Posts for tag: tooth decay
Until recently, the standard treatment for tooth decay remained essentially the same for nearly a century: Remove any decayed structure, then prepare and fill the cavity. But that singular protocol has begun to change recently.
Although "drilling and filling" saves teeth, it doesn't fully address the causes of decay. In response, dentists have broadened their approach to the disease—the focus now is on an individual patient's particular set of risk factors for decay and how to reduce those.
At the heart of this new approach is a better understanding of oral bacteria, the true cause of decay. Bacteria produce acid, which can erode tooth enamel and create a gateway into the tooth for decay to advance. We therefore want to lower those risk factors that may lead to bacterial growth and elevated acidity.
One of our major objectives in this newer approach is to reduce plaque, a thin film of food particles used by bacteria for food and habitation. Removing plaque, principally through better oral hygiene, in turn reduces decay-causing bacteria.
Plaque isn't the only mechanism for bacterial growth and acidity. Appliances like dentures or retainers accumulate bacteria if not regularly cleaned. Reduced saliva flow, often due to certain medications or smoking, limits this fluid's ability to buffer acid and acid reflux or acidic beverages like sodas, sports or energy drinks can disrupt the mouth's normal pH and increase the risk for enamel erosion.
Our aim, then, is to develop a long-term strategy based on the patient's individual set of oral disease risk factors. To determine those, we'll need to examine their medical history (including family), current health status and lifestyle habits. From there, we can create a specific plan targeting the identified risk factors for decay.
Some of the elements of such a strategy might include:
- Daily brushing and flossing, along with regular dental cleanings;
- Fluoride dental products or treatments to strengthen enamel;
- Changes in diet and excess snacking, and ceasing from any tobacco use;
- Cleaning and maintaining appliances, as well as monitoring past dental work.
Improving the mouth environment by limiting the presence of oral bacteria and acid can reduce the occurrence of tooth decay and the extent of treatment that might be needed. It's a more nuanced approach that can improve dental health.
If you would like more information on tooth decay prevention and treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Decay: How to Assess Your Risk.”
Although we've known for some time how tooth decay forms, it's still prevalent across the population—even more so than cancer or heart disease. Along with gum disease, it's a leading cause of tooth loss.
Fortunately, our knowledge about tooth decay has grown considerably, to the point that we now recognize a number of risk factors that make it more likely a person will develop this disease. By first identifying them in individual patients, we can take steps to address them specifically to reduce the chances of this destructive disease.
Genetics. Researchers have identified around 40 to 50 genes that can influence cavity development. The best way to assess your genetic risk is through family history—if numerous close family members contend with tooth decay, your risk may be high. If so, it's important to be extra vigilant with addressing other areas over which you have more control.
Saliva. Cavities are directly caused by oral acid, a byproduct of bacteria, that can erode tooth enamel over prolonged contact. This is minimized, though, through a normal saliva flow that neutralizes acid and helps remineralize enamel. But poor saliva production can slow acid neutralization. You can improve your saliva flow by drinking more water, changing medications or using saliva-boosting products.
Oral hygiene. You can reduce bacteria (and thus acid) by removing their "room and board"—dental plaque. This accumulating film of food particles harbors the bacteria that feed on it. Daily brushing and flossing, accompanied by regular dental cleanings, effectively removes dental plaque, which in turn lowers the levels of oral bacteria and acid.
Dental-friendly diet. Even if you diligently address the previous risk factors, your diet may fight against your efforts. Diets high in processed and refined foods, especially sugar, provide abundant food sources for bacteria. On the other hand, a diet primarily of whole foods rich in vitamins (especially D) and minerals like calcium and phosphorous strengthen teeth against decay.
Preventing tooth decay isn't a "one-size-fits-all" approach. By identifying your own particular risk, we can craft a care strategy that can be your best defense against this destructive dental disease.
Tooth enamel, to play on a phrase from Shakespeare, is made of “sterner stuff.” The strongest substance in the body, enamel can take years of biting and chewing and keep on going.
It does have one nemesis, though—mouth acid, which can soften and erode enamel’s mineral content. This is less of a concern if you have healthy saliva flow, because saliva neutralizes acid in thirty minutes to an hour after an acid attack and can also help re-mineralize the enamel. Daily brushing and flossing also help curb mouth acid by reducing the bacteria that produces it.
But as effective as saliva is at neutralizing mouth acidity, it can be overwhelmed by outside acid derived through certain foods and beverages. In the past couple of decades, at least two of these acid sources have grown in prominence: energy drinks and, believe it or not, sports drinks.
Just how acidic are they? The pH scale runs from 1 to 14, with acidity on the low end and alkalinity on the higher (7 is neutral). Tooth enamel begins dissolving below 5.5. Laboratory tests have pegged the average pH of energy drinks at 3.05 and sports drinks, 2.91.
