July 1st, 2009 by admin

Plaque is the cause of caries, and a
tooth which is completely free of plaque will not decay
.
However, it is not always possible to demonstrate a strong association
between the presence of dental plaque and caries, and there are some obvious
reasons for this. For one thing, people are not able to completely remove plaque
themselves, even with supervision. In addition, although the bacterial biofilm
is the cause of caries, there are other factors involved. This is why caries is
described as a multifactorial disease. These factors may increase or decrease the
rate of demineralization.
To give examples, increased sugar intake and decreased salivary  ow
speed up the carious process. On the other hand,  uoride tends to decrease
the rate of mineral loss. Thus it is not only amount of plaque that matters but
the combined effect of all the factors, and the combination of factors, which
will vary from patient to patient.
Brushing twice daily with a  uoride toothpaste has been advocated by the
profession for many years, and this behaviour is a routine part of many people’s
behaviour. This daily brushing with a  uoride toothpaste is believed to be the
primary reason for the decline of caries observed in many populations since the
1970s. The behaviour should not be taken for granted. Patients should always
be asked whether, and how often, they brush their teeth and what toothpaste
they use. Most toothpastes contain  uoride, but not all, and it is important to
check this. In UK a well-known brand of toothpaste for sensitive teeth is pro-
duced in a number of  avours, and at the time of writing, not all these products
contain  uoride. Since cavities in teeth can be sensitive to hot and cold, it is not
unusual for patients with caries to select a toothpaste for sensitive teeth. Thus
the very person who most needs a  uoride toothpaste is sometimes not using it.
Some herbal toothpastes are also formulated in a  uoride-free form