Posts for tag: tooth decay
For over a century dentists treated tooth decay by removing both diseased portions of the tooth and healthy structure deemed at risk for future decay. In the 1970s, though, a new approach emerged, known as Minimally Invasive Dentistry (MID). This practice protocol attempts to preserve as much of the healthy structure as possible.
Before MID, dentists followed a decay treatment protocol developed in the 19th Century. A part of this became known as extension for prevention calling for dentists to remove healthy structure considered vulnerable to decay. Besides reducing the tooth's volume, this practice also resulted in, by today's standards, larger than necessary fillings.
It was thought that removing this additional material would make it easier to clean bacterial plaque, the source of decay, but later, research showed the practice couldn't guarantee the teeth wouldn't be reinfected.
Since then we've learned a lot more about teeth and have developed new ways to detect decay at earlier stages. X-ray imaging, for example, has transitioned largely from film to digital technology, providing more detailed images at greater magnification. This, along with laser fluorescence and infrared cameras, has made it easier to detect the first tiny stages of decay.
We can also limit tooth decay damage by boosting enamel strength with fluoride applications and sealants or reducing decay-causing bacteria with anti-bacterial rinses. We've also seen advancement in techniques like air abrasion that remove decayed tooth material while leaving more healthy structure intact better than using a traditional dental drill.
Restoring teeth after treatment has also improved. While dental metal amalgam is still used for some fillings, the main choice is now composite resin. These new tooth-colored dental materials require less tooth preparation (and thus less material loss) and bond well to the remaining structure, resulting in a stronger tooth.
Following a MID protocol leads to less intervention and less time in the dentist's chair. It also means preserving more of a natural tooth, an important aim in promoting long-lasting dental health.
Humanity has been waging war against tooth decay for millennia — with this relentless opponent often getting the better of us.
Over the last century, however, significant treatment advances have turned the tide of battle in our favor. Perhaps the greatest of these advancements is our deeper grasp of the disease process — new understandings that have altered our treatment strategy. Rather than wait for cavities to occur and then repair the damage, we now focus on stopping the damage from occurring in the first place.
Prevention starts by reducing factors that contribute to tooth decay. We can signify these detrimental factors with the acronym BAD:
Bad Bacteria. Millions of bacteria inhabit our mouths at any one time, but only a few strains produce the acid that causes decay. We want to reduce their population by removing dental plaque (where they feed and grow) through daily brushing and flossing, and, at a minimum, semi-annual office cleanings.
Absence of Saliva. This important fluid neutralizes acid and strengthens tooth enamel. Some people, however, suffer from reduced saliva flow. We want to find the cause (for example, a side effect of certain prescription drugs) and then improve saliva flow.
Dietary Habits. A diet heavy in sugar and acid (particularly sodas and soft drinks) gives bacteria a ready food source and increases the mouth’s acidic level. Chronic high acid levels in particular are often too great for normal saliva flow to overcome and neutralize. Reducing the amount and frequency of these food items creates a healthier oral environment.
Reducing BAD factors is only half of our prevention focus. We also want to promote SAFE factors that enhance tooth health and strength: Sealants, especially for children, that shield tooth surfaces from decay; Antimicrobial rinses that target and rid the mouth of acid-producing bacteria and give healthy bacteria room to develop; Fluoride, a proven enamel-strengthening chemical available in dental products, many drinking water systems and as a topical application in dental offices; and an Effective diet that’s rich in nutrients and low in sugar and acid as already mentioned.
Keeping the focus on reducing BAD factors and promoting SAFE factors will greatly increase your chances of personally winning the war against tooth decay.
If you would like more information on the prevention and treatment of 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.”
Tooth decay is a primary cause of tooth damage and loss, with annual treatment costs in the billions of dollars. It arises mainly from oral bacteria, which proliferates in the absence of effective oral hygiene. There are, however, other risk factors besides poor hygiene that could make you more susceptible to this disease.
Many people, for example, have genetically inherited deeper grooves (fissures) and depressions (pits) than the average tooth anatomy. These may be harder to reach with a toothbrush and can become havens for bacterial plaque. Others may have health conditions that indirectly affect the mouth: bulimia or anorexia, psychological conditions that involve self-induced vomiting, or GERD, gastro-esophageal reflux disease, in which stomach acid could regurgitate into the mouth. These conditions could result in a highly acidic mouth environment.
Some medical and — ironically — dental treatments could also increase your tooth decay risk. Some medications can reduce saliva flow, which inhibits acid neutralization and re-mineralization of enamel. Retainers, braces, bite guards or other dental appliances may also reduce the saliva wash over teeth, and can make brushing and flossing more difficult.
