Posts for tag: Tooth decay
Ever wonder just exactly what causes cavities? Once upon a time, “Toothworms” — miniscule, yet relentless pests — were thought to be responsible for this widespread malady. This belief persisted from ancient times through the 17th Century; William Shakespeare even made reference to the baneful beasts in his play Much Ado about Nothing. (“What, sigh for a toothache? [It] is but a humor or a worm.”) Today, however, we know why no one ever observed an honest-to-goodness toothworm: it’s because they’re much too tiny to see with the naked eye.
Actually, it isn’t worms, but much smaller organisms that cause tooth decay. These harmful plaque bacteria (along with many helpful microorganisms) live in the mouth, and build up on surfaces of the teeth when they aren’t cleaned properly. They feed on sugar in the diet, and release substances that erode tooth enamel, which causes small holes called cavities. Cavities, in turn, are what’s responsible for most toothaches.
While we may scoff at old legends, one fact remains: Even today, according to the National Institutes of Health, tooth decay is the number one chronic disease of both children and adults; and it’s almost entirely preventable. We can’t blame it on toothworms — but what can we do about it?
Glad you asked! The best way to avoid decay is through prevention. That means brushing your teeth twice a day with a fluoride toothpaste, and flossing them every day. It also means eating a balanced diet and avoiding acidic and sugary foods — like soda, some juices, and sweet, sticky snacks. If you do consume these types of foods, limit them to mealtimes; that gives your saliva enough time in between to neutralize the acids naturally. And, of course, make an appointment see us twice a year for a complete check-up and professional cleaning.
If you do begin to notice the symptoms of tooth decay (toothache, for example) it’s important to come in to the dental office right away, so we can treat the problem before it gets worse. Prompt action can often help save a tooth that might otherwise be lost. Besides filling the cavity, we may be also able to recommend ways to help prevent the disease from affecting other teeth. And if you need a more extensive procedure to relieve the problem — such as a root canal — we can make sure you get the appropriate treatment.
We’ve come a long way since the “toothworm” days — but we can still do a lot more to make tooth decay a thing of the past.
If you would like more information about tooth decay and cavity prevention, please contact us or schedule an appointment. You can learn more in the Dear Doctor magazine article “Tooth Decay — The World’s Oldest & Most Widespread Disease” and “Tooth Decay — How To Assess Your Risk.”
Over the last century effectively treating a decayed tooth has often required removing any decayed structure with drilling and then filling the remaining cavity. While this approach does save teeth that might otherwise be lost, it can also result in a fair amount of healthy structure removed in the process.
But continuing advances in dentistry are now making possible a new approach to tooth decay treatment that preserves as much of the healthy portions of tooth as possible. This new way is often referred to as minimally invasive dentistry (MID).
The primary goal of MID treatment is to intercept and treat decay as early as possible to minimize tooth damage. It begins with helping patients identify their own individual risk factors for decay such as the presence of disease-causing bacteria, the adequacy of their saliva flow, or their lifestyle and dietary habits. We then recommend changes or preventive measures to reduce those risks.
The next step in MID is using various diagnostic technologies to find decay as early as possible. X-rays continue to play a major role, but dentists are also using dental microscopy to magnify the earliest forms of decay. Many also utilize laser fluorescence, infrared photography and optical scanning to further “see” decay difficult to detect with the naked eye.
In regard to treatments, MID adopts the adage “less is more.” If caught early enough, we can encourage the re-mineralization of enamel that acid has eroded with CPP-ACP, a substance acquired from milk, or strengthen teeth with topical fluoride applications. Instead of the dental drill, many dentists now turn to air abrasion for decay removal, equipment that emits a fine stream of abrasive particles that harms less healthy structure than a drill.
And if lasers continue to develop at their current pace, we’ll be able to use this technology to perform much more precise decay treatment than possible with manual instruments. As a result, we’ll be able to treat decayed teeth with less invasive means to preserve as much healthy structure as possible.
As these and other developments continue, MID promises a bright future for preventing and treating tooth decay. As a result, there’ll be less tooth structure loss and more attractive and healthy smiles.
If you would like more information on the latest techniques for treating 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.”
As we age we become more susceptible to dental diseases. A common but often initially unnoticed problem for seniors is root decay.
We’re all familiar with tooth decay in the crown, the visible tooth above the gum line. Bacteria feeding on leftover sugar in the mouth produce acid, which at high levels erodes the teeth’s protective enamel. This forms cavities and, if untreated, deeper infection within the tooth that could reach the bone via the root canals.
