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.”
While mouth pain can certainly get your attention, what exactly hurts may be difficult to identify. It might seem to emanate from a single tooth, or a group of teeth. Then again, it might not be clear whether it's coming from teeth or from the gums.
Still, it's important to pinpoint the cause as much as possible to treat it correctly. One of the main questions we often want to answer is whether the cause originates from within a tooth or without.
In the first case, tooth decay may have entered the pulp at the center of the tooth. The pulp contains nerve bundles that can come under attack from decay and transmit pain signals. Incidentally, if the pain suddenly goes away, it may simply mean the nerves have died and not the infection.
The decay can also spread into the root canals leading to the root and supporting bone, and then make the jump into the gum tissues. One possible sign of this is the one mentioned earlier—you can't quite tell if the pain is from the tooth or the surrounding gums.
The root canals could also serve as a transportation medium for infection in the other direction. In that case, gum disease has advanced into the bone tissues around a tooth near its roots. The infection can then cross into the tooth. Again, both a tooth and the gum tissue around it can become diseased.
We have effective treatments for individual occurrences of interior tooth decay or gum disease: The former usually requires a root canal treatment to remove infected tissue and fill and seal the tooth from future infection; we alleviate gum disease by removing the dental plaque causing it and helping the gum tissues to heal. But combined tooth and gum infection scenarios are more difficult to treat, have a poorer prognosis and may require specialists.
To reduce the risk of either tooth decay or gum disease developing into this greater problem, it's best to take action at the first sign of trouble. So, see your dentist as soon as possible when you encounter oral pain or if you notice swollen or bleeding gums. The earlier we treat the initial outbreak of disease, be it tooth decay or gum disease, the better your chances of a successful and happy outcome.
If you would like more information on tooth pain, 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 “Confusing Tooth Pain.”
If you do the right things—keep your teeth clean, see the dentist regularly, and eat a "tooth-friendly" diet—you stand a good chance of having healthy teeth and gums later in life. Even so, after eating well over 75,000 meals by age 70, you can expect some wear from all that biting and chewing.
But there's normal wear—and then there's excessive wear, which can be caused by a variety of factors. When it occurs, accelerated wear can increase your risk of dental disease—and your shorter-toothed smile can make you look older than your actual age.
Here are 3 dental problems that can lead to accelerated tooth wear, and what you can do about them.
Tooth decay. This dental disease can severely weaken a tooth's protective enamel surface, which can in turn increase wear. You can minimize your chances of developing tooth decay by brushing and flossing your teeth daily and undergoing regular dental cleanings. And the sooner you receive treatment for any diagnosed decay, the less likely your enamel will suffer significant damage.
Poor bite. Properly aligned teeth mesh well together while biting and chewing, which minimizes wearing. But misalignments put undue stress on teeth that can lead to accelerated wear. By correcting a bite problem through orthodontics, we can properly align teeth so that they interact with each other normally for less wear.
Teeth grinding. This unconscious habit of gnashing or grinding teeth (often during sleep) can produce abnormally high biting forces. Among other adverse outcomes, this can also increase teeth wearing. If you grind your teeth, there are therapeutic methods that could reduce the habit. You can also obtain a custom night guard to reduce biting forces while you sleep.
If you've already experienced excessive dental wear, there are cosmetic options like porcelain veneers or dental bonding that can restore your smile to a more youthful appearance and help protect your teeth. But if you haven't reached that point, you can make sure you don't by taking care of your teeth and gums and seeking prompt dental treatment for problems leading to accelerated wear.
If you would like more information on teeth wear, 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 “How and Why Teeth Wear.”
Ashley Graham has a beautiful and valuable smile—an important asset to her bustling career as a plus-size model and television host. But she recently revealed on Instagram a “confrontation” between one of her teeth and a frozen oatmeal cookie. The cookie won.
Holding her hand over her mouth during the video until the last moment, Graham explained how she sneaked a cookie from her mom's freezer and took a bite of the frozen treat. Taking her hand from her mouth, she revealed her broken tooth.
Okay, maybe it wasn't an actual tooth that was broken: the denticle in question appeared to have been previously altered to accommodate a porcelain veneer or crown. But whatever was once there wasn't there anymore.
Although her smile was restored without too much fuss, Graham's experience is still a cautionary tale for anyone with dental work (and kudos to her for being a good sport and sharing it). Although dental work in general is quite durable, it is not immune to damage. Biting down on something hard, even as delicious as one of mom's frozen oatmeal cookies, could run you the risk of popping off a veneer or loosening a crown.
To paraphrase an old saying: Take care of your dental work, and it will take care of you. Don't use your teeth in ways that put your dental work at risk, tempting as it may be given your mouth's mechanical capabilities.
Even so, it's unwise—both for dental work and for natural teeth—to use your teeth and jaws for tasks like cracking nuts or prying open containers. You should also avoid biting into foods or substances with hard textures like ice or a rock-hard cookie from the freezer, especially if you have veneers or other cosmetic improvements.
It's equally important to clean your mouth daily, and undergo professional cleanings at least twice a year. That might not seem so important at first since disease-causing organisms won't infect your dental work's nonliving materials. But infection can wreak havoc on natural tissues like gums, remaining teeth or underlying bone that together often support dental enhancements. Losing that support could lead to losing your dental work.
And it's always a good idea to have dental work, particularly dentures, checked regularly. Conditions in the mouth can change, sometimes without you noticing them, so periodic examinations by a trained dental provider could prevent or treat a problem before it adversely affects your dental work.
We're glad Ashley Graham's trademark smile wasn't permanently harmed by that frozen cookie, and yours probably wouldn't be either in a similar situation. But don't take any chances, and follow these common sense tips for protecting your dental work.
If you would like more information on care and maintenance of cosmetic dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty as Never Before” and “Dental Implant Maintenance.”
Your child's dental development is in overdrive between birth and early adulthood. The rapid growth of the teeth, gums and jaws occurs mostly on its own—but tooth decay could significantly derail it.
Although most cases of dental disease occur in adults, tooth decay is a major problem for children, particularly involving primary teeth. These teeth are much more important than they seem given their short lifespans: Because they help incoming permanent teeth to align properly, their premature loss due to decay can create future bite problems.
To prevent this from happening, taking steps to prevent tooth decay in young children is well worth the effort. The best strategy is a double-pronged approach. You'll first want to address certain areas that directly contribute to tooth decay. You'll then want to add measures that strengthen the teeth themselves against the disease.
In regard to the former, reducing the levels of harmful bacteria in the mouth tops the list. These bacteria produce acid as a byproduct that in turn softens and erodes enamel, the teeth's natural barrier against decay. We reduce bacteria by eliminating dental plaque, a film of built-up food particles that feeds and shelters bacteria, through daily brushing and flossing.
Certain dietary choices may also contribute to bacterial growth. Refined sugar is a prime food source for bacteria, so limiting it in the diet will help reduce tooth decay. Furthermore, a diet rich in whole, unprocessed foods and dairy provide nutrients strengthen teeth against decay.
The other prong in defeating tooth decay mainly involves protective measures provided by your dentist. Sealants applied to the chewing surfaces of a child's teeth help protect the enamel from the buildup of bacteria in these highly susceptible areas. An occasional direct application of fluoride to teeth further strengthens their enamel, and makes them less susceptible to decay.
This approach can minimize the chances of tooth decay, but it won't eliminate the risk altogether. If it does occur despite your best efforts, prompt treatment can limit the damage and preserve the teeth. Working with your dentist, you can help ensure your child's teeth are protected from this damaging disease.
If you would like more information on best dental care practices 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 “Dentistry & Oral Health for Children.”
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