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.”
The Millennials, those born around the turn of the Millennium in 2000, are entering adulthood. Like any generation, they have their collective promise—and problems. An example of the latter seems to involve their teeth: an estimated one in three people between the ages of 18 and 34 have some form of tooth decay.
If a recent survey is correct, that may be a result of poor oral hygiene practices. The absence of a consistent, daily habit of brushing and flossing to remove disease-causing dental plaque is the number one cause for dental disease. But a survey of 2,000 millennials found only three in ten brushed their teeth at least once a day with many often skipping brushing for two or more days a time.
Interestingly, more than half of the survey also reported an aversion to dental visits. That will likely need to change if these trends in poor hygiene continue, as aging millennials will eventually need extensive treatment for tooth decay and its close counterpart periodontal (gum) disease to save their teeth. Dental professionals recommend a different dental care track: stop dental disease before it develops. And the key to that is a simple but powerful daily brushing and flossing routine.
This routine should involve brushing teeth up to twice and flossing at least once a day. Brushing should be done with gentle strokes, but include all exposed tooth surfaces (about two minutes to perform a thorough job). Flossing is less popular than brushing, but it’s essential for removing plaque between teeth your brush can’t reach. To make it easier, you can use pre-threaded floss or a water flosser that removes plaque with a stream of water.
To round out your prevention strategy, you should see a dentist at least twice a year for professional cleanings of hardened plaque deposits (calculus), as well as overall monitoring of your dental health. And if dental visits make you anxious, your dental professional has a number of ways to help you relax.
One thing’s for sure: like any other generation, millennials prize both good health and an attractive smile. Adopting a solid oral hygiene lifestyle will do the most to achieve both.
August is National Wellness Month. Since part of staying in good overall health is taking care of your dental health, it's a good time to look at ways you can improve and maintain your oral health. Here are some tips:
Practice good oral hygiene. A fundamental key to a long life of healthy teeth and gums is keeping them clean of dental plaque. This thin biofilm of bacteria and food particles is the number one cause of tooth decay and periodontal (gum) disease. Brushing twice and flossing once each day gets rid of that unpleasant grittiness and reduces your risk of disease.
See your dentist regularly. A good daily oral hygiene habit works best at controlling soft plaque. But any that you miss—a possibility even with great brushing and flossing skill—can harden into calculus (tartar). To remove it, you'll need professional cleaning by a dental professional. The American Dental Association recommends a comprehensive dental cleaning at least twice a year to fully minimize your disease risk.
Eat a low-sugar, dental-friendly diet. Oral bacteria love to feast on the leftovers from your eating, especially sugar. So, cutting back on foods with added sugar isn't just good for other aspects of your health, it can also help "starve out" bacteria and reduce their population in your mouth. You can also boost oral health by eating foods rich in minerals like calcium to maintain strong bones and teeth, and antioxidants that guard against oral cancer.
See your dentist at the first sign of problems. While hygiene, dental care and a nutritious diet can greatly reduce your risk of disease, it won't eliminate it completely. So see your dentist promptly if you notice red, swollen or bleeding gums, mouth pain or unusual spots on your teeth. The sooner you're diagnosed and treated, the less damage from dental disease and future treatment expense you'll endure.
Manage other inflammatory conditions. If you're dealing with a condition like heart disease, diabetes or arthritis, it could increase your risk of gum disease or make any occurrence of it worse. That's because gum disease and many systemic conditions share chronic inflammation as a common link. If an inflammatory condition is not managed through proper treatment, it could worsen any gum disease symptoms you have.
Pursuing wellness is a worthy goal—just be sure you include your oral health in the mix. A healthy mouth is a key ingredient for a healthy life. If you would like more information about gaining and maintaining optimum oral health, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Daily Oral Hygiene” and “Good Oral Health Leads to Better Health Overall.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
Tooth decay is a destructive oral disease, which along with periodontal (gum) disease is most responsible for tooth loss. And as you age, your disease risk goes up.
One form of decay older people often experience is root cavities. Unlike those occurring in the visible crown, root cavities often occur below the gum line and are especially destructive to tooth structure.
That's because, unlike the crown protected by ultra-hard enamel, the roots are covered by a thin, mineralized material called cementum. Although cementum offers some protection, it can't compare with the decay-resistant capacity of enamel.
The roots also depend on gum coverage for protection. But unfortunately, the gums can shrink back or recede, usually due to gum disease or over-aggressive brushing, and expose some of the root surface. With only the cementum to protect them, the roots can become highly susceptible to decay. If a cavity forms here, it can rapidly advance into the tooth's interior, the pulp, weakening the tooth and increasing its risk of loss.
To stop the decay, we must treat root cavities much like we do with crown cavities: by removing any decayed structure and then filling the cavity. But root cavities are often more difficult to access depending on how far below the gum line they extend. We may need to perform minor gum surgery to expose the cavity to treat it.
But as with any form of tooth decay, the best strategy is to prevent root cavities in the first place. Your first line of defense is a daily hygiene habit of brushing and flossing to remove dental plaque, the main cause for tooth decay. You should also visit your dentist at least twice a year (or more, if recommended) for more thorough cleanings and checkups. Your dentist can also recommend or prescribe preventive rinses, or apply fluoride to at-risk tooth surfaces to strengthen them.
You should also be on the lookout for any signs of gum disease. If you see swollen, reddened or bleeding gums, see your dentist as soon as possible. Stopping possible gum recession will further reduce your risk of root cavities.
If you would like more information on the prevention and treatment 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: Tooth Decay Near the Gum Line Affects Many Older Adults.”
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