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Tooth Decay — How To Assess Your Risk

Don’t Wait For Cavities — Stop Them Before They Start!

By Dr. V. Kim Kutsch and Dr. Douglas A. Young

This article is endorsed by the
American Academy of Cosmetic Dentistry.


Diagnosis and Prevention — Testing

Today it is possible to test for the acid-producing bacteria by taking a sample of your plaque (biofilm) and testing it for acid producing bacteria. You can also try to eradicate these bacteria by changing the conditions (pH balance) of your mouth. Testing meters can now give estimates of acid producing bacteria in 15 seconds. A reading from 0 - 1500 correlates with low risk and a reading of 1501-9999 correlates with higher risk.

Testing meter.
Testing meters can evaluate your mouth chemistry and determine its potential for causing tooth decay.

This provides a diagnosis based on your personal risk, which is important for three reasons. Firstly, it is based on identifiable evidence, secondly, it can be modified based on recommendations and actions, and thirdly, repeating the procedure can objectively measure progress at reducing your personal risk of tooth decay.

In addition to the traditional things you’ve always been recommended to do, treatment and preventive strategies are now based on your personal risk. If your risk for tooth decay is high, it can be reduced or eradicated. Some of the newer and more specific methods and agents include:

  • Rinses containing a safe dilution of sodium hypochlorite solution that can kill bacteria and lower acidity (raise pH). Other products are available that are designed to balance an acidic mouth (keep the pH neutral) and encourage more normal bacteria.
  • Rinses containing chlorhexidine, an antibacterial agent, are used to reduce bacterial counts, thereby disrupting their influence and ability to cause disease.
  • Fluoride containing products strengthen enamel surfaces making them more resistant to decay while encouraging re-mineralization.
  • Xylitol, a natural “sugar alcohol” used for years as a sweetener and alternative to sucrose (table sugar), is known to disrupt the ability of acid-producing bacteria to thrive and attach to teeth. Xylitol is available in a rinse, spray, chewing gum, as well as breath-mints.
  • Calcium and phosphate minerals naturally exist in saliva; they promote re-mineralization. Dental products that contain or mimic them can help re-mineralize the teeth, especially if saliva is lacking (as in dry mouth.)

Based on known science, a Caries Management By Risk Assessment (CAMBRA) dental professional can quickly and easily assess your risk and recommend appropriate measures that you should try as part of your daily oral/dental health regimen.

Finally, it’s about partnership. Your relationship with your dental office team is based on both a scientific approach as well as caring health professionals who working together will ensure dental decay is a disease of your past.