Posts for tag: tooth decay
As we age we become more susceptible to dental diseases. A common but often initially unnoticed problem for seniors is root decay.
We’re all familiar with tooth decay in the crown, the visible tooth above the gum line. Bacteria feeding on leftover sugar in the mouth produce acid, which at high levels erodes the teeth’s protective enamel. This forms cavities and, if untreated, deeper infection within the tooth that could reach the bone via the root canals.
But decay can also directly attack a tooth’s roots below the gum line. Roots are made of dentin and covered by a very thin layer of mineralized tooth structure called cementum. Cementum, which is much softer than enamel, is often lost because of its thinness, thus exposing the root’s dentin. This can make the area more susceptible to decay than the enamel-covered crown. Normally, though, the roots also have the gums covering them as added protection against bacterial infection.
But gum recession (shrinkage), a common experience for people in their later years, can expose the root surfaces. As a result, the roots become much more susceptible to decay. And an ensuing infection could spread more quickly into the interior of the tooth than decay originating in the crown.
That’s why it’s important to remove the decayed material and fill the root cavity to prevent the infection’s spread. While similar to a crown filling, the treatment can be more difficult if the root cavity extends below the gum line. In this case, we may need to perform a surgical procedure to access the cavity.
There are other things we can do to help prevent root cavities or limit their damage. We can apply fluoride varnish to strengthen the teeth and provide extra protection against cavities, or prescribe a fluoride rinse for use at home. We can also keep an eye out and treat periodontal (gum) disease, the main cause for gum recession.
The most important thing, though, is what you do: brush and floss thoroughly each day to remove bacterial plaque and limit sugary or acidic foods in your diet. Preventing decay and treating cavities as soon as possible will help ensure you’ll keep your teeth healthy and functional all through your senior years.
Since the late 19th Century, dentists have used established protocols to successfully prevent and treat tooth decay. But there've been changes to this approach the last few years to improve its effectiveness, changes we now refer to as Minimally Invasive Dentistry or MID.
The older approach for treating dental caries (tooth decay) follows the protocols established by Dr. G.V. Black, considered the father of modern dentistry. Black advocated removing not only decayed structure but also some of the healthier but vulnerable portions of a tooth, to avoid further decay and make the tooth easier to clean. This resulted in larger fillings, although they've become smaller as dental techniques have advanced.
MID, on the other hand, aims to remove as little tooth structure as possible while still effectively treating and preventing future decay. To achieve that goal we begin first with a complete assessment of a patient's individual decay risk, known as Caries Management By Risk Assessment (CAMBRA).
With CAMBRA, we're looking at other factors besides individual tooth health: a patient's hygiene, lifestyle and dietary habits; the types and amount of bacteria present; and the quality of saliva flow, needed to neutralize mouth acid. With these the results we develop a customized prevention and treatment strategy.
MID also focuses on detecting dental caries as early as possible. Besides traditional x-rays, we're beginning to use other methods like dental microscopes, laser fluorescence, infrared photography or optical scanning. Early detection leads to early intervention, and with techniques that are much less invasive than the traditional approach.
The new approach also changes how we repair decayed teeth. We're increasingly using air abrasion, a technology that uses fine particles in a pressurized air stream to remove softer decayed tooth material and less healthy structure than the traditional dental drill. We're also using composite resin and other advanced materials for filings: these tooth-colored materials are stronger than previous versions and are quickly taking the place of metal amalgam, requiring less structural removal to accommodate them.
MID's core principles are early disease detection, proactive prevention and treatment with less structural removal. With this enhanced approach to effective dentistry, we're keeping your teeth healthy with minimal discomfort, lower costs and less long-term impact.
Among our most common diseases, tooth decay can be a big problem at any age: in the U.S., one in four children 5 and under has some form of the disease, as well as ninety percent of those 60 and older — and a quarter of those have suffered complete tooth loss.
Fortunately, we now know what needs to be done on a regular basis to prevent tooth decay. Unfortunately, many are uninformed about all they need to do to lower their risk.
Here, then, are 5 questions to ask yourself to see if you’re on the right prevention path or not.
Do I brush and floss daily? If not, you’re aiding and abetting the “enemy” — bacteria that cause tooth decay. Bacteria that make up plaque feed on any food remnants that adhere to tooth surfaces. Brushing at least once daily (twice is better) removes plaque, while flossing removes plaque between teeth that can’t be reached with a brush. Removing plaque will lower your mouth’s acid levels that cause a loss of minerals to the enamel surface.
Do I use the proper techniques for brushing and flossing? While it’s important to establish daily hygiene habits, if you’re not performing them properly you won’t realize the full benefit from your efforts. But don’t dismay — we can train you in the proper techniques for brushing and flossing your teeth.
Do I use fluoride toothpaste? This naturally-occurring chemical strengthens tooth enamel and makes it more resistant to decay. You can increase fluoride’s absorption rate into enamel by using hygiene products that contain it.
