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.”
In one respect, celebrities are no different from the rest of us—quite a few famous people love to collect things. Marie Osmond collects dolls (as well as Johnny Depp, reportedly); Leonardo DiCaprio, vintage toys. And, of course, Jay Leno has his famous fleet of cars. But Victoria Beckham's collection is unusually "familial"—she's kept all of her four children's "baby" teeth after they've fallen out.
Best known as Posh Spice of the 1990s group Spice Girls and now a fashion designer and TV personality, Beckham told People Magazine that she has an "entire bucket" of her kids' primary teeth. And, she recently added to it when her nine-year old daughter lost another tooth earlier this year.
You may or may not want to keep your child's baby teeth, but you'll certainly have the opportunity. Children start losing their first set of teeth around age 6 or 7 through early puberty. During the process, each tooth's roots and gum attachment weakens to the point that the tooth becomes noticeably loose. Not long after, it gives way and falls out.
Although a baby tooth doesn't normally need any help with this, children (and sometimes parents) are often eager to accelerate the process. A loose tooth can be annoying—plus there's often a financial incentive via the "Tooth Fairy!"
First off, there's not much harm in a child wiggling a loose tooth—it may even help it come out. It's also possible to help the tooth safely detach sooner by taking a small piece of tissue, folding it over the tooth and giving it a gentle downward squeeze. If it's loose enough, it should pop out.
If it doesn't, don't resort to more forcible measures like the proverbial string and a door—just wait a day or two before trying the gentle squeeze method again. Once the tooth comes out, the empty socket may bleed a bit or not at all. If heavy bleeding does occur, have the child bite down on a piece of clean gauze or a wet tea bag until it stops. You may also have them eat softer foods for a few days to avoid a resumption of bleeding.
Beyond that, there's little else to do but place it under your child's pillow for the Tooth Fairy. And if after their "exchange" with that famous member of the Fae Folk you find yourself in possession of the erstwhile tooth, consider taking a cue from Victoria Beckham and add it to your own collection of family memories.
The worst outcome of periodontal (gum) disease is tooth loss—but it isn't the only form of misery you might suffer. One of the more troublesome results associated with gum disease is gum recession.
Normal gum tissue covers teeth from just above the visible crown to the roots, providing protection against bacteria and oral acid similar to the enamel on the crown. But advanced gum disease can weaken these tissues, causing them to pull away or recede from the teeth.
Not only can this diminish your smile appearance, but the exposed areas are more susceptible to further disease and painful sensitivity. And it certainly can accelerate tooth loss.
But there are some things we can do to reduce the harm caused by gum recession. If we're able to diagnose and treat a gum infection early while the gums have only mildly receded, the tissues could stabilize and not get worse.
The chances for natural regrowth are unlikely, especially the more extensive the recession. In such cases, the gums may need some assistance via plastic periodontal surgery. Surgeons reconstruct gum tissues by grafting like tissues to the area of recession. These grafts serve as a scaffold for new tissues to gradually grow upon.
There are two general types of grafting procedures. One is called free gingival grafting. The surgeon completely removes a thin layer of skin from elsewhere in the mouth (such as the palate), then shapes and attaches it to the recession site. Both the donor and recession sites heal at approximately the same rate, usually within 14-21 days. This procedure replaces missing gum tissue, but doesn't cover exposed tooth roots to any great extent.
In cases of root exposure, dentists usually prefer another type of procedure, known as connective tissue grafting. The donor tissue is usually taken again from the palate, but the design of the surgery is different. A flap of tissue at the recipient site is opened so that after the connective tissue from the palate is placed at the recipient site to cover the exposed roots, the flap of tissue covers the graft to provide blood circulation to the graft as it heals.
Both kinds of procedures, particularly the latter, require detailed precision by a skilled and experienced surgeon. Although they can successfully reverse gum recession, it's much better to avoid a gum infection in the first place with daily oral hygiene and regular dental care.
If you would like more information on treating gum recession, 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 “Periodontal Plastic Surgery.”
From birth to early adulthood, your child's teeth, gums and jaws develop at a rapid pace. And, for the most part, nature takes its course without our help.
But tooth decay can derail that development. The result of bacterial acid eroding enamel, tooth decay is the top cause for premature primary tooth loss in children. One particular form, early childhood caries (ECC), can rapidly spread from one tooth to another.
Many parents assume prematurely losing teeth that are destined to fall out soon anyway is inconsequential. But primary teeth play a critical role in the proper eruption of permanent teeth, serving as both placeholders and guides for those teeth developing just below them in the gums. A permanent tooth without this guidance can erupt out of alignment to create a poor bite that may require future orthodontics.
Being proactive about tooth decay lessens that risk—and the best time to start is when the first teeth begin to erupt. That's when you should begin their regular dental visits sometime around their first birthday.
Dental visits are an important defense against tooth decay. Besides routine dental cleanings, your child's dentist can offer various preventive treatments like sealants to stop decay from forming in the biting surfaces of back molars or topically applied fluoride to strengthen tooth enamel.
Daily home care is just as important in the fight against tooth decay. Oral hygiene should be a part of your child's daily life even before teeth: It's a good habit to wipe an infant's gums with a clean cloth after nursing. As teeth arrive, oral hygiene turns to brushing and flossing—perhaps the best defense of all against dental disease.
It's also important to watch their intake of sugar, a prime food source for bacteria that produce harmful acid. Instead, encourage a "tooth-friendly" diet of whole foods to keep teeth and gums healthy.
Even if they do develop tooth decay, there are effective treatments to minimize any damage and preserve affected primary teeth until they've served their purpose. By adopting these prevention strategies and prompt treatment, you can stay ahead of this destructive disease.
We're all interested in how our toothpaste tastes, how it freshens breath or how it brightens teeth. But those are secondary to its most important function, which is how well our toothpaste helps us remove dental plaque, that thin bacterial film on teeth most responsible for both tooth decay and gum disease.
Daily brushing and flossing clear away dental plaque, resulting in a much lower risk for dental disease. But while the mechanical action of brushing loosens plaque, toothpaste helps complete its removal. It can do this because of two basic ingredients found in nearly every brand of toothpaste.
The first is an abrasive (or polishing agent), a gritty substance that boosts the effectiveness of the brushing action (which, by the way, alleviates the need for harmful aggressive brushing). These substances, usually hydrated silica, hydrated alumina or calcium carbonate, are abrasive enough to loosen plaque, but not enough to damage tooth enamel.
The other ingredient, a detergent, works much the same way as the product you use to wash greasy dishes—it breaks down the parts of plaque that water can't dissolve. The most common, sodium lauryl sulfate, a safe detergent found in other hygiene products, loosens and dissolves plaque so that it can be easily rinsed away.
You'll also find other ingredients to some degree in toothpaste: flavorings, of course, that go a long way toward making the brushing experience more pleasant; humectants to help toothpaste retain moisture; and binders to hold bind all the ingredients together. And many toothpastes also contain fluoride, a naturally-occurring chemical that strengthens tooth enamel.
You may also find additional ingredients in toothpastes that specialize in certain functions like reducing tartar buildup (hardened plaque), easing tooth or gum sensitivity or controlling bacterial growth. Many toothpastes also include whiteners to promote a brighter smile. Your dentist can advise you on what to look for in a toothpaste to meet a specific need.
But your first priority should always be how well your toothpaste helps you keep your teeth and gums healthy. Knowing what's in it can help you choose your toothpaste more wisely.
If you would like more information on oral hygiene products and aids, 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 “Toothpaste: What's in It?”
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