Here are a few sites to look over for some info that may help...

http://www.ada.org/public/topics/decay.asp

http://www.animated-teeth.com/tooth_decay/t1_tooth_decay_cavities.htm

http://en.wikipedia.org/wiki/Tooth_decay

Don't apologize for asking questions! See if these resources give you some
of the basic info, and let us know if you have any other specific questions.

T

Hi Tulert,
I don't know you personally or your oral hygiene habits, but I believe
your problems are caused by your diet. As you say, you will eat
something while reading and this will probably happen quite often in
your reading sessions, which are frequent since you are a student.
Everytime you eat something containing sugar, the acidity of your oral
environment is increased and your teeth attacked. Saliva will usually
be able to decrease the acidity to normal levels within a couple of
hours. This means that if you eat through your reading sessions, you
pretty much ensure that your mouth will be full of acids for the whole
day, which is very damaging to your teeth.
Frequency is much more important than quantity. It is much better to
eat 10 chocolates within 10 minutes than 3 chocolates throughout the
day. Also remember, that most of the food we eat in the western world
is processed and refined. Hidden sugar is everyway, from orange juice
to snacks. Check labels before eating something and pick healthy
snacks.
What I think is that you have to alter your diet significantly, so that
it contains the normal 3 meals and little more. Apart from that, a high
fluoride regiment will work; this may come in the form of a high
fluoride toothpaste (like duraphat) or mouthwash, which are usually
prescription medications and not over the counter, at least in my part
of the world. Since your permanent teeth have already been fully formed
and erupted , I don't see how calcium can help you. Stick with
fluoride.
You should visit your dentist at least every 6 months initially and
have bitewing xrays taken to monitor the progress of those early decay
lesions. They might remineralise without progressing to full cavities.

Regards,
George

Hi,
I'm not a dentist, just a guy with bad teeth not unlike you. I have
been told by dentists that some people do have softer and more
sensitive teeth than other people. My whole family both on my dad and
my mom's sides had bad teeth. Could be that no one took care of them;
I know I did not until I was about 22 and by then I'd already lost 1/3
of my teeth but that was I believe as much the fault of a faulty
dentist (read: malpractice) as it was anything I did.

Nevertheless I do believe there is a genetic component to extremely
bad teeth, but then again, I'm not a dentist; and I know some dentists
say the genetic aspect is minimal.

So I don't know who to believe. All I know is that I know people who
NEVER floss and only brush once or twice a day, eat sugar, never go
for a cleaning and they have strong teeth at the age of 60. So yes I
think there is a genetic component.

The bottom line is this: we have bad teeth. So what do we do about it?

In my case, I started brushing after every meal. Even if you have to
get one of those little "travel toothbrushes" and carry it with you
and brush once during the day, then once in the morning after
breakfast, and once after dinner.

Flossing I think is the key that screwed me up. I hated flossing and
just could not get myself to do it. What finally got me at least
somewhat into it are these little hand-held "floss picks" like
toothpicks but with a strand of floss on the end. It's not as good as
"regular flossing" I've been told but it beats not flossing at all.
And I hate using regular strands of floss wrapped around my finger.
Can't explain why, but I just hate it. So I use these Dentek Silk
Floss floss picks.

But the thing is, I brushed 2-3 times a day, brushed well, used
mouthwash, and STILL kept getting cavities. The only thing I did not
do "by the book" besides using floss was that I would sometimes not go
in for a teeth cleaning for a year or two. I have now also corrected
that.

From what I have learned, if you have teeth that aren't too strong to
begin with, you probably need to be VERY DILIGENT about all the above
plus not drink or eat sugar. I do use sugar in my tea (tea, while it
may stain your teeth is good for your teeth and gums; especially green
tea; and if you need sweetener use xylitol.) but use only 1/3 sugar
and 2/3 xylitol, then I do brush later.

Since you are having trouble doing it twice a day I'd recommend in the
morning after you get up and the evening before you go to bed. The
whole idea with placque formation is to disturb it  after x hours.
Sure its better if you brush  after you eat, but you already know you
don't.

