It seems like the ads are everywhere these days—repair your enamel and reverse tooth decay with a tube of toothpaste! Are these claims too good to be true? Let’s dive into the science of tooth decay—how decay develops and how (and if!) it can be reversed.

Teeth can stand up to the powerful pressures of biting and chewing because over 95% of our enamel is made up of minerals. Calcium and phosphate ions in our teeth bond to form a crystal structure called hydroxyapatite. Because of the strength of this crystalline design, tooth enamel is the hardest substance in our bodies, even stronger than our bones. 

But bones, like most other parts of our bodies, are living tissue, which means that they can create new cells to replace old or damaged cells. Tooth enamel can’t regenerate new cells to repair itself. This means that when a cavity has made a hole in the tooth, the enamel can’t grow back. And, while enamel structure is very strong, it’s also vulnerable to damage—specifically, damage from acids. 

Our teeth are exposed to acids throughout the day, whether they are acids created by plaque bacteria or the acidic foods and drinks we consume. Acids dissolve mineral bonds, stripping calcium and phosphate minerals from the enamel and leaving weak spots in the tooth surface. This process is called demineralization. Demineralization is the first stage of tooth decay.

The good news? Our bodies are designed with a built-in defense mechanism to prevent demineralization from causing lasting damage. All through the day, saliva helps wash away acids in the mouth and bathes our teeth with new calcium and phosphate ions. These ions bond with the calcium and phosphate in our enamel, restoring enamel strength. This protective repair process is called remineralization. 

Now for the bad news. In the tug of war between demineralization and remineralization, saliva can only do so much. If your diet is heavy with acids, if you don’t brush away acid-producing plaque bacteria regularly, if you eat a lot of the sugars and starches which feed plaque bacteria, the remineralizing effects of saliva can’t keep up with the demineralizing effects of acids.

The first visible sign of demineralization is often a white spot on the tooth where minerals have been stripped from enamel. Studies have shown that enamel-strengthening toothpaste can be effective in this very first stage of tooth decay. Toothpastes which advertise enamel repair generally contain one or more of these ingredients:

• Calcium Phosphate
• Hydroxyapatite
• Fluoride 

Toothpastes with calcium phosphate or hydroxyapatite contain calcium and phosphate minerals, the building blocks of tooth enamel. Studies have suggested that these minerals can replace the calcium and phosphate ions stripped from enamel. These toothpastes may or may not contain fluoride, which is something you should discuss with your dentist before deciding on a specific toothpaste.

Fluoride toothpastes remineralize enamel—and more! Fluoride ions are attracted to the tooth’s surface, and, when fluoride ions join with the calcium and phosphate ions there, they form fluorapatite. Fluorapatite crystals are larger, stronger, and more resistant to acids than hydroxyapatite crystals. And, once bonded with tooth enamel, fluoride attracts the calcium and phosphate ions in saliva to remineralize the teeth more quickly. 

Why consider enamel-repair toothpaste? 

Once enamel is gone, it’s gone for good. If excess demineralization isn’t treated, a weak spot on the tooth surface will continue to erode, growing bigger and deeper until it becomes a hole in the enamel. This is a cavity, and your dentist will need to treat and repair your tooth to prevent the cavity from growing and potentially exposing the tooth’s pulp to bacteria and infection. 

If you wear braces, you want to be especially careful about excess demineralization. Because it can be hard to brush and floss effectively with braces, white spots and discolored patches are a common concern for those with braces, especially on the enamel around brackets.  

Talk to Drs. Cartsos and Zavras at our Chestnut Hill, Massachusetts office about which toothpastes can help restore a healthy balance between the ongoing cycles of demineralization and remineralization when you have braces. While tooth-repair toothpaste can’t fix cavities, these products can often strengthen demineralized enamel and reverse this earliest stage of tooth decay.

Taking care of your oral health involves a daily regimen of brushing, flossing, and rinsing to prevent tooth decay and bacterial infections. Though you may have asked us which toothbrush to use, few patients at Convivial Dental ask about mouthwash.

However, different mouthwashes you might choose will have varying effects on your oral health. So which type is best for you?

