The Prevalence and Preventability of Tooth Decay

If I asked you to list the top 10 most prevalent diseases in the world, you would most likely begin listing diseases such as diabetes, asthma, acne, or perhaps even Alzheimer’s disease. However, much to the surprise of many, dental caries, more commonly known as tooth decay, really should make an appearance in that list. Although tooth decay is prevalent, particularly throughout the western world, it is also highly preventable and has been occurring more and more often in recent years. In fact, a paper by Dr. Robert Bagramian from the University of Michigan School of Dentistry labeled dental caries as a, "pending public health crisis."

Recently, a shift in diet of the western world has lead to the prevalence of tooth decay. Historically, people have eaten a diet consisting of proteins, carbohydrates, and fats. However, more recently there has been a trending shift where people shy away from fats and replace them with carbohydrates, namely, sugars; and this is part of why tooth decay is running rampant. Tooth decay occurs when bacteria in the mouth feed off of sugars, left over from eating, in the mouth. After processing the sugars, the bacteria then excrete an acid. According to webMD.com, these acids will persist in the mouth for about 20 minutes after you eat, causing tooth decay. Additionally, these acids can become trapped in food and other material in the mouth, persisting for much longer and forming a plaque. This makes most people highly susceptible to suffering from tooth decay. Below are some examples of what extreme tooth decay can look like.

Child Presenting with Severe Tooth Decay

Tooth decay is extremely prevalent, including richer countries. According to the Center for Disease Control, tooth decay, while largely preventable, is the most prevalent disease in children and adolescents aged from 6 to 19.  This is a particularly appalling statistic because, like the Center for Disease Control said, it’s largely preventable. They also cite that tooth decay is four times more common than asthma in adolescents and children. Finally, they cite that 9 out of 10 adults over the age of 20 have, or will have, some form of tooth root decay during their lifetimes. If these statistics alone are not saddening enough, perhaps worst of all is how preventable this disease really is. To illustrate this, below is a map of the world showing the prevalence of dental caries by the number of decayed, filled or missing teeth for 12 year old children for a given country.

Map Showing Average Number of Decayed, Missing and Filled Teeth in 12-year-olds

Although tooth decay is prevalent, it is very easily preventable. In fact, simplest way to prevent tooth decay is for one to brush their teeth twice a day using a sugar-free fluoridated tooth paste. The American Dental Association includes this along with the following as a comprehensive method to prevent tooth decay: cleaning in between your teeth with floss or an interdental cleaner, eating nutritionally balanced meals and limiting snacking, visiting a dentist regularly for cleaning and oral examination, and checking with your dentist whether or not supplemental fluoride and/or dental sealants may be appropriate for you to use. The adoption of these measures by people throughout the world would lead to a significant decline in the prevalence of tooth decay. There are some people, however, who will still suffer from tooth decay because they are predisposed to the disease. The Center for Disease Control cites one example of a condition which does not directly cause tooth decay but accelerates the process is xerostomia, commonly known as dry mouth.

In summary, although tooth decay is prevalent, it does not have to be. While tooth decay is currently one of the most prevalent diseases in western society, particularly among the young, simple oral hygene can be used to almost completely prevent the disease. Although there are some cases where people are predisposed to tooth decay, they remain as the very few, and failure to adhere to the simple guidelines of the Center for Disease Control and other professional sources are the true cause for the disease.

Photos courtesy of:
1) Imaging Systems

2) The Royal College of Surgeons