Posts for tag: tooth decay

TheresMoreWeCanDoAboutToothDecayBesidesDrillandFill

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.”

SavingPrimaryTeethFromDecayIsTotallyWorthIt-HeresHow

The few teeth your one or two year old has will eventually fall out in a few years—so, why be concerned about tooth decay this early? Actually, you should: Fighting tooth decay should always be a priority, even at this early age.

Even though primary teeth are short-lived, they make a huge impact on future dental health. These early teeth help guide the eruption of permanent teeth—if lost prematurely to decay, the later teeth may come in misaligned and create a poor bite. Preserving them could help you avoid later orthodontic treatment.

Fortunately, you can help prevent decay in your child's primary teeth. Here's how.

Practice oral hygiene even before teeth. You should begin daily oral hygiene, the principal defense against tooth decay, even before their first teeth emerge. You can reduce harmful bacteria in their mouths by wiping their gums with a clean cloth after nursing. When teeth appear, begin brushing with just a smear of toothpaste.

Limit sugar consumption. Because decay-causing bacteria thrive on sugar, reduce your child's intake in snacks and beverages. For example, don't put them down for bed with a bottle filled with a sugary liquid like juice, sweetened drinks or even formula or breast milk. If you do give them a night-time bottle, fill it only with water.

Avoid bacterial transfer. Your child's immature immune system can't handle the same level of bacteria as in your mouth. So, reduce the chances of bacterial transfer that may cause tooth decay by avoiding kissing on the mouth or sharing eating or drinking utensils with your infant.

Begin dental visits early. Even though they may have few teeth by their first birthday, it's still a good time to begin your child's regular dental visits. Your dentist may be able to diagnose decay early (and treat for maximum effectiveness), as well as provide sealants, topical fluoride and other measures for preventing decay.

Tooth decay at an early age could impact your child's future dental health. Taking steps now to reduce it could help ensure they have healthy teeth and gums later in life.

If you would like more information on dental care 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 “Do Babies Get Tooth Decay?

3ReasonsWhyTreatingCavitiesIsBecomingMoreEffective

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.”

TopicalFluorideAddsExtraProtectionagainstToothDecay

Protecting a child's primary (“baby”) teeth from tooth decay should be a top priority. If one is lost prematurely due to decay, it could cause the permanent tooth to misalign when it comes in.

The basic prevention strategy for every child is daily brushing and flossing and regular dental visits. But children at higher risk for decay may need more:  additional fluoride applied to teeth enamel during office visits.

This natural mineral has been shown to strengthen enamel, teeth's protective layer against decay, especially during its early development. Enamel is composed of calcium and phosphate minerals interwoven to form a crystalline structure called hydroxyapatite. Fluoride joins with this structure and changes it to fluorapatite, which is more resistant to mouth acid than the original structure.

We mostly receive fluoride through fluoridated drinking water and dental care products like toothpaste. Topical fluoride takes it a step further with a stronger dose than found in either of these sources. It can be applied with a foam, varnish or gel using an isolation tray (foam or gel) or painted onto the enamel (varnish or gel).

But does topical fluoride effectively reduce the occurrence of decay? Research indicates yes: a recent review of 28 studies involving over 9,000 children found an average 28% reduction in decayed teeth in children who underwent topical fluoride treatments.

There is, though, one potential side effect: children who swallow the fluoride substance can become sick and experience headache, stomach pain or vomiting. This can be avoided with proper precautions when applying it; the American Dental Association also recommends using only varnish for children younger than 6 years. It's also recommended that children receiving gel or foam not eat or drink at least thirty minutes after the treatment (those who receive the varnish aren't restricted in this way).

Topical fluoride is most effective as part of an overall prevention strategy. Besides daily hygiene and regular dental visits, you can also help reduce your child's decay risk by limiting the amount of sugar in their diet. Sealants, which are applied to the nooks and grooves of teeth where plaque can build up, may also help.

If you would like more information on fluoride gels and other clinical treatments to prevent tooth decay, please contact us or schedule an appointment for a consultation.

HeresWhattoDoifYourChildhasaToothache

What should you do if your child complains about a toothache? Before calling our office, try first to learn what you can about the toothache.

You should first ask them where exactly the pain is coming from — one particular tooth or a generalized, dull ache. Also try to find out, as best they can tell you, when they first noticed the pain. Try then to look at the tooth or area where they indicate the pain is coming from: since tooth decay is a prime cause for tooth pain, you should look for any obvious signs of it like brown spots or cavities. You should also look at the gums around the teeth for any redness or swelling, a sign of an abscess or periodontal (gum) disease.

If you notice any of these signs, the pain persists for more than a day, or it has kept the child awake during the night, you should have us examine them as soon as possible. If you notice facial swelling or they’re running a fever, please call and we will see them immediately. If it’s definitely tooth decay, it won’t go away on its own. The longer we wait to treat it, the worse its effects in the mouth.

In the meantime, you should also try to alleviate the pain as best you can. If when looking in the mouth you noticed food debris (like a piece of hard candy) wedged between the teeth, try to gently remove it with dental floss. Give them ibuprofen or acetaminophen in an appropriate dosage for their age to relieve pain, or apply an ice pack on and off for about 5 minutes at a time to the outside of their jaw.

If any of these remedies stops the pain within an hour, you can wait until the next day to call for an appointment. If the pain persists, though, then an abscess could be developing — you should call that day to see us.

Regardless of when the pain stops, or whether you see any abnormal signs, it’s still important your child see us for an accurate diagnosis. Their toothache maybe trying to tell you something’s wrong — and the earlier a problem is found and treated, the better the outcome.

If you would like more information on dental problems in young 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 “A Child’s Toothache.”