Caries is one of the most prevalent diseases of humanity. It affects 44% of the population at one point or another in life. Secondary? Not as much as it may seem at first.
Carles Subirà Pifarré
Specialist doctor in stomatology. Director of the Department of Odontostomatology, University of Barcelona
A carious lesion usually alters the quality of life of the individual who suffers from it. His treatment involves costs both for the patient and her environment and for the society where he lives and works. In addition, it tends to be more frequent and more seriously affect the poorest social strata.
On the other hand, periodontal disease (or gum disease) It is the second most frequent cause of tooth loss in the general population and the first among the elderly. Periodontitis or pyorrhea manifests as the loss of bone that surrounds the teeth. Today, bone loss can occur around dental implants, known as periimplantitis.
Only a small group of the population will be affected by the most aggressive forms of both diseases, but a large percentage of the population may be affected by one moderate dental bone loss.
Is caries a communicable disease?
Absolutely yes, but not as we understand contagion in most communicable diseases.
If we go back to the moment of delivery, it turns out that the baby, before being born, does not have any kind of microbe in your oral cavity. But right after birth, bacteria from the birth canal appear in the mouth. From the sixth month of life the first milk teeth, usually the lower incisors. And it is at that moment when the mouth begins to be colonized by bacteria that will be located around the teeth and gums.
Where does this authentic initial dental biofilm come from? Well, it has been observed that it comes from the people who have the most intimate contact with the baby. Classically, there is talk of a mother-to-child transmission due to the role that mothers had in caring for babies. Today it is not so clear that it is only the mother who is involved in the transmission of the oral biofilm to her children, although her role continues to be preponderant.
Does caries only depend on the bacterial flora?
For an infection to appear, a series of variables or biological characteristics must come together: the so-called perfect storm or dysbiosis. And that also applies, of course, to cavities.
In the first place, the bacteria capable of producing acid stand out, which will be the one that will dissolve the tooth enamel. Second, to produce acid, bacteria need an adequate nutritional substrate, mostly refined sugars. Thirdly, the acid must overcome the presence of neutralizing elements, the main of which is saliva. Therefore, the less we salivate, the easier it will be for caries to advance.
Fourthly, the absence of hardening chemical elements of the tooth enamel, of which the main representative is fluoride. And, finally, all these elements come together and are maintained over time if oral hygiene is deficient.
The most harmful foods for teeth
Seen this way, it is easy to understand why a person with a history of caries, with a diet rich in carbohydrates (chocolate, pastries, honey, pre-cooked meals, packaged fruit juicessugary drinks, snacks, etc.), who brushes their teeth little or not at all and who, in addition, takes medications that dry out their mouths (sleeping pills, blood pressure pills, psychotropic drugs, etc.), probably, in a short interval of time, it will develop various carious lesions.
On the other hand, age also influences: the risk of caries is not the same throughout a person’s life.
Take care of the teeth, but also the gums
Are tooth decay and periodontal disease related? Yes. It seems that some of the risk factors associated with the presence of cavities also contribute to gum disease. Both are enhanced, and fighting one usually improves the other as well.
In relation to genetic factors, it seems that periodontal disease has a higher prevalence in certain families.
In the case of dental caries, vertical bacterial transmission from mother to baby and the dietary habits learned in the family environment are decisive when it comes to establishing the risk of caries. The genetic origin would be more related to the development of pathologies of the enamel and dentin, which would favor the accumulation of plaque potentially generating caries.
Definitely, with age, risk factors for periodontitis accumulate and age-related immunological alterations (immunosenescence) promote loss of support around some teeth.
Disseminate healthy health habits at the dietary leveloral hygiene, rational consumption of medicines and hard tissue supplements in the form of fluorinated salts have an impact on the prevention of the two diseases that most affect tooth loss: caries and periodontal disease.