But decay can also directly attack a tooth’s roots below the gum line. Roots are made of dentin and covered by a very thin layer of mineralized tooth structure called cementum. Cementum, which is much softer than enamel, is often lost because of its thinness, thus exposing the root’s dentin. This can make the area more susceptible to decay than the enamel-covered crown. Normally, though, the roots also have the gums covering them as added protection against bacterial infection.
But gum recession (shrinkage), a common experience for people in their later years, can expose the root surfaces. As a result, the roots become much more susceptible to decay. And an ensuing infection could spread more quickly into the interior of the tooth than decay originating in the crown.
That’s why it’s important to remove the decayed material and fill the root cavity to prevent the infection’s spread. While similar to a crown filling, the treatment can be more difficult if the root cavity extends below the gum line. In this case, we may need to perform a surgical procedure to access the cavity.
There are other things we can do to help prevent root cavities or limit their damage. We can apply fluoride varnish to strengthen the teeth and provide extra protection against cavities, or prescribe a fluoride rinse for use at home. We can also keep an eye out and treat periodontal (gum) disease, the main cause for gum recession.
The most important thing, though, is what you do: brush and floss thoroughly each day to remove bacterial plaque and limit sugary or acidic foods in your diet. Preventing decay and treating cavities as soon as possible will help ensure you’ll keep your teeth healthy and functional all through your senior years.
What you eat (and how often you eat it) is a major factor in the ongoing battle to prevent tooth decay. High levels of sugar or similar carbohydrates in your diet could encourage the growth of bacteria that cause tooth decay. Constantly sipping on acidic beverages like sodas or sports drinks can lead to enamel erosion.
You may be well aware of the kinds of foods that contribute to tooth decay. But did you know some foods can actually protect us from this damaging disease? Here are 4 kinds of foods believed to inhibit tooth decay.
Cheese. This food formed from milk is rich in calcium and has a stimulating effect on saliva. By eating a little cheese after a sugary snack, the increase in saliva can help neutralize the acid produced by the bacteria feeding on the sugar; the added calcium will also strengthen tooth enamel.
Fibrous plant foods. Beans, peanuts and leafy vegetables are rich in fiber and many require vigorous chewing. This in turn stimulates saliva flow, which as previously noted helps to neutralize high levels of acid.
Black and green teas. Beverages brewed from these plants are rich in polyphenols and flavonoids, providing an antioxidant effect on cells. Black tea also contains fluoride, which helps strengthen tooth enamel.
Chocolate. There’s some evidence that cocoa (from which chocolate is derived) may have some properties that inhibit tooth decay. But there is a catch — this evidence is based on unrefined cocoa, without the addition of any sugar. The high levels of sugar in processed chocolate negate this effect. Sorry chocolate lovers!
Of course, any of these and similar foods (like cow’s milk) should be considered complements to a comprehensive prevention approach that includes daily oral hygiene, limits on sugar and acidic food consumption and regular dental cleanings and checkups.
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 “Nutrition & Oral Health.”
Even though a child’s primary (“baby”) teeth eventually give way, it’s still important to treat them if they become decayed. Primary teeth serve as guides for the emerging permanent teeth — if they’re lost prematurely, the permanent tooth may come in misaligned.
If the decay, however, affects the tooth’s inner pulp, it poses complications. A similarly decayed adult tooth would be treated with a root canal in which all the pulp tissue, including nerve fibers and blood vessels, are removed before filling and sealing. Primary teeth, however, are more dependent on these nerves and blood vessels, and conventional filling materials can impede the tooth’s natural loss process. It’s better to use more conservative treatments with primary teeth depending on the degree of decay and how much of the pulp may be affected.
If the decay is near or just at the pulp, it’s possible to use an indirect pulp treatment to remove as much of the softer decay as possible while leaving harder remnants in place: this will help keep the pulp from exposure. This is then followed with an antibacterial agent and a filling to seal the tooth.
If the pulp is partially exposed but doesn’t appear infected, a technique called direct pulp capping could be used to cover or “cap” the exposed pulp with filling material, which creates a protective barrier against decay. If decay in a portion of the pulp is present, a pulpotomy can be performed to remove the infected pulp portion. It’s important with a pulpotomy to minimize the spread of further infection by appropriately dressing the wound and sealing the tooth during and after the procedure.
A pulpectomy to completely remove pulp tissue may be necessary if in the worst case scenario the pulp is completely infected. While this closely resembles a traditional root canal treatment, we must use sealant material that can be absorbed by the body. Using other sealants could inhibit the natural process when the primary tooth’s roots begin to dissolve (resorb) to allow it to eventually give way.
These all may seem like extraordinary efforts to save a tooth with such a short lifespan. But by giving primary teeth a second chance, their permanent successors will have a better chance of future good health.
If you would like more information on treating decay in primary teeth, 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 Canal Treatment for Children’s Teeth.”