In the morning, floss (same bit about placque formation)

If you can afford it, buy an electric tooth brush, like soni-care.
They have timmers on them that will makse sure you brush for at least
2 minutes

During the day, after eating, rinse your mouth with water. If there is
food between your teeth, get it out with a toothpick I like the soft
plastic toothpicks called brushpicks, They are soft and sturdy  enough
you can't jam or break them between teeth. like you can with wooden
toothpicks

If you want to get "fanatic' carry a tooth brush and dry brush after
meals ( back to that disturb the placque business)

--G

Where do you live?  From your email address, it looks like West England, but
you said you were in the US.  Let me know and I can recommend a good dental
school which could be close to where you are.  The work done in the dental
school will be VERY closely supervised by dentists, so that's not a problem
when a student does the work; they will have had a minimum of 2 years of
dental school before they treat you, and maybe more.  Also, the cost to you
will be about 1/2 of the cost at a private dentist.

Gel Kam is ok, but the Prevident would be much better!

The Trident has VERY little xylitol in it; it's mostly sweetened with
sorbitol and mannitol, both of which are not nearly as good as xylitol for
someone like you.  Don't waste your money on Trident, get something like
Epic or Spry, which you can find on the web -- the companies are in Utah.

I would get the cavities treated asap, but it's impossible to say how bad
they are without seeing them.  If they are small, they could become
"arrested" and not progress any further, sort of like healing.  If they are
past that stage, then they'll need to be restored.  Don't use the
chlorhexidine if the cavities are deep and need treatment; wait until they
are restored.

Let me know where you live.

If you go to a dental school GRADUATE STUDENT they are nearly
full-fledged dentists, AND have their profs supervising. My experience
with a grad student has been great. Of course they are still not cheap
by any means, but they are cheaper than most dentist offices, and the
best thing is that you are not being sold crap you don't need. For
basic filling and stuff I would trust a regular dental student. For
more involved things such as root canals and bridges, etc., I'd want a
grad student.

Here's a source for Spry chewing gum and also xylitol sugar substitute
in bulk:
http://www.xylitolforyou.com/products.html

Combine xylitol sugar substitute with green tea and you have a
mouth-healthy drink! You can use it in virtually anything you would
put sugar in, it has the same consistency as sugar, it's just a little
less sweet (and more expensive). But if you don't use a lot of sugar
in the first place, it really lasts a long time.

I have a PDF file with my X-rays. If you don't mind I can send it to you or
post somewhere. I think most of them would require restoration (given my
earlier experiences).

I'm, in Illinois, in one
of the Chicago suburbs. I bet there are a lot of dental schools around.

___________________________________________

Not anymore. Northwestern and Loyola both had great dental schools, but
were forced to close them due to the high costs of dental education.
The University of Illinois would be a good place to go.

Use the Gel-Kam if you didn't get a Prevident prescription.

best regards,
- dentaldoc

It's a bit difficult to see what's what with the radiographs but not seeing
you.  It also looks like in some areas the bone has begun to receed a bit.
Do you use dental floss regularly?  Has your dentist mentioned anything
about periodontal disease [gum disease]?  This is an insidious, painless
disease that if left untreated will continue to progress and you could end
up loosing teeth.  The major problems with the decay have been taken care of
from what you say, so that's good.  You really need to get on top of things
very soon to prevent more problems from developing.  It's good that you're
aware of the problem and have decided to seek some type of treatment.  If
you're going back to the UK soon, you might want to visit a dental school
there.  Dental schools generally have fees that are significantly lower and
the work that's done is generally excellent, and under the direct
supervision of faculty dentists.  Good luck!

_________________________________

Your films show that #4, #5, #6, #10, #13 and #19 have obvious lesions
with an immediate need for restoration. (As you mentioned, #19 could be
a chip.)

It's good that #4, #5, and #19 have already been treated.

Also, as you mentioned, the spots on #2 and #3 (also on #14, #18, #31
and others) could be a radiolucent restorative material, or could be
something else. It would take a visual exam to help determine that
question.

#30 has a severe bone loss in the furcation. That is not a good sign.
That could be a cracked root or a perforation. Either way, it needs to
be diagnosed in order to determine a course of treatment.

The angulation of the upper anterior films leaves teeth #7 and #10
partially obscured. That's why I strongly prefer to use the #1 size
xray film for anteriors instead of the #2 size film -- the smaller #1
size film allows better angulation for the picture, and thus better
visualization and diagnosis. Tooth #10 appears to have a possible
problem on the mesial, and tooth #7 needs a better picture.

Also, teeth #12 and #21 are almost completely missing from the bitewing
films. I would recommend taking that left side bitewing film over
again, in order to show these two teeth sufficiently to enable a
diagnosis.

I am particularly concerned about teeth #30 and #6, as these require a
close exam to determine their condition, and we can't do that over the
Internet.

Best of luck to you,
- dentaldoc