Posts for tag: tooth decay
For several decades, dentists have been saving teeth from tooth decay following a few basic guidelines: 1) Identify decay as soon as possible; 2) Thoroughly remove decayed tooth structure; and 3) Fill any cavities. With millions of diseased teeth rescued, observing these simple steps have proven a rousing success.
But as with most things, even this successful protocol isn't perfect. For one, some healthy tissue gets removed along with the diseased portions. The average percentage of "collateral damage" has dropped over the years, but it still happens—and a reduction in healthy tissue can make a tooth less structurally sound.
Another drawback, at least from the patient's perspective, is the dental drill used for removing decay and preparing cavities for filling. Many people find drilling unpleasant, whether from its vibrations in the mouth or its high-pitched whine. The drill's burr head design also contributes to greater healthy tissue loss.
But those weaknesses have lessened over the last few years, thanks to innovations on a number of fronts.
Better risk management. Tooth decay doesn't occur out of thin air—it arises out of risk factors unique to an individual patient like personal hygiene, bacterial load, saliva production or even genetics. Taking the time to identify a patient's "tooth decay risk score" can lead to customized treatments and practices that can minimize the occurrence of decay.
Earlier detection. Like other aspects of dental health, the sooner we detect decay, the less damage it causes and the more successful our treatment. X-rays remain the workhorse for detecting decay, but now with improvements like digital film and better equipment. We're also using newer technologies like laser fluorescence and infrared technology that can "see" decay that might otherwise go undetected.
Less invasive treatment. The dental drill is now being used less with the advent of air abrasion technology. Air abrasion utilizes a concentrated spray of particles to remove diseased tooth structure more precisely than drilling. That means less healthy tissue loss—and a more pleasant (and quieter!) experience for the patient.
In effect, "less is more" could describe these improvements to traditional decay treatment. They and other methods promise healthier teeth and happier patients.
If you would like more information on current treatments for tooth decay, 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 “Minimally Invasive Dentistry: When Less Care is More.”
Preventing tooth decay from developing in your child's teeth requires a strong commitment to daily oral hygiene. But if you have a child with a chronic physical or behavioral condition, you might find it difficult to keep that commitment in the light of other pressing health needs.
But tooth decay is just as important a health issue as the others with which you may contend. Because primary teeth guide incoming permanent teeth to erupt properly, losing them prematurely can lead to a poor bite and other associated problems. This could further diminish their quality of life already compromised by their chronic condition.
Helping your special needs child avoid tooth decay isn't easy—but it can be done. Here's how!
Brush and floss for them. Normally, a parent's goal is to help their children learn to care for their teeth on their own. But depending on the nature of your child's chronic disease, that may not be possible. Instead, you may need to take an active role in their daily hygiene for the foreseeable future, even brushing and flossing for them if necessary.
Model proper dental care. Even so, it's still a good idea to guide them toward performing oral hygiene tasks without assistance, according to their abilities. This could be a long road, though, one that requires your active participation. You can ease this process by continuously modeling good dental care behavior for them through brushing and flossing together.
See an understanding dentist. Although caring for a special needs child can be isolating, you don't have to go at it alone. That includes taking care of their teeth and gums: A dentist who has both training and experience in treating children with chronic health conditions can become an important partner in your efforts to fight tooth decay.
Communicate between all care providers. Likewise, having everyone involved in your child's care on the same page can make decay prevention a much easier process. Be sure then to share your concerns about your child's needs, including dental care, with attending physicians, therapists and, of course, dentists.
If you would like more information on dental care for special needs 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 “Managing Tooth Decay in Children With Chronic Diseases.”
Finding out you have a cavity isn't the best of news. But finding out it's a root cavity is even worse: if not treated, the decay can spread more rapidly than a cavity occurring in the tooth's crown surfaces.
Our teeth are basically composed of two parts: the crown, the visible tooth above the gum line, and the roots, the hidden portion beneath the gums. The root in turn fits into a bony socket within the jaw to help hold the tooth in place (along with attached gum ligaments).
A tooth crown is covered by an ultra-hard layer of enamel, which ordinarily protects it from harmful bacteria. But when acid produced by bacteria comes into prolonged contact with enamel, it can soften and erode its mineral content and lead to a cavity.
In contrast to enamel, the roots have a thin layer of material called cementum. Although it offers some protection, it's not at the same performance level as enamel. But roots are also normally covered by the gums, which rounds out their protection.
