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.
With a 95-plus percent survival rate after ten years, dental implants are one of the most durable replacement restorations available. Implants can potentially last much longer than less expensive options, which could make them a less costly choice in the long run.
But although a rare occurrence, implants can and do fail—often in the first few months. And tobacco smokers in particular make up a sizeable portion of these failures.
The reasons stem from smoking’s effect on oral health. Inhaled smoke can actually burn the outer skin layers in the mouth and eventually damage the salivary glands, which can decrease saliva production. Among its functions, saliva provides enzymes to fight disease; it also protects tooth enamel from damaging acid attacks. A chronic “dry mouth,” on the other hand, increases the risk of disease.
The chemical nicotine in tobacco also causes problems because it constricts blood vessels in the mouth and skin. The resulting reduced blood flow inhibits the delivery of antibodies to diseased or wounded areas, and so dramatically slows the healing process. As a result, smokers can take longer than non-smokers to recover from diseases like tooth decay or periodontal (gum) disease, or heal after surgery.
Both the higher disease risk and slower healing can impact an implant’s ultimate success. Implant durability depends on the gradual integration between bone and the implant’s titanium metal post that naturally occurs after placement. But this crucial process can be stymied if an infection resistant to healing arises—a primary reason why smokers experience twice the number of implant failures as non-smokers.
So, what should you do if you’re a smoker and wish to consider implants?
First, for both your general and oral health, try to quit smoking before you undergo implant surgery. At the very least, stop smoking a week before implant surgery and for two weeks after to lower your infection risk. And you can further reduce your chances for failure by practicing diligent daily brushing and flossing and seeing your dentist regularly for cleanings and checkups.
It’s possible to have a successful experience with implants even if you do smoke. But kicking the habit will definitely improve your odds.
If you would like more information on dental implants, 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 “Dental Implants & Smoking.”
If you’re taking medication to regulate your blood pressure, you may be familiar with some of the general side effects, like nausea, drowsiness or dizziness. But some blood pressure drugs might also cause complications with your oral health.
This is true of one class of drugs in particular used for blood pressure regulation. Calcium channel blockers (CCBs) are used to regulate blood pressure by dilating (relaxing) blood vessels, making it easier for the heart to pump blood. They’re often prescribed to patients who can’t tolerate beta blockers, another common blood pressure drug.
Besides other general side effects, CCBs can also cause gingival hyperplasia (gum overgrowth) and mouth dryness. The former condition occurs when the gum tissues grow and extend beyond their normal size over the teeth. Besides pain and discomfort, hyperplasia creates an abnormal appearance which can be embarrassing. Research findings also indicate that hyperplasia development from CCB use is also linked to poor hygiene habits, which give rise to periodontal (gum) disease.
Mouth dryness is defined as less than normal saliva flow. Besides discomfort, the condition may increase your risk of dental disease: saliva is a key part in keeping bacterial levels low and maintaining the mineral content of enamel. Inadequate saliva flow can’t maintain this balance, which increases the bacterial population in the mouth and the risk of infection leading to gum disease or tooth decay.
To avoid both of these side effects, it’s important first to let us know if you’re taking blood pressure medication and what kind. You may also need more frequent dental visits, especially if you’re displaying symptoms of dental disease. Studies have found that frequent dental visits to remove bacterial plaque and calculus (hardened plaque deposits) may significantly reduce gum overgrowth in patients taking a CCB. You should also maintain a recommended daily regimen of oral hygiene (brushing and flossing).
Because of possible effects on your dental health from a number of drugs, it’s always important to let us know the medications you’re regularly taking. As with CCBs, we can incorporate that knowledge into your dental treatment to assure your safety and optimal oral health.
If you would like more information on managing your oral care while on medication, 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 “Blood Pressure Medications.”
Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.
That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!
Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.
Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”
One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.
Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.
Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”Â Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
Each part of the human body is an intricate wonder. Take your teeth, for example: they’re so woven into everyday life we don’t notice them, yet they each work seamlessly with the jaws and mouth so we can eat, speak and even smile.
Here, then, are a few facts to help you understand — and appreciate — these tiny, amazing wonders we call teeth.
Layer Upon Layer. Rather than one solid mass, teeth are composed of different layers of slightly different tissues each with a unique role in protecting and enabling a tooth to function. Innermost is the pulp filled with connective tissue encasing blood vessels and nerves that transmit sensations to the brain. The next layer out is the dentin, a bone-like material sensitive to touch and other stimuli, which also absorbs some of the forces generated when biting or chewing. The outermost layer is enamel, the hardest material in the body and the tooth’s first defense against infection and other dangers.
Front and Center. Teeth perform different functions depending on their type and location. Front teeth are our “onstage performers” — they help us to speak and enunciate words clearly and, of course, contribute to our smile. They’re also adept at cutting through food when it first enters our mouths.
The Support Team. In keeping with our theater analogy, back teeth are our “backstage crew”: they help support our facial height, provide balance for the jaws as we swallow and protect the front teeth from too much vertical force. They’re also able to crush food before we finally swallow, which aids in the digestive process.
Intended for a Lifetime. If you consider all the environmental factors our teeth face — acidic foods, biting forces and temperature swings to name a few — you then can appreciate their resiliency. Of course, teeth have their enemies: decay, infection and trauma. With daily brushing and flossing and at least a couple of visits a year to our office for cleanings and checkups, you can help thwart many of those enemies. With both our efforts we can make sure your teeth really do last a lifetime.
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