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by mishu2 632 days ago
While there are indeed many factors (genetics, the specifics of the microbiome in your mouth, probably some we don't even understand at the moment) at play, oral hygiene (and diet for caries, but not gum disease) is currently considered by far the most important modifiable risk factor.
1 comments
alphazard 632 days ago
Considered by who? Dentists, or scientists? Dentists seem to be about 5-10 years behind the research on this topic. I know of a single practice that has started doing oral microbiome testing.

We know that caries are caused by acid eroding the teeth. And we know which bacterial species produce this acid, how quickly they secrete it, and how common they are. The most significant source is Strep. Mutans. Sugar is an input to this process, and Xylitol (a sugar alcohol) can kill this bacteria selectively.

Diet is probably the most significant way to affect gum disease. Gum disease is associated with systemic inflammation and auto-immunity. The same dietary interventions that are used to treat those conditions also treat gum disease.

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mishu2 632 days ago
> Dentists seem to be about 5-10 years behind the research on this topic.

Generalizations are usually not helpful, I think it really depends on the dentist. I'm not sure there are proven benefits to oral microbiome testing, except in some very specific cases.

> The most significant cause for caries is S. mutans.

The 'Beyond Streptococcus mutans' section in TFA explains that the situation is much more complex than this; even if it is, good oral hygiene and reduced sugar intake (both in quantity and frequency) are still the best way to reduce the amount of biofilm present on teeth (which is a requirement for caries formation, whether S. mutans is there or not).

> Diet is the most significant way to affect gum disease.

The current clinical treatment guidelines for periodontitis[1,2] only mention that the benefit of weight-reducing diet and lifestyle changes is unclear (for treating periodontitis, obviously), and that oral hygiene is still the most important thing you can do yourself for the prevention, and, once established, to assist in the treatment of the disease.

[1] Infographic: https://www.efp.org/fileadmin/uploads/efp/Photos/Continuing_...

[2] Source article: https://onlinelibrary.wiley.com/doi/10.1111/jcpe.13290

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