Gum Health

Antiseptic mouthwashes are designed to reduce the majority of bacteria on and near the gum line. Using an antiseptic mouthwash can help decrease your chances of developing gingivitis. If possible, look for a mouthwash with antibacterial or antimicrobial ingredients.

Fluoride

Fluoride is beneficial for oral health and can help prevent tooth decay. If you drink a lot of bottled water without fluoride, we may recommend that you purchase a rinse with fluoride in it.

Bad Breath

Although mouthwash is designed to prevent bacterial build-up within the mouth, many people use it to combat bad breath. Most mouthwashes will help eliminate the bacteria that cause bad breath, and some are specifically designed to do so.

However, if bad breath is a chronic problem that requires daily treatment with a mouth rinse, contact Convivial Dental to discuss your symptoms.

American Dental Association Approval

The ADA reviews mouth rinses for safety and effectiveness. A mouthwash with the ADA Seal of Approval will meet strict criteria, and will have scientific evidence or clinical studies that support the claims of the manufacturer. If possible, select a mouthwash that bears the ADA Seal of Approval to ensure you are using a quality rinse.

Considerations

If you are unsure as to which mouthwash is right for you, contact our Chestnut Hill, Massachusetts office or ask Drs. Cartsos and Zavras during your next visit. Also, be sure to keep mouthwash out of the reach of children, as it contains alcohol and other substances that could be harmful to them. Avoid letting children under age six use a mouth rinse, and discontinue use if you experience a burning sensation in the soft tissues of your mouth.

If you’re brushing your teeth twice a day during your orthodontic treatment, Drs. Cartsos and Zavras and our team think that’s wonderful! But, don’t forget that it’s also important for you to visit your general dentist every six months, or as recommended, in addition to brushing your teeth and flossing. (And visiting Convivial Dental for regular adjustments, of course.)

Dental checkups are crucial for maintaining good oral health. Your general dentist can check for problems that might not be seen or felt, detect cavities and early signs of tooth decay, as well as catch and treat oral health problems early. During an oral exam, your dentist can also check the health of your mouth, teeth, gums, cheeks, and tongue. Checkups will also include a thorough teeth cleaning and polishing.

If you have not been to the dentist in the last six months, let us know during your next adjustment visit and we will provide a few great references in the Chestnut Hill, Massachusetts area!

The Convivial Dental team knows that oral hygiene is important, whether you have braces on your teeth or not. But if you are a person who wears braces, caring for your teeth and gums can become somewhat challenging. Without daily oral hygiene practices, you may become prone to cavities and tooth decay during your time in braces.

Naturally, you know that brushing your teeth each morning and night, as well as after you eat, will help keep your mouth healthy and clean during the months you wear braces. But flossing is also an important part of your hygiene routine. Flossing with braces can be tricky, but it’s not impossible. Drs. Cartsos and Zavras, your general dentist, or your dental hygienist can help you become more comfortable and adept at flossing your teeth during the months you wear braces.

Flossing Tips for Those with Braces

• Use Tools Provided by Our Office. A floss threader is a small, plastic needle that will help you floss between the wires and your teeth. Thread a 12-to-18-inch piece of floss onto the needle, and use the needle to get the floss easily behind the wires.
• Flossing Under the Wires. Once the floss is behind the wires, use your hands to manipulate the floss. Move it up and down along the wires to remove food particles.
• Flossing Between Your Teeth. Floss between your teeth as you normally would without braces. Move the floss up and down between your teeth, using a clean section of floss for each tooth.
• After You Finish Flossing. Your orthodontist may have suggested that you use a water pik or proxy brush after you finish brushing. Either of these tools will help remove any loosened food particles to ensure that your teeth and braces are clean.

Continue Good Oral Hygiene Habits

Good oral hygiene habits you use while wearing braces will help you achieve the beautiful smile you and the Convivial Dental team have been working toward. Once your braces are off, it may be tempting to slack off on the brushing and flossing. Don’t let yourself fall into any habits that will have a negative impact on your oral health or the attractive smile you waited for throughout the months you wore braces. See your general dentist for regular cleanings, and continue to brush and floss your teeth each day.