helps in case of bruxism (a habit of clenching, clenching or grinding the teeth, which damages some parts that make up the oral cavity) thanks to the muscle relaxant action.
Milk and derivatives such as ricotta and fresh cheeses such as stracchino or mozzarella, consuming them no more than three times a week as an alternative to the second course of meat or eggs. Grana Padano DOP can be eaten as a second course twice a week in place of other fresh cheeses or grated as a condiment for pasta, rice, and vegetable soups. This cheese is a milk concentrate, it is very rich in highly assimilable phosphorus and calcium, a nutrient, the latter, which allows the dental enamel to be strengthened since, together with phosphorus, it forms hydroxyapatite, the essential component for enamel. Calcium also plays a vital role in developing teeth and the bones that support them. Eating cheese helps to raise the calcium concentration in saliva, thus promoting the repair of weakened enamel.
- Lean meats, such as beef, poultry, and veal, are stripped of visible fat.
- Lean cold cuts such as bresaola, roast chicken or turkey, and raw or cooked ham without fat.
- Bony fish, fresh or frozen, cooked, boiled or steamed, grilled or baked without fat for their phosphorus and omega three content.
- Eggs, no more than 2-4 servings per week.
- Legumes provide energy, protein, iron, and fiber and are excellent to add to soups or soups.
- Olive oil flavor dishes for their vitamin E content, a powerful antioxidant.
The Importance Of Oral Hygiene
Even before the first milk tooth eruption, it is advisable for the parent to ensure oral cavity hygiene by passing a moist gauze over the small arches, still without teeth, after each breastfeeding or use of the Bieber. After the first six months of the child’s life, the eruption of the first teeth begins, and from this moment on, the use of the toothbrush can be introduced. In this way, the little one will immediately get used to cleaning his mouth.
which is becoming a familiar daily action. From 2-3 years old, it is good to start regular check-ups with a child dentist or dental hygienist to get simple instructions on the best way to ensure your child’s oral hygiene, as well as check through orthodontics if there is an abnormality of the teeth and palate. Parents play an essential role in establishing children’s dietary preferences and making good oral hygiene a habit.
Not all sugars are harmful and favor the formation of tooth decay. The sugars preferred by the bacteria responsible for plaque are the simple ones, i.e., those with a sweetening power, sucrose (ordinary white cooking sugar), glucose, and fructose. Complex sugars, however, such as those contained in pasta, rice, bread, and cereals in general, do not meet the preferences of these bacteria. Among the sweeteners, we can distinguish those:
- Natural calories: palatinose in honey, polyalcohols such as xylitol are present in many chewing gums and sweets, erythritol, sorbitol, maltitol, and lactitol. Both palatinose and sugar alcohols do not promote tooth decay.
- Natural non-caloric: stevia, thaumatin, and monellin. Studies are known only on the first (stevia) and do not favor caries formation.
- Of chemical synthesis: aspartame and sucralose. They are not prone to tooth decay. However, prolonged consumption is not recommended.
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