more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.
Dietary changes that may be helpful
It has been noted for over 50 years that the incidence of tooth decay is low in people of traditional rural societies, such as Eskimos and African Bantus. However, the incidence of cavities increases as their diets begin to include more “westernized” processed foods.
Although many different factors have been implicated in this observation, including refined flours, inactivation of vitamins by heating foods, and sugar intake, no single agent has been found responsible. Nevertheless, a diet high in whole grains and low in processed foods is a healthful choice that probably helps defend against tooth decay.
Sugar, especially sucrose (table sugar), appears to be required by the oral bacteria for the production of tooth decay. This finding has caused sugar to be widely blamed in the popular press as the primary cause of dental caries. However, caries incidence has recently declined in a time of increasing sugar intake.
This has led to a reevaluation of caries causation, and sugar is now understood to be only one of the factors in the development of tooth decay. Nearly as important as the total amount of sugar intake seems to be the consistency of the sugary foods and the length of time they are in contact with the teeth. Dry and sticky foods tend to stay in contact longer, causing more plaque formation. Still, reduction of total dietary sugar is probably the most accepted dietary recommendation for the prevention of dental caries.
Drinking fluoridated water (1 mg fluoride per liter) has led to an estimated 40 to 60% reduction in dental caries in many cities in the United States and worldwide. While most experts believe water fluoridation to be associated with minimal risk, others disagree. A minority of scientists believe fluoridation to be associated with an unacceptable risk of skeletal damage, including osteoporotic fractures and bone tumors, in exchange for a modest dental benefit. Fluoride has topical action as well as whole-body effects, suggesting that those who do not have access to fluoridated water can achieve some benefit with fluoride-containing toothpaste and mouthwashes. In areas without fluoridated water, a number of controlled trials have found oral use of chewable fluoride tablets (1 to 2 mg per day of fluoride) or fluoride mouthrinses (0.05% to 0.2% fluoride content) also reduce caries risk in children. Fluoride tablets and mouthwash have been found to be effective for caries prevention in young adults and the elderly. Tablets are slightly more effective than a mouthrinse for caries protection. These products should not be used by young children (under three years of age), who might accidentally swallow dangerous amounts of fluoride. The American Dental Association (ADA) recommends supplementing children in areas without fluoridated water with liquid fluoride drops, but this should be done with the guidance of a dentist.
Lifestyle changes that may be helpful
The ADA recommends regular tooth brushing—daily brushing, ideally after each meal. Although thorough brushing varies from person to person, five to ten strokes in each area should be adequate. Toothpastes containing 1,000 to 2,500 ppm (1 to 2.5 mg per gram) of fluoride have been shown to reduce caries risk.
A recent population survey found blood lead levels were associated with the amount of dental caries in children and adults. The authors estimated that lead exposure is responsible for roughly 10% of dental caries in young Americans. For this and other health reasons, known and potential sources of lead exposure should be avoided.
Common sources of lead exposure may include paint, foods grown near roadways, and water from lead pipes.
Other therapies
Treatment includes daily brushing of teeth with toothpaste (especially after meals), flossing, limiting sugar in the diet, and regular professional teeth cleanings by a dental hygienist. Dentists commonly apply fillings to dental cavities. Topical fluoride applications or sealants (plastic coatings that form a barrier between bacteria and the chewing surfaces of the teeth) may be recommended.
Vitamins that may be helpful
Test tube studies show that vitamin B6 increases the growth of beneficial mouth bacteria and decreases the growth of…