But what happens when the gums shrink back or recede? This often occurs with gum disease and is more prevalent in older people (and why root cavities are also more common among seniors). The exposed area of the roots with only cementum standing in the way of bacteria and acid becomes more susceptible to cavity formation.
Root cavities can be treated in much the same way as those that occur in the crown. We first remove any decayed tooth structure with a drill and then place a filling. But there's also a scenario in which the cavity is below the gum line: In that case, we may need to gain access to the cavity surgically through the gums.
If you have exposed root areas, we can also treat these with fluoride to strengthen the area against cavity formation. And, as always, prevention is the best treatment: maintain a daily schedule of brushing and flossing and regular dental cleanings to remove bacterial plaque.
Because decay can spread within a tooth, dealing with a root cavity should be done as promptly as possible. But if we diagnose and initiate treatment early, your chances of a good outcome are high.
If you would like more information on treating root cavities and other forms of tooth decay, 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 Cavities.”
Although techniques and materials have changed, dentists still follow basic principles for treating tooth decay that date from the late 19th Century. And for good reason: They work. These principles first developed by Dr. G.V. Black—the "father of modern dentistry"—are widely credited with saving millions of teeth over the last century.
One of the most important of these treatment protocols is something known as "extension for prevention." In basic terms, it means a dentist removes not only decayed tooth structure but also healthy structure vulnerable to decay. But although effective in saving teeth, practicing this principle can result in loss of otherwise healthy tissue, which can weaken the tooth.
But with new advances in dentistry, decay treatment is getting an overhaul. While Dr. Black's time-tested protocols remain foundational, dentists are finding new ways to preserve more of the tooth structure in a concept known as minimally invasive dentistry (MID).
Better diagnostic tools. Because tooth decay can ultimately infect and damage the tooth's interior, roots and supporting bone, the best way to preserve more of the tooth structure is to treat it as early as possible. Now, new diagnostic tools like digital x-rays, microscopic magnification and optical scanning are helping dentists detect and treat decay earlier, thus reducing how much tissue is removed.
Better prevention methods. Oral hygiene and regular dental care are our basic weapons in the war with tooth decay. In addition, utilizing topical fluoride in combination with a milk-derived product called CPP-ACP dentists can get more of the cavity-fighting organic compound into the tooth enamel to strengthen it against acid attack.
Better treatment techniques. Using air abrasion (a fine particle spray that works like a miniature sandblaster) and lasers, dentists can now remove decayed structure with less harm to healthy tissue than with a traditional dental drill. And new, stronger dental fillings like those made with composite resins require less structural removal to accommodate them.
With these innovative approaches, dentists aren't just saving teeth, they're preserving more of their structure. And that can improve your overall dental health for the long-term.
If you would like more information on minimally invasive dentistry, 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 “Minimally Invasive Dentistry: When Less Care is More.”
Although dental care has made incredible advances over the last century, the underlying approach to treating tooth decay has changed little. Today’s dentists treat a decayed tooth in much the same way as their counterparts from the early 20th Century: remove all decayed structure, prepare the tooth and fill the cavity.
Dentists still use that approach not only because of its effectiveness, but also because no other alternative has emerged to match it. But that may change in the not-too-distant future according to recent research.
A research team at Kings College, London has found that a drug called Tideglusib, used for treating Alzheimer’s disease, appears to also stimulate teeth to regrow some of its structure. The drug seemed to cause stem cells to produce dentin, one of the tooth’s main structural layers.
During experimentation, the researchers drilled holes in mouse teeth. They then placed within the holes tiny sponges soaked with Tideglusib. They found that within a matter of weeks the holes had filled with dentin produced by the teeth themselves.
Dentin regeneration isn’t a new phenomenon, but other occurrences of regrowth have only produced it in tiny amounts. The Kings College research, though, gives rise to the hope that stem cell stimulation could produce dentin on a much larger scale. If that proves out, our teeth may be able to create restorations by “filling themselves” that are much more durable and with possibly fewer complications.
As with any medical breakthrough, the practical application for this new discovery may be several years away. But because the medication responsible for dentin regeneration in these experiments with mouse teeth is already available and in use, the process toward an application with dental patients could be relatively short.
If so, a new biological approach to treating tooth decay may one day replace the time-tested filling method we currently use. One day, you won’t need a filling from a dentist—your teeth may do it for you.