There are also risk factors that result from our lifestyle choices. Eating a lot of foods rich in sugars and other carbohydrates, for example, or acidic beverages like soda, energy or sports drinks contributes to the rise of bacteria in our mouths.
There are ways to reduce the effects of these risk factors. In addition to a daily habit of effective brushing and flossing, you should also include semi-annual cleanings and checkups at our office a part of your routine. If you have genetic, medical or dental issues that are out of your control, we can discuss solutions, such as alternatives to medications or different techniques for cleaning around dental appliances. For lifestyle-related factors, you should consider removing the habit or modifying it: for example, snacking at specific times or drinking acidic beverages only at mealtime.
While tooth decay is a serious, destructive disease, it is highly preventable. Addressing all your risk factors, not just hygiene, will reduce your chances of having it.
If you would like more information on tooth decay prevention, 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.”
Over the last century dentistry has acquired the knowledge, techniques and treatments to prevent or minimize tooth decay. With this enhanced knowledge we’ve amassed a wealth of data about what increases dental disease development and what prevents it.
This has produced a balanced approach to identifying and treating disease-causing factors and incorporating factors that inhibit tooth decay. Known as Caries Management By Risk Assessment (CAMBRA), this approach first identifies each patient’s individual set of risk factors for dental disease and then develops a customized prevention and treatment plan to minimize their risk.
Rather than simply reacting to occurrences of tooth decay — “drill and fill” — CAMBRA anticipates and targets your susceptibility to decay. The primary factors can be represented by the acronym BAD: Bad bacteria, particular strains that produce acid, which at high levels erode enamel and expose the teeth to infection; Absence of saliva, or “dry mouth,” an insufficient flow of saliva that can’t effectively neutralize acid and restore mineral content to enamel; and Dietary habits too heavy in sugar or acid, which can result in bacterial growth and enamel erosion.
With an accurate picture of your particular risk level we can then apply countering factors from the other side of the balance — those that protect teeth from decay. In this case, we use the acronym SAFE: stimulating Saliva flow when needed or applying Sealants on chewing surfaces most susceptible to decay; Antimicrobials that reduce unhealthy bacteria levels and give healthy bacteria an opportunity to thrive; incorporating Fluoride, a chemical known to strengthen enamel, through hygiene products or direct application to the teeth; and an Effective diet, low in sugar and acid and high in fresh fruits, vegetables and whole grains.
There are a number of preventive and treatment measures that fall into each of the four preventive factors. Using the CAMBRA approach we can develop a treatment and prevention plan that incorporates measures that uniquely fit your dental health situation. With such a plan we can greatly reduce your risk of disease development and impact and better ensure a long and healthy life for your teeth and gums.
If you would like more information on managing dental disease prevention, 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.”
Tooth decay doesn’t suddenly appear out of the blue. Cavities and other damage are the result of a long process that begins with bacteria living in a thin biofilm on tooth surfaces known as plaque. These bacteria thrive on sugars from leftover food in your mouth and then produce acid as a waste product. Chronic high levels of acid cause your enamel, the protective layer of your teeth, to soften and erode.
While there are treatment options at each stage of decay — including crowning or even tooth replacement — the best approach is to try to prevent plaque buildup that supports disease-causing bacteria. Here are 3 of the best ways you can do that.
Brush and floss daily. It usually takes 12-24 hours for enough plaque buildup to support bacteria. By brushing and flossing at least once a day, you can remove most of this buildup, with twice a year dental cleanings to remove hard to reach plaque you may have missed. Be sure to use fluoride toothpaste to help strengthen enamel against high acid. And wait a half hour to an hour after eating before brushing to give saliva time to reduce the acid level in your mouth.
Cut back on sweets. You’re not the only one who loves sugary snack foods — so do oral bacteria. The more sugar and other carbohydrates they feast on, the more they produce acid. The best approach is to cut out sugar-rich snacks altogether and instead snack on fresh fruits, raw vegetables or dairy products. Limit sweet treats to meal times.
Use decay-fighting supplements. Your mouth and hygiene efforts may need a little assistance, especially if you have low saliva flow. You can boost this with an artificial saliva supplement as well as with products containing xylitol, an alcohol-based sugar. Xylitol also has an added benefit in the fight against decay because it inhibits bacterial growth. And be sure to talk with us first before taking any dental supplement.
If you would like more information on dental hygiene and care, 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 “Cost-Saving Treatment Alternatives.”