Tooth decay is the number one childhood disease in the US. Although it is largely preventable, it is five times more common than asthma. As our knowledge of this disease process deepens, it is clearer that this is a complex disease. However, in order to prevent decay, it is obvious that simply fixing cavities does nothing to effectively treat the disease process.
Decay is an infectious disease located in the biofilm on teeth. Since teeth are the only non-shedding surface on the body, the biofilms on teeth tend to be more diverse and complex than previously understood. A healthy mouth will have around 113 different bacterial species present, while a person with high risk for decay will have an average of only 94. Why the lower number? It appears that mouths with lower pH (more acidic) will push the biofilm to destroy harmless species, cause harmful bacteria to multiply, and even cause some bacteria to change metabolism to become harmful and multiply in a more acidic environment. Thus fewer (but more harmful) bacterial species is a function of pH not sugar availability. The lower pH can come from type of diet (external), acid reflux (internal), or lack of ability to buffer the pH to prevent its lowering. The goal of raising the pH of the saliva may be the simplest, most broad sweep approach to preventing decay, overcoming the complexities of other methods like vaccines, gene therapies, or antimicrobials. Carifree.com is the only company to bring products to the market designed to improve the pH of the mouth to alter the composition of the biofilm. Their site has more in depth information on assessing your risk and the research behind the validity of this approach to reducing our most common disease.
The dental profession is beginning to recognize the value of diagnosing the disease risk as opposed to simply repairing teeth. Identifying individuals at risk and altering the pH of the susceptible to prevent decay is future of preventive dentistry.