Shiloh: For this experiment, my foster brother
had experienced horrible tooth decay, and
he was only five years old.
I was told he drank lots of sugary drinks
like sodas and juices.
Which conditions caused all this decay?
Is there anything he can do to help prevent
further decay?
Dr. Raczka: Those are good questions.
So, what likely caused the cavity in the first
place, sounds like his diet, okay.
By eating a lot of sugar, that is what contributed
to the cavities.
The cavity process is more complex than what
I'm about to tell you, but it's easier to
understand it this way, is in our mouth we
have a ton of bacteria, thousands and thousands
of bacteria, and those naturally occurring,
and in the sterile environment they generally
don't cause a problem at all, but when they
combine with the carbohydrates from sugary
foods, they produce an acid, and the acid
then sits on our teeth if it's not brushed
off or removed in another way.
Then over time, the acid starts to wear away
the outer layer, called the enamel of your
tooth.
And as it progresses its way inward, it starts
forming a cavity, which is basically a hole
in your tooth.
So, the fact that your cousin ate all these,
or your step brother, ate all these sugary
foods then the bacteria in his mouth started
to interact with that and caused this acid.
So, the ways you can prevent it are very simple,
actually, is to minimize his exposure to foods
that have sugar, or anything with high carbohydrates,
and two, to also be brushing and removing
in it effectively so that the plaque in our
mouth doesn't have an opportunity to react
to the acid.
Shiloh: Okay.
Here is my next question.
So in your years of experience, what is the
most common culprit of tooth decay that you've
ever seen?
Dr. Raczka: Pretty much that.
And the factor in that the poor oral hygiene
in that community and a diet that is very
high in sugar.
Shiloh: Mm-hmm (affirmative) In my experiment I performed
three trials of soaking hollowed out eggshells
for five days in Coca-Cola, orange juice and
water.
I measured the pH values before and after
the experiment.
There was no change in the pH of the water.
It stayed at pH of seven.
For orange juice it changed from a pH of a
four to a pH of a six.
And for the Coca-Cola it changed from pH of
three to a pH of seven.
Could you help me explain why this occurred?
Dr. Raczka: I can't explain that (laughs).
I'm afraid I can not explain that.
They're both very acidic and why they became
more basic over that time period,
I'm afraid I do not have an answer for you
there.
That might be good for another research experiment.
Shiloh: Yeah.
The eggshell soaked in Coca-Cola showed the
most staining.
Does staining mean there's also decay?
Dr Raczka: No.
No.
You can have a lot of stain and the teeth
can be rock solid hard.
Staining does not necessarily indicate a cavity.
Sometimes staining can be a cavity, but not
always.
Shiloh: The orange juice soaked eggshell seemed to
have had a breakdown in the outer layer of
the shell but had less staining.
Is this what you would expect to see?
Dr. Raczka: Well, the less staining I would definitely
expect to see.
In orange juice that does not surprise me.
As far as breaking down the shell, there may
be something in orange juice different from the
soda that interacts with a component of that
shell.
I don't know exactly what an eggshell is comprised
of.
But I would think that even the soda had some
breakdown, but maybe just more apparent in
the orange juice.
I wouldn't necessarily read too much into
that.
But the staining, sure.
Orange juice definitely just does not stain
as much as Coke or coffee or various things
like that.
That does not surprise me.
Shiloh: What role does soda explain a person's having
teeth which will or will not decay?
Dr. Raczka: That is a difficult question to answer.
It has been debated for years and years and
years.
What scientists have found is that early on
during the development of your primary or
your baby teeth and perhaps a little bit in
the permanent teeth, is that genetics has
more of a role then when you get older.
They have located some genes that may be associated
with decay, but can they single out certain
lines in certain people that they should be
contributing, have not been able to replicate
anything like that.
So their thoughts are is that as I said early
on, your gene's may contribute to the development
of a cavity and it's really because the plaque,
which is a bacteria that interacts with the
acid and carbohydrates, that may be what you
call, it maybe inherited and as a result,
maybe even your stepbrothers young age, there's
possibly a genetic component in that.
But what they have found is that as we've
gotten older, by the time you're probably
10 or 12 the environment overtakes the power
of genetics, so it's more environmental factors
that are contributing to the development of
decay then genetics.
And as I said, it's really, it's more complex
than how simple I tried to make it because
it has to do with the components of your saliva
as well.
You know what really is in that plaque microbiome.
Just you know, things that interact in your
mouth so that genetic component, there's still
a question in that and that is something that
I can assure you that people are in labs as
we speak trying to see how big a role it really
does play and is that something that we can
affect.
So, I guess early on, yes, genetics may play
a role, but by the time you're into puberty
and for the rest of your life, the environment
is much more powerful than any genetic component
could be.
Shiloh: That's very interesting.
Dr. RaczkaYes.
Shiloh: Well, thank you so much for helping!
Dr. Raczka: I did find one thing of value for you. You can take this.
That's yours if you'd like and just kind of
goes over.
The big thing is what we're seeing more in
our population today than we did when your
mother was growing up or when I'm even much
older that her, when I was growing up is because
there's a role of how acidic foods are.
When I was growing up and your mother we drank
a lot more milk and water from the tap.
Nowadays, people are drinking from bottles,
which do not have fluoride and we're drinking
a lot more soda and sports drinks like Gatorade
and those are all very acidic to begin with.
And so we do tend to see more cavities nowadays
from these reasons than we used to.
And we also see a lot more wear.
There's something, a term called acid erosion,
which is not a cavity, but if you start to
see, see how the whiter here and then that
is white here.
Shiloh: Mm-hmm (affirmative).
Dr. Raczka: So this is the enamel, the outer layer of
the tooth structure, this here.
Much more white and we call this it's radiopaque
because anything that's white on an x-ray
is opaque.
So this is the enamel.
Now if you'll look here, you see a little
dark spot right there?
Shiloh: Mm-hmm (affirmative).
Dr. Raczka: That's the beginnings of the cavity.
Okay, right here.
So in this patient, I would not recommend
that we fill the tooth yet because in order
for us to want to fill a cavity, we generally
want that to be at least halfway through the
enamel.
This right now just a little tiny spec.
So what did I tell this patient?
I told him, you know what, you have the beginnings
of a cavity, something we call incipient decay.
You need to go home and you need to make sure
you floss every day because it's right in
between here is where you'd be flossing to
remove any plaque or food that gets stuck
in there.
Obviously you brush.
And the last thing I want you to do is to
rinse with a fluoride rinse for one full minute
every night.
Swish it around your mouth really well, and
then you spit it out and you can't rinse your
mouth out for half an hour and can't eat or
drink for half an hour.
So it gives time for the fluoride in that
rinse to penetrate that because that fluoride
can go right to that spot and it can stop
it right away.
It can stop it from progressing and it can
actually remineralize it and you can make
that stronger.
So a year from now, when I take that next
x-ray, I'm going to zoom in for sure at that
spot.
Now, what happened over the past year?
Did that get bigger?
Because now do I have to fill it?
Did it stay the same to which we'll continue
to monitor it or did it actually shrink a
little bit because it got remineralized?
Shiloh: So interesting because I just also am not
a dentist or anything, but just I wouldn't
have even noticed anything so small.
Dr. Raczka: You're right.
It is very small.
Obviously my eye is trained but you're right,
but that's the critical part of that is noticing
things early on.
Try to be proactive.
So the next time, as I said, if that gets
to be more than halfway through that outer
layer of the enamel then at that point we
need to do a filling.
This here, as long as we're here, I'll just
go over this with you a little bit.
So this is, as I said, this white portion
on the x-ray is the enamel, the outer layer.
Then this is the dentin, the inner layer.
This is more yellow in color and I'm sure
you've seen it on your models and then this
is what I know you see it on your model, but
the pulp or the nerve tissue, this is what
it looks like on an x-ray.
And I'll show you this individual just had
a root canal.
He had trauma to one of his front teeth.
It doesn't show up real well in this x-ray,
but you can see, see this little white material,
goes all the way down to down the root.
That's what a root canal looks like when it's
all done.
They removed all the bacteria and the bacterial
byproducts, the nerve is in that and all of the
blood vessels are in there too.
So everything had been removed during your
root canal process and now you have a hollow
tube and you have to fill that.
So that's what a filling looks like on the
root canal.
Not the same type of filling we would do on
the front of your tooth but it's a filling
material, different type.
 
 