Because of their acidity, frequent energy or sports drink consumption will bring mouth pH into the danger zone for tooth enamel. It’s even more likely if these beverages are sipped over an extended period, which can prevent saliva from getting ahead of any newly introduced acid.
Keeping your distance from these beverages is probably the safest bet. But if you do imbibe occasionally, follow these common sense tips:
- Avoid sipping the beverage over long periods—and try to limit drinking them to meal times;
- After drinking a beverage, wash your mouth out with water and wait an hour to brush to give your saliva time to neutralize any acid.
- Practice consistent, daily brushing and flossing.
Above all, keep a healthy respect for acidic foods and beverages like energy and sports drinks and don’t overuse them. Your tooth enamel will appreciate it.
If you would like more information on the effect of sports and energy drinks on dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Think Before You Drink Sports and Energy Beverages.”
Most dental problems arise from tooth decay and periodontal (gum) disease. But they aren't the only source of danger to your teeth—gastroesophageal reflux disease (GERD) could be just as damaging to your tooth enamel as dental disease.
GERD usually occurs when a ring of muscles at the top of the stomach weaken, allowing stomach acid to enter the esophagus. This resulting acid reflux can make life unpleasant and pose potential health dangers—over time it can damage the lining of the esophagus and cause ulcers and pre-cancerous cells. It can also erode tooth enamel if acid enters the mouth and raises its level of acidity.
This can be a problem because acid can soften and dissolve the mineral content of tooth enamel. This is the primary cause of tooth decay as acid produced by oral bacteria attack enamel. The more bacteria present, often thriving in dental plaque, the higher the potential levels of acid that can damage enamel. Stomach acid, which is strong enough to break down food, can cause similar harm to enamel if it causes higher than normal acidity in the mouth.
There are some things you can do to protect your teeth if you have GERD, namely manage your GERD symptoms with lifestyle changes and medication. You may need to avoid alcohol, caffeine or heavily acidic or spicy foods, all known to aggravate GERD symptoms. Quitting smoking and avoiding late night meals might also ease indigestion. And your doctor may recommend over-the-counter or prescription drugs to help control your acid reflux.
You can also boost your teeth's enamel health by practicing daily brushing and flossing—but not right after a reflux episode. The enamel could be softened, so brushing can potentially remove tiny particles of mineral content. Instead, rinse with water mixed with or without a little baking soda to help neutralize acid and wait about an hour—this will give saliva, the mouth's natural acid neutralizer, time to restore the mouth's normal pH level.
And be sure you're using a fluoride toothpaste. Fluoride strengthens enamel—in fact, your dentist may recommend topical fluoride applications to boost the effect.
These and other tips can help minimize the effects of GERD on your dental health. With an ounce of prevention, you can keep it from permanently damaging your teeth.
If you would like more information on managing your dental health with GERD, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “GERD and Oral Health.”
Nothing grabs your attention like a sharp tooth pain, seemingly hitting you out of nowhere while you’re eating or drinking. But there is a reason for your sudden agony and the sooner you find it out, the better the outcome for your oral health.
To understand tooth sensitivity, we need to first look at the three layers of tooth anatomy. In the center is the pulp filled with blood vessels and nerve bundles: it’s completely covered by the next layer dentin, a soft tissue filled with microscopic tubules that transmit sensations like pressure or temperature to the pulp nerves.
The third layer is enamel, which completely covers the crown, the visible part of a tooth. Enamel protects the two innermost tooth layers from disease and also helps muffle sensations so the tooth’s nerves aren’t overwhelmed. The enamel stops at about the gum line; below it the gums provide similar protection and sensation shielding to the dentin of the tooth roots.
Problems occur, though, when the dentin below the gums becomes exposed, most commonly because of periodontal (gum) disease. This bacterial infection caused by dental plaque triggers inflammation, which over time can weaken gum tissues and cause them to detach and shrink back (or recede) from the teeth. This can leave the root area vulnerable to disease and the full brunt of environmental sensations that then travel to the nerves in the pulp.
Tooth decay can also create conditions that cause sensitivity. Decay begins when certain oral bacteria multiply and produce higher than normal levels of acid. The acid in turn dissolves the enamel’s mineral content to create holes (cavities) that expose the dentin. Not treated, the infection can eventually invade the pulp, putting the tooth in danger of being lost unless a root canal treatment is performed to remove the infection and seal the tooth from further infection.
So, if you begin experiencing a jolt of pain while eating or drinking hot or cold foods or beverages, see your dentist as soon as possible to diagnose and treat the underlying cause. And protect your teeth from dental disease by practicing daily brushing and flossing, as well as seeing your dentist for regular dental cleanings and checkups. Don’t ignore those sharp pains—your teeth may be trying to tell you something.
If you would like more information on tooth sensitivity, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treatment of Tooth Sensitivity.”