The biofilm that settles on teeth is also called plaque.
The plaque consists of about 20% bacteria while the rest is made up of a so-called "extracellular mass", which includes decomposed food particles. Two factors are needed for caries to develop. Sugar and acid-forming bacteria in the plaque. Some bacteria can break down sugars into acids, which break down the enamel layer on the tooth. It's a process that takes a long time. Once the enamel is broken down, the tooth bone (dentin) itself is attacked and if the process is not stopped in time, caries penetrates the nerve of the tooth and a tooth root infection develops. If this happens, there are only two treatment options, either to extract the tooth or to do a root canal. Read more about the concept of the biofilm itself
Caries in adults
Most people think of caries as childhood or adolescent phenomenon. It is true that the incidence peaks among the young, but there is a peak later in life. The cases often seen are caries developing in conjunction with a previously placed filling, popularly called "secondary caries" and in other cases, caries attacks the dentin itself below the enamel line in elderly people who have a reduced gum line. This means that in these cases the bacteria skip the enamel layer and attack the dentin directly, which is of course a rapidly accelerating process.
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What can you do as a patient to avoid caries?
As already mentioned, there must be a plaque with sugar and acid-forming bacteria to develop caries. So first of all, you need to brush your teeth regularly to remove the plaque. Secondly, you can reduce your sugar intake as much as possible, both the direct sugar intake from sugar in coffee and tea, soft drinks, sweets, and cakes, and the indirect sugar intake which is in many industrially produced foods.
It is important to attend dental check-ups so that a caries attack is detected in time before it develops into a more aggressive attack that can cause tooth loss.
Another new approach is to change the composition of the bacteria in the biofilm (plaque) so that the highly acid-forming bacteria are replaced by strains of bacteria that produce almost no acid from sugars.
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