What causes tooth decay?
Tooth decay is a disease process where the calcified tissues of a tooth are damaged by the acidic byproducts created by bacteria that live in dental plaque when they consume dietary sugars. The formation of tooth decay is not a straight-line process. Instead it is the end result produced during a constant battle between two opposing processes, tooth demineralization and remineralization, when the demineralization process has predominated.
- Tooth demineralization
- Tooth structure demineralization is a process that damages teeth. When it occurs mineral content is literally dissolved from calcified tooth tissues (enamel and dentin) due to the presence of a highly acidic environment. As it progresses over weeks and months, a transition takes place from one of minor tooth surface changes, to the presence of both surface and internal damage, to finally a point where the tooth's structural integrity has been so compromised that an outright hole forms (literally a "cavity").
In order for demineralization to occur, at minimum the following conditions need to be met.
- A location on a tooth where dental plaque is allowed to accumulate.
- A presence of specific types of bacteria in the dental plaque (known as "cariogenic" bacteria, which means bacteria capable of causing tooth decay).
- A sufficient food supply for these bacteria (especially sucrose, also referred to as table sugar).
The idea is that when we eat sugary foods (or types of foods that can be broken down into sugars) the cariogenic bacteria get a meal too. When they digest these sugars the end result is they are broken down into acidic waste byproducts that are ultimately excreted into the dental plaque environment in which they live.
As more and more sugar is digested by the bacteria the acidity of the dental plaque will increase. If it reaches a point where its pH is on the order of 5.5 or lower, conditions are acidic enough that mineral content will be dissolved from the tooth's calcified tissues.
- Tooth remineralization
- Tooth remineralization can be considered to be the reverse of tooth demineralization. Whereas demineralization occurs at dental plaque pH levels of 5.5 and below, remineralization can occur when less acidic conditions exist. During the remineralization process minerals found in the oral environment incorporate themselves into areas where demineralization has previously occurred. Remineralization can be considered to be a healing process that attempts to keep the progress of cavity formation in check.
Xylitol use helps to promote conditions favorable for the remineralization process.
The two processes, demineralization and remineralization, are in constant competition with each other. And whichever process predominates decides what type of decay rate the person will experience.
Individuals who don't brush and floss effectively and constantly snack on sugary foods and beverages will tip the scales in favor of demineralization process and the likelihood that they will experience a high decay rate. Those who practice habits that interfere with allowing all of the elements needed for tooth decay formation to be present (dental plaque, cariogenic bacteria, dietary sugars) will typically maintain an environment having a higher pH range (one that allows remineralization to be the dominant process). Thus offering them the protection and corresponding low decay rate that remineralization offers.
As you read through the pages of this site you will find that xylitol's role in tooth decay prevention is really quite straightforward. Xylitol use helps to prevent those conditions that are required before tooth demineralization can occur. It also may play a role that facilitates the remineralization process.
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