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February 5, 2009 – Vol. 3 • No. 6
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Questions & Answers

1.1. Is fluoride beneficial to adults as well as children?

Yes. Fluoride forms a protective outer coating around the teeth to protect against harmful acids that cause decay. Fluoride is especially important as children’s teeth develop because it becomes incorporated into the permanent structure of the teeth and provides protection later in life. In adults, it is incorporated into the surface of teeth, making them more resistant to decay. Fluoride is naturally present in all water and is now added to toothpastes and mouthwashes for extra benefit.

2. Why is flossing essential to good oral hygiene?

Flossing removes the plaque and bacteria that form between the teeth and under the gum lines in areas where regular brushing can’t reach. Plaque, the white sticky film we feel on our teeth, is composed of bacteria that when mixed with the sugars we eat (from candies and cookies) create harmful acids that attack the teeth and gums. Over time, the acids can cause tooth decay and gum infections, which can result in tooth loss. Flossing regularly prevents the buildup of plaque and tartar, and diminishes the risk of cavities and inflammation.

3. Why does smoking increase the risk of gum disease?

Research shows that smokers are four times more likely to have gum disease than non-smokers. Smoking and chewing tobacco decrease your body’s ability to fight infection, making you more susceptible to the bacteria found in plaque that leads to gum disease. Additionally, it is believed that smoking can cause your gums to recede and can cause bone loss, worsening the effects of oral infections. Smoking is also thought to impair blood flow to the gums which affects wound healing.

4. Do sealants, the plastic coating placed on the back teeth, have to be replaced periodically?

Sealants help prevent tooth decay by covering the small pits and grooves of the back teeth, where a high percentage of decay occurs. Because sealants are usually applied to the tops — or chewing surfaces — of the molars, they wear down over time and need to be replaced. In general, sealants last about five years. It is important to have your sealants checked periodically by your dentist for damage (they may be chipped by hard foods) and for regular wear and tear from chewing.

5. Why do experts believe there is a link between gum disease and cardiovascular disease?

Some experts believe that the bacteria causing gum disease can enter the blood stream and cause inflammation and plaque buildup in the arteries leading to the heart and the brain, increasing the risk of a heart attack or stroke. But gum disease is preventable with good oral health and hygiene, so speak to your dentist about the best ways to prevent gum disease.

6. Is there a particular brand of toothpaste a person should buy?

Not necessarily. Look for brands that contain fluoride and are approved by the American Dental Association. Toothpastes that claim to reduce plaque buildup, help decrease sensitivity or whiten teeth have become more popular, but the main ingredient to look for is fluoride.

7. Is tooth decay reversible?

If a cavity is found early, sometimes a dentist can reverse or prevent further decay by applying a fluoride treatment. In general, though, decay cannot be reversed, but it can be stopped and treated (fillings, crowns, etc.) to prevent the decay from worsening. The good news is tooth decay can be prevented with good oral health and hygiene. The American Dental Association recommends that everyone brush at least twice a day and floss at least once a day, and visit their dentist regularly for regular cleanings and exams.

8. Is tooth loss a natural part of aging?

Tooth loss, usually caused by severe tooth decay and gum disease, is not a natural part of aging. In fact, studies show that seniors today keep more of their natural teeth than before. With good oral health and regular visits to your dentist, your teeth can last a lifetime.

Marina C. Cervantes of the Disparities Solutions Center participated in the preparation of these responses.

Lisa Michelle Owens
Joseph R. Betancourt, M.D.
Director of the Disparities Solutions Center, Massachusetts General Hospital

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