Dental decay (caries) is the destruction of the tooth enamel and dentine. This process, if allowed to continue, will lead to holes in the teeth requiring fillings or more extensive treatment. There are four requirements to allow dental decay to occur, and eliminating any one of these will reduce the chances of dental decay. These factors are: bacteria (plaque), sugar, teeth and time for the bacteria to work.

There has been a reduction in tooth decay over the last 30 years and this has been related to increased exposure to fluoride, improved levels of oral health and visits to the dentist. Our understanding of diseases has increased dramatically over the decades; and tooth decay is one of the diseases we understand best and can, therefore, reduce.

We can reduce the chances of tooth decay by reducing the amount of bacteria through good and efficient teeth cleaning, using brushes, floss and fluoride toothpaste. You need to be efficient in cleaning your teeth – it is quality not quantity! All the surfaces of your teeth need to be cleaned, especially in between teeth. These are usually the places where decay starts. This will reduce the amount of bacteria present, therefore, reduce the acid the bacteria produces. The bacterium requires sugars to produce acid, so reducing the amount of sugar in your diet would also help in combating tooth decay. Saliva is very important in fighting tooth decay and some research has shown that chewing sugar-free gum after meals increases saliva flow and has a beneficial anti-decay effect.

Tooth decay is one of the most preventable diseases known to man, but I still see patients every day who have holes in their teeth that could have been prevented. With good oral health care, and regular visits to the dentist this can be minimised. There are, however, individuals who are very prone to tooth decay; these are “high risk” or “highly susceptible” patients. These patients have a long history of tooth decay from an early age; have the majority of their teeth filled and require frequent and regular check ups and treatments. Why these patients are high risk we are still not sure; but the same applies to them as everybody else, except that they need extra monitoring by their dentist. The mouth needs to be immaculately clean at all times, you need to reduce or even eliminate sugar, to use fluoride regularly and have frequent and regular dental check ups as advised by your dentist.

Tooth decay is still a common disease and is likely to remain so, but this should decrease with information and education. There are many ways the general public can help themselves, and with the advice above, this should certainly be the case in Guernsey.