Posts for: March, 2015
Dental decay is an infectious and very common disease, but it's also very preventable. Today's dentistry has many tools at its disposal to accurately determine your risk for tooth decay, lower it, turn it around, and completely prevent it. What's more, we can even reverse early decay. You might never have to see or hear the drill again.
Striking the right balance between factors that promote oral health and those that cause disease is of the utmost importance. And knowing whether or not you have indicators of disease or risk for tooth decay is a great place to start.
We will scientifically calculate your risk for tooth decay by:
- Recording and monitoring your oral and dental health: Our risk assessment/evaluation form allows us to gather information about critical dental health habits. Oral hygiene habits, use of fluoride toothpaste, tobacco smoking, frequent snacking on sugary foods and beverages, and past experience of decay are all examples of disease indicators that will help gauge your level of risk. For example, using fluoride toothpaste decreases your risk, but smoking and between-meal snacking increases it.
- Testing for decay producing bacteria: You've probably heard of dental bacterial plaque, the biofilm that sticks to your teeth, forming in the tiny little grooves on the biting surfaces of the teeth where decay starts (and along the gum line). Today, acid-producing bacteria responsible for causing decay can be tested by simply sampling your biofilm on a swab, and placing it in a meter to accurately determine acid-producing activity. A high number indicates high risk. You can see it for yourself in less than a minute.
- Saliva testing: A simple history will tell us whether your mouth is dry or moist most of the time. A saliva test will tell us if your saliva is acidic or neutral. A dry acidic mouth promotes decay, while a moist neutral mouth with healthy saliva promotes health. Measuring salivary “pH,” the measure of acidity, is another factor for determining your risk for decay and reversing it. Special rinses can help reduce decay-producing bacteria and reduce acidity.
- Very early decay detection: Modern ultra-low-dosage x-ray equipment allows us to determine the very earliest signs of decay. Decay that is detectable with the naked eye (or feel with a dentist's instrument, an explorer) is already at an advanced stage. Catching the disease very early with the help of this sophisticated equipment can allow us to reverse early decay before it has even turned into cavities. It can actually be reversed with remineralizing fluids, rinses that put calcium back into the tooth surfaces reforming and hardening them.
This is a new and exciting era in the fight against tooth decay and we have all the tools to determine your decay risk and reverse it.
If you would like us to determine your risk for tooth decay, please call the office to schedule an appointment. To read more about disease indicators and risk factors for dental caries, read the Dear Doctor magazine article “Tooth Decay: How To Assess Your Risk.”
As a new permanent tooth develops, the roots undergo a process of breakdown and growth. As older cells dissolve (a process called resorption), they’re replaced by newer cells laid down (deposition) as the jaw develops. Once the jaw development ends in early adulthood, root resorption normally stops. It’s a concern, then, if it continues.
Abnormal root resorption most often begins outside of the tooth and works its way in, beginning usually around the neck-like (or cervical) region of the tooth. Also known as external cervical resorption (ECR), the condition usually shows first as pink spots where the enamel is being undermined. As these spots continue to erode, they develop into cavity-like areas.
While its causes haven’t been fully confirmed, ECR has been linked to excessive pressure on teeth during orthodontic treatment, periodontal ligament trauma, teeth-grinding or other excessive force habits, and bleaching techniques performed inside a tooth. Fortunately, ECR is a rare occurrence, and most people who’ve had these problems won’t experience it.
When it does occur, though, it must be treated as quickly as possible because the damage can progress swiftly. Treatment depends on the size and location of the resorption: a small site can often be treated by surgically accessing the tooth through the gum tissue and removing the offending tissue cells. This is often followed with tooth-colored dental material that’s bonded to the tooth to replace lost structure.
A root canal treatment may be necessary if the damage has extended to the pulp, the tooth’s interior. However, there’s a point where the resorption becomes too extensive to save the tooth. In these cases, it may be necessary to remove the tooth and replace it with a dental implant or similar tooth restoration.