Do I constantly snack between meals? Saliva neutralizes acid remaining in the mouth after eating in about 30 to 60 minutes. If you’re constantly snacking or sipping acidic beverages, however, saliva can’t do this effectively. It’s best to limit snacking to a few, specific times and restrict acidic beverages to meal time only.
Do I visit the dentist for cleanings and checkups? While brushing and flossing reduce plaque, it can’t remove it from hard-to-reach places below the gums or harder deposits (calculus) that have developed. A professional cleaning twice a year removes the plaque and calculus left from daily hygiene. We can also gauge the health of your teeth and determine if tooth decay or gum disease may be developing.
If you would like more information on tooth decay prevention, 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.”
Ever wonder just exactly what causes cavities? Once upon a time, “Toothworms” — miniscule, yet relentless pests — were thought to be responsible for this widespread malady. This belief persisted from ancient times through the 17th Century; William Shakespeare even made reference to the baneful beasts in his play Much Ado about Nothing. (“What, sigh for a toothache? [It] is but a humor or a worm.”) Today, however, we know why no one ever observed an honest-to-goodness toothworm: it’s because they’re much too tiny to see with the naked eye.
Actually, it isn’t worms, but much smaller organisms that cause tooth decay. These harmful plaque bacteria (along with many helpful microorganisms) live in the mouth, and build up on surfaces of the teeth when they aren’t cleaned properly. They feed on sugar in the diet, and release substances that erode tooth enamel, which causes small holes called cavities. Cavities, in turn, are what’s responsible for most toothaches.
While we may scoff at old legends, one fact remains: Even today, according to the National Institutes of Health, tooth decay is the number one chronic disease of both children and adults; and it’s almost entirely preventable. We can’t blame it on toothworms — but what can we do about it?
Glad you asked! The best way to avoid decay is through prevention. That means brushing your teeth twice a day with a fluoride toothpaste, and flossing them every day. It also means eating a balanced diet and avoiding acidic and sugary foods — like soda, some juices, and sweet, sticky snacks. If you do consume these types of foods, limit them to mealtimes; that gives your saliva enough time in between to neutralize the acids naturally. And, of course, make an appointment see us twice a year for a complete check-up and professional cleaning.
If you do begin to notice the symptoms of tooth decay (toothache, for example) it’s important to come in to the dental office right away, so we can treat the problem before it gets worse. Prompt action can often help save a tooth that might otherwise be lost. Besides filling the cavity, we may be also able to recommend ways to help prevent the disease from affecting other teeth. And if you need a more extensive procedure to relieve the problem — such as a root canal — we can make sure you get the appropriate treatment.
We’ve come a long way since the “toothworm” days — but we can still do a lot more to make tooth decay a thing of the past.
If you would like more information about tooth decay and cavity prevention, please contact us or schedule an appointment. You can learn more in the Dear Doctor magazine article “Tooth Decay — The World’s Oldest & Most Widespread Disease” and “Tooth Decay — How To Assess Your Risk.”
Dentists go to great lengths to save an adult permanent tooth. Even though restoration technology is incredibly advanced, none can completely replace the biological function of natural teeth. Treating a diseased tooth to preserve it is a high priority in dentistry.
It would seem, though, that a child’s primary (baby) tooth might not warrant the same treatment. Since the tooth eventually detaches from the jaw to make way for a permanent tooth, why save it?
It is worth the effort, because primary teeth provide more than a chewing function: they also serve as guides for their permanent successors. When they’re lost prematurely, the permanent teeth may not come in correctly, leading to a malocclusion (poor bite). Other areas of development, like speech and dental bone growth, may suffer as well from the longer time gap between the premature loss and the permanent tooth eruption.
Saving an infected primary tooth should be considered, especially if significant time remains in its lifespan. Due to differences between primary and permanent teeth, though, the treatment approach isn’t the same. For example, the body gradually absorbs the roots of a primary tooth (a process called resorption) as the permanent tooth beneath erupts applying pressure to the primary roots (this is what enables its eventual detachment). Dentists must factor this process into their diagnosis and treatment plan for a primary tooth.
The level of treatment may vary depending on how deep the infection has advanced. If the decay is limited to the tooth’s outer layers and only partially affects the pulp, the innermost layer of the tooth, a dentist may remove as much soft decay as possible, apply an antibacterial agent for any remaining hardened infection, and then restore the tooth with filling materials.
For deeper infection, the dentist may remove some or all of the pulp, disinfect and clean the area, and then fill and seal the empty space with a filling. A filling material like zinc oxide/eugenol paste should be used that’s capable of resorption by the body to coincide with the natural root resorption. After treatment, the tooth should continue to be monitored for changes in appearance or gum swelling, just in case the infection returns or advances.
Although it may seem counterintuitive, treating a primary tooth as you would its successor is worth the effort. Your child will reap the health benefits, both now and long after the primary tooth is gone.
If you would like more information on endodontic treatment for children, 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 “Root Canal Treatment for Children’s Teeth.”