What do traditional architecture and tooth decay have in common?
At first blush, maybe nothing, right?
But as you’ll find in this article, our teeth are built very similarly to the way traditional arches were constructed by our ancestors.
While it seems that cavities in teeth happen in a random pattern (wherever we allow the bugs implicated with tooth decay to colonize), cavities actually tend to happen in a very predictable pattern throughout the life of a tooth.
Understanding this pattern can help us pay attention to the various areas depending on what stage in life we find ourselves which helps us make wiser decisions regarding our oral health across the span of our entire lives.
(We are blessed to have amazing professional friends who introduce fascinating ideas for us to research. In this case, we thank our friend Dr. Ellie Phillips for first sharing this idea with us. Here’s a fun expert interview we did with Dr. Phillips titled, ‘How to help your family be free from tooth decay‘)
Teeth – Nature’s archway
Just like how everything in nature is majestic and divinely perfect, the way our teeth form during their development is nothing short of amazing.
Various different types of cells work synergistically to orchestrate the construction of a living, crystal matrix which makes our teeth.
But the pattern these living crystals are ‘stacked’ or formed in isn’t random.
Each of our teeth is formed in a little archway.
I’m not talking about the ‘dental arch’ which is the shape that all of the teeth on our upper and lower jaws form together. In this case, the crystals that form each tooth are ‘stacked’ into an archway.
The hydroxyapatite crystals arrange themselves almost like bricks in a wall into this precise architecture required to form an archway.
Incidentally, this is why early childhood nutrition is so critically important for the healthy expression of the child’s genetic potential. For that matter, our nutritional needs preconception (of both the woman and man) also play into the puzzle for the child’s genetic expression.
Without the necessary nutrition during development (or imbalanced exposure in the case of too much fluoride) the teeth can form in a less-than-optimal structure and never reach their full potential.
How archways are built
Several years ago, we lived in Ashland, Oregon. One of the coolest things for us about Ashland (other than the community for sure!) was a place called, Science Works. Science Works is an experiential educational center for kids (of all ages! I’m not sure who enjoyed going there more, the children or parents!)
One of the cool ‘learn while you play’ experiences there, was a 5’ tall archway made out of pillow blocks. It was always a favorite as kids would build the archway, then knock it down, only to do it again.
When building the archway, the last piece to go in place is the ‘capstone’ which is the one piece at the very top and holds all the other pieces in place.
While all pieces of an archway are equally important, it’s easy to see the capstone as the iconic ‘most important’.
After all, if the capstone is compromised or not properly placed, each stack on either side of the arch would collapse from leaning into the middle.
For an arch to hold strong through challenges and stresses, it needs strong side pillars, resilient pieces when the pillar begins to ‘lean’ inward, and of course, a strong, well-placed capstone.
So, let’s bring this archway discussion into each of our mouths…
The first insult of decay on most teeth…
Dr. Ellie first introduced this idea that decay happens in a rather orderly fashion in most cases.
Focusing specifically on molars, the chewing surface (called occlusal surface in dentistry) is almost always the first surface to become compromised by decay.
If you think back to your own youth (or feel back through the molars in your mouth) you’ll most likely notice that many, if not all, of your molars, have a filling in the deepest part of the chewing surface. (Incidentally, this is the argument dentistry makes for sealants. Here’s our view on the safety of dental sealants.)
Nature’s perfect archway now has a different capstone at the top.
Rather than the perfectly stacked living crystals throughout to support the archway, now a different material is holding the precious capstone position.
The next domino to fall…
(From my vast experience watching foam block archways be constructed and smashed :), when an archway collapses from the capstone being compromised, the most common next spot to break is roughly halfway between the base and the pieces near the top right next to the capstone.
If we translate this into the archway in each of our teeth, this point is right around where one molar butts up again his/her neighbor on either side.
Dentistry calls this region ‘proximal or interproximal’ (where two teeth meet).
Incidentally, this is why for years dentistry has promoted flossing, to reduce the risk of interproximal cavities. While the myth that flossing reduces the risk of cavities between teeth has been disproven, here’s why we still feel that flossing can be a healthy habit.
Final region to decay…
Once the capstone and beginning arch have been compromised, the only part left to decay is the base.
The side of the tooth, where the enamel crown stops and meets with the tooth root, normally is the last region of a tooth to suffer from decay.
Interestingly, if you have any fillings along/under the gum line, notice that they are on the ‘outside’ surface (called the buccal – ‘buckle’ surface). We believe there is a strong argument that the reason why root decay occurs most often on this outer facing surface is because less saliva reaches these areas compared to inward facing surfaces. Here’s an article how saliva provides so much benefit for our oral health.
One problem with fillings…
Ok, so we’ve established that our teeth are little living archways. How decay first strikes the ‘capstone’ of our molars. And how the decay process follows a fairly consistent path of degradation.
What happens when we place a filling at the capstone that isn’t ‘just right’?
Let’s also factor into the equation that filling materials (both amalgam and composite) have the tendency to expand and contract in size based on exposure to varying temperatures.
You don’t have to be an architect to see the inherent risks of having a capstone that changes its shape/size, even if in very, very small amounts, like what occurs with dental fillings.
In fact, it’s not a big leap to ponder whether the potential of filling expansion/contraction could increase the speed in which the tooth is next compromised at the interproximal point on each tooth.
While we haven’t done any research on the validity of whether having an occlusal (capstone) filling speeds the compromise of other regions, clearly, the real solution is to maintain the perfect arch in one intact piece and avoid having decay that requires dental restorations at all.
Thus our mission and focus to help each of us better understand the various aspects involved in walking this path to optimal oral health.
Each of us understanding and sharing these gems provides us and even more importantly, future generations, the opportunity to live a cavity free life.
If you find benefit from this information, please help us help others and share this article with your loved ones. Also, you’ll find several helpful articles and resources listed below.
Helpful, Related Resources:
How to help your family be free from tooth decay [[expert interview video with Dr Ellie Phillips]]
Are dental sealants safe? [article]
Is fluoride safe to use? [article]
Is flossing actually bad for you? [article]
Is the key to greater oral health already in your mouth? [article]
Putting the pieces together to reverse cavities and remineralize your teeth [article]
Sources:
Amazing article.
All the info I was looking for in one place keep writing ?? : )
Wonderful Article, you write up very well. How diet is important and other things you mention in your posting which is really helpful for readers.
Very interesting! If one has fillings, it is best to avoid sharp differences in temperature of the food and drinks. A hot tea is about 71 degrees Celcius, 34 above body temperature, ice cream at -10 C is 47 below body temperature. From hot tea to ice cream, the difference is a screaming 81 C ! Avoiding extreme will reduce the expansion compression of the fillings.
So…would there be any conclusions that could reasonably be drawn in an instance where this pattern is not being followed? The only fillings I had, my whole life, were a couple small ones in about the dead center of the buccal surface of a couple of molars. Never had another problem until the past few years (I’m in my 30s, with several pregnancies now in my history), when I have a number of rear molars disintegrating from the gumline outward (and one around that old filling, which makes sense to me — I assume the filling itself compromises the tooth). Nothing is decaying from the chewing surface. I wonder if this suggests the cause of my tooth decay is atypical?
Really good points here Rachel.
I wonder if you had sealants to ‘protect’ the occlusal surfaces of your molars? Not sure here. I think this pattern is generally recognized as typical progression of decay.