Prevention and remineralisation

As the mouth provides a window into an individual’s general health status, strategies to prevent dental problems have evolved over the years.

Research suggests that dental caries might be triggered by three main factors: the host defence mechanism, the oral environment and bacteria. Dental plaque is often seen as the precursor to tooth decay, contributing to the oral cavity’s overall dynamic environment that frequently undergoes rapid changes in pH, nutrient availability and oxygen tension. Under suitable conditions, periodontal pathogens colonise the subgingival environment, incorporating into a tenacious biofilm, impacting both caries and periodontal disease. The plaque bacteria (Streptococcus mutans) demineralise the tooth surface by producing acid through the metabolisation of carbohydrates and therefore attack the minerals in the enamel, the cementum and the dentin. This is also often connected to gum problems and tooth sensitivity.

The late eminent American periodontist, Prof Perry Ratcliff maintained that the causes of periodontal disease are a combination of many processes, including activation of the immune system, alterations in connective gingival tissue metabolism, production of proteinases and cytokines and the destruction of host tissue by bacterial enzymes along with a multitude of other factors. He claimed that extremely low concentrations of volatile sulphur compounds are also highly toxic to the tissues in the mouth.