Marvin A. Fier, DDS, FASDA

Article  

Healing Teeth

When we talk about healing, the first picture that might come to mind is a wound on the skin. When a person is healthy and the wound is taken care of, the skin almost miraculously knits itself back together. This healing process is familiar, but did you know that there's also a healing process for your teeth?

Minerals in the teeth: a balancing act

Remineralization is the name for your teeth's natural healing capabilities. It's part of an ongoing, back-and-forth process that occurs naturally in the mouth. To understand how it works, it's useful first to understand its opposite: demineralization. Demineralization is the earliest stage of tooth decay. It's called demineralization because, during this part of the process, the tooth enamel loses the minerals that make up its structure.

Tooth enamel is formed of a lattice-like matrix of mineral. The mineral is a calcium-phosphate compound called hydroxyapatite (hy-drok-see-APP-uh-tite). This is one of the strongest materials in the body, but it can be destroyed by the bacteria in plaque, the sticky, colorless film that forms constantly on teeth.

To understand how to help maintain a balance between demineralization and remineralization and keep your teeth healthy, it's important to know more about what causes teeth to lose their minerals.

Plaque: the enemy of teeth

The demineralization process starts with plaque. The bacteria in plaque that cause demineralization survive by digesting the foods you eat, specifically high-sugar and high-carbohydrate foods that can be broken down into simple sugars.

When bacteria feed on these sugars, they produce acid. The more the bacteria get to eat, the more easily they reproduce. And the more bacteria there are, the more acid they produce. The acid causes demineralization by dissolving the minerals in tooth enamel. Sometimes you can see demineralization as small white or brown spots on the teeth.

Saliva: the hero of remineralization

In ideal circumstances, your body helps teeth recover from acid attack by replacing these lost minerals. This is remineralization, and the hero of this process of saliva. It contains dissolved minerals, which it gets from the foods and water you take in. As your saliva washes over your teeth, these minerals can be incorporated into demineralized areas, making the enamel strong again.

If there is fluoride in your saliva, the results are even better, because the fluoride strengthens your teeth by becoming part of their mineral structure. Your saliva would include fluoride if you drink fluoridated water or take prescription fluoride.

Toothbrush and floss: bacteria fighters

This healing process requires healthy conditions. For example, a skin wound that isn't cleaned probably won't heal well and may even grow worse. Similarly, a demineralized area that isn't kept clean will continue to grow until it forms a small hole in the tooth, called a cavity. Once a cavity forms in the tooth, it can't be healed naturally through remineralization. In this situation, we will need to restore the tooth with a filling, crown, or other restoration.

Demineralization can't be stopped completely. There will always be bacteria in the mouth, and since you need to eat, there will always be some food for the bacteria, too. However, you can help keep demineralization in balance by regularly removing plaque with thorough brushing and flossing. Here's why removing plaque is important:

  • As more plaque accumulates on the teeth, more bacteria are available to produce acid, making the process quicker and more widespread.
  • Plaque accumulations hold bacterial acids in close contact with the tooth surface, making the destruction more insidious.
  • Accumulations of plaque cover the tooth surface and prevent the minerals in the saliva from reaching demineralized areas on the tooth surface.

Brushing removes plaque from the biting surfaces and flat areas of the teeth. Flossing removes plaque from between the teeth, where plaque tends to build up very easily and toothbrush bristles can't reach. Using a fluoride toothpaste can help, too, because it make fluoride available to the teeth for several minutes. Make sure to brush twice a day and floss at least once a day because plaque will regrow on your teeth within 3 to 4 hours.

Healthy diet: beyond the "breakfast of champions"

There are additional steps that you can take to keep demineralization down to a minimum. First, starve the decay-causing bacteria by reducing the high-carbohydrate foods in your diet. You already know that this includes candy and sweets, but other high-carbohydrate foods, like pasta, bread, cereals, chips, dried fruits, juices, and sweetened drinks are also easily broken down into the simple sugars that decay-causing bacteria love.

Moderate the acid levels in your mouth by reducing your intake of high-acid foods, especially soft drinks (both regular and diet), energy drinks, sports drinks, and citrus fruits and juices. These make the plaque and the inside of your mouth more acidic, which softens the enamel and leaves it more vulnerable to the acids produced by bacteria.

If you do have a soft drink or eat high-carbohydrate foods, take them with a meal and brush your teeth soon afterward. This will reduce the amount of time that your teeth are exposed to the sugars and acids, and will promote the natural healing process.

For more information

At your regular appointments, we'll examine your mouth for decay and assess your risk for demineralization and cavities. If we find that you're at high risk for tooth decay, we may recommend changes to your homecare routine and diet, or additional treatments to help keep it under control. We want to do everything we can to help you avoid cavities and the need for fillings.

If you have any questions or concerns, please ask. You might find these resources valuable, also: