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August 23. 2014 7:02PM

Were you born with good teeth? Maybe, notes Portsmouth dentist

While teeth brushing and overall good dental home care is essential in the prevention of cavities, other factors play a role.

Genetics is one factor, as it helps determine the quality and hardness of the enamel as teeth are formed. "Individuals with softer enamel could be more prone to getting cavities, as the acids that form from sugar intake or the breakdown of foods can more easily penetrate softer enamel, which causes cavities," said Dr. James Fishbein, DDS of Portsmouth.

According to Dr. Bryan Hoertdoerfer, DDS of Hoertdoerfer Dentistry in Manchester, genetics are also responsible for one's overall saliva acidity. "Inability to neutralize saliva can cause more cavities," he added.

Genetics also help determine the shape and placement of teeth, as some people have molars with very deep grooves on the top surfaces, which tend to trap plaque and could lead to cavities.

"When we see children with these deep grooves in their molars and premolars, we may recommend placing sealants on these teeth," said Fishbein, who noted jaw size, tooth size and position can also lead to cavities. "Some situations such as very crowded teeth in a small mouth makes effective plaque removal difficult."

Diet is another cavity-causing factor, as Hoertdoerfer noted people who eat foods high in sugar are much more susceptible to cavities.

"The question is how long does the sugar sit on the teeth?" he said. "It's not just candy either - it's fruit with fructose, milk and lactose. Anything you eat has sugar in it, which is why I recommend restricting and reducing sugar as much as possible."

Fluoride is critical, too, although it is not just the kind one finds in a toothpaste.

"It's whether you had fluoride in your water when you were young or if you had fluoride in your vitamins as a child," Hoertdoerfer said. "That fluoride becomes part of each tooth and makes it stronger. Unfortunately, if you didn't have that as a child, you're not going to get it back."

While genetics, diet and fluoride all play a critical role in helping determine the prevalence of cavities, brushing one's teeth is still key to preventing them.

Brushing tips

Soft bristled toothbrushes are most effective in plaque removal, as the bristles are more flexible and allow you to clean gently under the gums. Harder toothbrushes can cause abrasion of the tooth structure, which leads to defects in the teeth - especially around the necks of the teeth near the gingiva.

It is not necessary to scrub using a death grip on the toothbrush, as gentle brushing is more effective and lessens the chance of causing harm to the teeth and surrounding tissues.

Hold the brush with the bristles at a 45-degree angle, which will allow you to gently clean under the gums where plaque accumulates. Failure to remove this plaque can lead to periodontal (gum) disease.

You should brush your teeth three times a day, two minutes at a time, according to the American Dental Association.

To clean in between the teeth, flossing is most effective, although it is important to do so in an up and down motion rather than back and forth.

"While you can't control your genetics or whether you had fluoride as a child, a proper diet and good home care can prevent many smaller cavities from forming - it can make a difference," Hoertdoerfer said.


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