Posts for tag: tooth decay
Until recently, the standard treatment for tooth decay remained essentially the same for nearly a century: Remove any decayed structure, then prepare and fill the cavity. But that singular protocol has begun to change recently.
Although "drilling and filling" saves teeth, it doesn't fully address the causes of decay. In response, dentists have broadened their approach to the disease—the focus now is on an individual patient's particular set of risk factors for decay and how to reduce those.
At the heart of this new approach is a better understanding of oral bacteria, the true cause of decay. Bacteria produce acid, which can erode tooth enamel and create a gateway into the tooth for decay to advance. We therefore want to lower those risk factors that may lead to bacterial growth and elevated acidity.
One of our major objectives in this newer approach is to reduce plaque, a thin film of food particles used by bacteria for food and habitation. Removing plaque, principally through better oral hygiene, in turn reduces decay-causing bacteria.
Plaque isn't the only mechanism for bacterial growth and acidity. Appliances like dentures or retainers accumulate bacteria if not regularly cleaned. Reduced saliva flow, often due to certain medications or smoking, limits this fluid's ability to buffer acid and acid reflux or acidic beverages like sodas, sports or energy drinks can disrupt the mouth's normal pH and increase the risk for enamel erosion.
Our aim, then, is to develop a long-term strategy based on the patient's individual set of oral disease risk factors. To determine those, we'll need to examine their medical history (including family), current health status and lifestyle habits. From there, we can create a specific plan targeting the identified risk factors for decay.
Some of the elements of such a strategy might include:
- Daily brushing and flossing, along with regular dental cleanings;
- Fluoride dental products or treatments to strengthen enamel;
- Changes in diet and excess snacking, and ceasing from any tobacco use;
- Cleaning and maintaining appliances, as well as monitoring past dental work.
Improving the mouth environment by limiting the presence of oral bacteria and acid can reduce the occurrence of tooth decay and the extent of treatment that might be needed. It's a more nuanced approach that can improve dental health.
If you would like more information on tooth decay prevention and treatment, 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.”
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.”
Tooth decay is a destructive disease that could rob you of your teeth. But it doesn't appear out of nowhere—a number of factors can make it more likely you'll get cavities.
But the good news is you can be proactive about many of these factors and greatly reduce your risk of tooth decay. Here are a few questions to ask yourself to point you in the right direction for preventing this destructive disease.
Do you brush and floss every day? A daily habit of brushing and flossing removes buildup of dental plaque, a bacterial film on teeth that's the top cause for tooth decay and periodontal (gum) disease. Hit or miss hygiene, though, can greatly increase your risk for developing a cavity.
Do you use fluoride? This naturally occurring chemical has been proven to strengthen tooth enamel against decay. Many locations add fluoride to drinking water—if your area doesn't or you want to boost your fluoride intake, use toothpastes, mouthrinses or other hygiene products containing fluoride.
Do you smoke? The nicotine in tobacco constricts blood vessels in the mouth so that they provide less nutrients and antibodies to the teeth and gums. Your mouth can't fight off infection as well as it could, increasing your risk of dental diseases like tooth decay.
Do you have dry mouth? This isn't the occasional bout of “cotton mouth,” but a chronic condition in which the mouth doesn't produce enough saliva. Saliva neutralizes mouth acid, so less of it increases your risk for decay. Chronic dry mouth can be caused by medications or other underlying conditions.
Do you snack a lot between meals? Sugary snacks, sodas or energy drinks can increase oral bacteria and acidity that foster tooth decay. If you're snacking frequently between meals, your saliva's acid neutralizing efforts may be overwhelmed. Coordinate snacking with mealtimes to boost acid buffering.
You can address many of these questions simply by adopting a daily habit of brushing and flossing, regular dental cleanings and checkups, and eating a healthy, “tooth-friendly” diet. By reducing the risk factors for decay, you can avoid cavities and preserve your teeth.
If you would like more information on preventing 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 “Tooth Decay: How to Assess Your Risk.”
If you've ever had a run-in with cavities, you know the drill (no pun intended): After getting a local anesthetic for pain, the dentist removes any decayed dental tissue, as well as some healthy tissue, and then fills the cavity to restore the tooth. It's an effective treatment protocol we've been using for well over a century.
It does, however, have its drawbacks. For one, although necessary, removing healthy dental tissue can weaken the overall tooth structure. The dental drill used during the procedure is also unpleasant to many people: Although it doesn't cause any pain thanks to the anesthetic, the sounds and pressure sensations associated with it can be unsettling.
But advances in dental tools, technology and techniques are addressing these drawbacks in traditional tooth decay treatment. In other words, treating a tooth with cavities today is taking on a lighter touch. Here are 3 reasons why.
Earlier detection. The key to effective treatment is to find tooth decay in its earliest stages. By doing so, we can minimize the damage and reduce the extent of treatment needed. To do this, we're beginning to use advanced diagnostic tools including digital x-rays, intraoral cameras and laser fluorescence to spot decay, often before it's visible to the naked eye.
Re-mineralizing enamel. One of the advantages of early detection is to catch tooth enamel just as it's undergoing loss of its mineral content (demineralization) due to contact with acid. At this stage, a tooth is on the verge of developing a cavity. But we can use minimally invasive measures like topically applied fluoride and CPP-ACP (a milk-based product) that stimulates enamel re-mineralization to prevent cavity formation.
Less invasive treatment. If we do encounter cavities, we no longer need to turn automatically to the dental drill. Air abrasion, the use of fine substance particles under high pressure, can precisely remove decayed material with less loss of healthy tissue than a dental drill. We're also using newer filling materials like composite resins that don't require enlarging cavities as much to accommodate them.
These and other techniques—including laser technology—are providing superior treatment of tooth decay with less invasiveness. They can also make for a more pleasant experience when next you're in the dentist's chair.
If you would like more information on effectively treating dental disease, 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.”
Tooth decay is one of two dental diseases most responsible for tooth loss (gum disease being the other). In the absence of treatment, what starts as a hole or cavity in a tooth's outer layers can steadily advance toward its interior.
Most people associate cavities with the crown, the part of a tooth you can see. But cavities can also occur in a tooth's roots, especially with older adults. Root cavities pose two distinct difficulties: They can lead to more rapid decay spread than crown cavities within a tooth; and they're harder to detect.
Tooth roots are ordinarily covered by the gums, which protects them from bacterial plaque, the main cause for decay. But roots can become exposed due to receding gums, a common problem with seniors who are more susceptible to gum disease.
Unlike the enamel-covered crowns, tooth roots depend on gum coverage for protection against bacteria and the acid they produce. Without this coverage, the only thing standing between tooth decay and the roots is a thin material called cementum.
If decay does enter a tooth's interior, saving it often requires a root canal treatment to remove decayed tissue in the inner pulp and root canals, and then replacing it with a filling. But if we're able to discover a root cavity in its early stages, we may be able to fill it like a crown cavity.
The best strategy, though, is to prevent root cavities from forming. This starts with a dedicated daily regimen of brushing and flossing to remove dental plaque. If you're at high risk for root cavities, we may also recommend antibacterial mouthrinses and other aids.
Regular dental visits are also a must: a minimum of twice-a-year dental cleanings to remove stubborn plaque and calculus (hardened plaque) deposits. For added protection against root cavities, we can also apply fluoride varnish to strengthen teeth. And regular visits are the best way to detect any cavity in its early stages when treatment is less invasive.
A heightened risk of dental problems like root cavities are a part of the aging process. But partnering together, we can lower that risk and increase the longevity of your teeth.
If you would like more information on root cavities, 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.”