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蛀牙,真的是虫蛀的吗?

蝌蚪五线谱 2018-07-31

  炎热来袭,在山城的重庆,没有什么比在空调房间里吃火锅、喝冰啤酒更巴适的了!

  一口涮牛肚,一口冰啤酒……

  哎哟,牙好疼!

  拿出小镜子,张开嘴巴,牙齿上黑色的东西好刺眼,漱口漱不掉,刷牙也刷不小,小伙伴惊呼,你的牙齿被虫蛀了!

  真的是这样子的吗?

  其实,我们口中的蛀牙就是龋齿,龋齿不是虫蛀的,是牙齿上面的细菌捣的鬼!

  在说龋齿之前,我们来看看正常的牙齿什么样。

  牙齿的结构(图片来源:image.baidu.com)

  牙齿的结构主要分三层:牙釉质、牙本质和牙髓。

  坚硬的牙釉质住在最外层部,如同牙齿的盔甲,刷牙就像是在给“盔甲”做清洗和保养。每天刷牙,可以有效保护牙釉质。

  牙釉质内部是脆弱的牙髓和牙本质。牙髓的主要组成成分是神经、血管等,牙本质则由许多排列规则的细管——牙本质小管——组成的,管内有神经纤维。

  龋齿模型(图片来源:image.baidu.com)

  既然牙齿有“盔甲”保护,细菌又是如何“攻城略地”、造成龋齿的呢?

  我们知道,细菌无处不在,口腔作为人体呼吸、摄取食物和交流的工具,无时无刻不在跟空气、食物中的细菌打交道。这些细菌很喜欢牙齿上的食物残渣和口腔里面的唾液,如果我们不注意口腔卫生,比如刷牙不彻底或者饭后没有漱口、刷牙的习惯,齿缝里的食物残渣就会成为细菌繁殖的沃土。

  这些细菌绝非善类,就像口腔会分泌唾液一样,细菌也会分泌一些酸性的物质[1]和酶[2],它们是牙釉质的“天敌”,能将坚硬的牙釉质一点点腐蚀掉[2]。盔甲破溃后,这些细菌就会很开心地跑到牙釉质的内部——牙本质里去“玩耍”。细菌分泌的酸性物质和酶也会破坏牙本质,并刺激里面的神经末梢,甚至导致炎症,神经就会把这些消息以痛觉的形式传给大脑:“好痛啊!”。

  这时,如果我们再吃冷热酸甜等刺激性食物,对脆弱的牙神经来说无疑是雪上加霜。缺少牙釉质保护的神经末梢,接触到这些刺激性食物,也会本能地向大脑反馈:“痛痛痛!”

  所以,龋齿不是牙虫捣的鬼,罪魁祸首是细菌!

  牙齿表面的细菌(图片来源:dailymail.co.uk)

  第三次全国口腔健康流行病学抽样调查[4]结果表明, 我国35~44岁年龄段人群的患龋率为88.1%。由此可见,龋齿不是小孩子的“特权”,中年人发生龋齿的概率也高居不下。我们知道恒牙是无法再生的,因此对于龋齿和众多口腔问题,预防是关键[2-4]:

  (1)养成良好的饮食习惯,少吃甜食,多吃富含纤维的食物。

  (2)养成良好的口腔卫生习惯,饭后和吃零食后都要漱口,早晚各刷牙一次,掌握正确的刷牙方法。

  (3)氟化物可以巩固牙齿,用含氟牙膏有助于预防龋齿。对儿童来说,在臼齿完全长成后,可以做窝沟封闭。

  (4)每年最好定期进行口腔检查,早发现,早诊断,早治疗。 

  参考资料:

  [1]Playboy Reporter.Dentists.h2g2[EB/OL].https://h2g2.com/edited_entry/A292376. 2002–01–28/2018–07–19.

  [2]王凌卿.儿童龋齿的发病原因分析及其预防措施[J].医学理论与实践,2014,27(23):3226-3227.

  [3]全国牙病防治指导组. 第三次全国口腔健康流行病学抽样调查 [M]. 北京:人民卫生出版社, 2008:46-47.

  [4]李良忠,张宏印,关雪琳,郝南.大学新生口腔健康状况调查[J].华西口腔医学杂志,2009,27(03):294-296.  

责任编辑:sun

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