In its early stages, ECR may be difficult to detect, and even in cases where it’s been diagnosed more advanced diagnostics like a CBCT scanner may be needed to gauge the extent of damage. In any case, it’s important that you have your teeth examined on a regular basis, at least twice a year. In the rare chance you’ve developed ECR, the quicker it’s found and treatment begun, the better your chances of preserving the tooth.
Periodontal (gum) disease is the most likely cause of a loose, permanent tooth. This progressive infection causes damage to the gums and bone tissues that hold teeth in place, leading to looseness and ultimately tooth loss.
Gum disease, however, isn’t the only cause: although not as common, excessive biting forces over time may also lead to loose teeth. The excessive force stretches the periodontal ligaments that hold teeth in place, causing the teeth to become loose.
This condition is called occlusal trauma. In its primary form, the patient habitually grinds or clenches their teeth, or bites or chews on hard objects like pencils or nails. Generating 20-30 times the normal biting force, these habits can cause considerable damage. It can also be a factor when gum disease is present — supporting bone becomes so weakened by the disease, even normal biting forces can cause mobility.
If you recognize the early signs of grinding or clenching, particularly jaw soreness in the morning (since many instances of teeth grinding occur while we sleep), it’s important to seek treatment before teeth become loose. The symptoms are usually treated directly with muscle relaxants, an occlusal guard worn to soften the force when teeth bite down, or stress management, a major trigger for teeth grinding. The sooner you address the habit, the more likely you’ll avoid its consequences.
If, however, you’re already noticing a loose tooth, treatment must then focus on preserving the tooth. Initially, the tooth may need to be splinted, physically joined to adjacent teeth to hold it in place while damaged tissues heal. In some cases, minute amounts of enamel may need to be removed from the tooth’s biting surfaces to help the tooth better absorb biting forces. Other treatments, including orthodontics and gum disease treatment, may also be included in your treatment plan.
If you notice a loose tooth, it’s critical you contact us as soon as possible for an evaluation — if you delay you increase the chances of eventually losing it. The earlier you address it, the better your chances of preserving your tooth.
If you would like more information on loose 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 “Loose Teeth.”
As a parent you’re concerned with a number of issues involving your child’s health, not the least of which involves their teeth. One of the most common is thumb-sucking.
While later thumb-sucking is a cause for concern, it’s quite normal and not viewed as harmful in infant’s and very young children. This universal habit is rooted in an infant swallowing pattern: all babies tend to push the tongue forward against the back of the teeth when they swallow, which allows them to form a seal while breast or bottle feeding. Infants and young children take comfort or experience a sense of security from sucking their thumb, which simulates infant feeding.
Soon after their primary teeth begin to erupt, the swallowing pattern changes and they begin to rest the tongue on the roof of the mouth just behind the front teeth when swallowing. For most children thumb sucking begins to fade as their swallowing pattern changes.
Some children, though, continue the habit longer even as their permanent teeth are beginning to come in. As they suck their thumb the tongue constantly rests between the front teeth, which over time may interfere with how they develop. This can cause an “open bite” in which the upper and lower teeth don’t meet properly, a problem that usually requires orthodontic treatment to correct it.
For this reason, dentists typically recommend encouraging children to stop thumb-sucking by age 3 (18-24 months to stop using a pacifier). The best approach is positive reinforcement — giving appropriate rewards over time for appropriate behavior: for example, praising them as a “big” boy or girl when they have gone a certain length of time without sucking their thumb or a pacifier. You should also use training or “Sippy” cups to help them transition from a bottle to a regular cup, which will further diminish the infant swallowing pattern and need for thumb-sucking.
Habits like thumb-sucking in young children should be kept in perspective: the habit really isn’t a problem unless it goes on too long. Gentle persuasion, along with other techniques we can help you with, is the best way to help your child eventually stop.
If you would like more information on thumb sucking, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Thumb Sucking in Children” and “How Thumb Sucking Affects the Bite.”