Since the late 19th Century, dentists have used established protocols to successfully prevent and treat tooth decay. But there've been changes to this approach the last few years to improve its effectiveness, changes we now refer to as Minimally Invasive Dentistry or MID.
The older approach for treating dental caries (tooth decay) follows the protocols established by Dr. G.V. Black, considered the father of modern dentistry. Black advocated removing not only decayed structure but also some of the healthier but vulnerable portions of a tooth, to avoid further decay and make the tooth easier to clean. This resulted in larger fillings, although they've become smaller as dental techniques have advanced.
MID, on the other hand, aims to remove as little tooth structure as possible while still effectively treating and preventing future decay. To achieve that goal we begin first with a complete assessment of a patient's individual decay risk, known as Caries Management By Risk Assessment (CAMBRA).
With CAMBRA, we're looking at other factors besides individual tooth health: a patient's hygiene, lifestyle and dietary habits; the types and amount of bacteria present; and the quality of saliva flow, needed to neutralize mouth acid. With these the results we develop a customized prevention and treatment strategy.
MID also focuses on detecting dental caries as early as possible. Besides traditional x-rays, we're beginning to use other methods like dental microscopes, laser fluorescence, infrared photography or optical scanning. Early detection leads to early intervention, and with techniques that are much less invasive than the traditional approach.
The new approach also changes how we repair decayed teeth. We're increasingly using air abrasion, a technology that uses fine particles in a pressurized air stream to remove softer decayed tooth material and less healthy structure than the traditional dental drill. We're also using composite resin and other advanced materials for filings: these tooth-colored materials are stronger than previous versions and are quickly taking the place of metal amalgam, requiring less structural removal to accommodate them.
MID's core principles are early disease detection, proactive prevention and treatment with less structural removal. With this enhanced approach to effective dentistry, we're keeping your teeth healthy with minimal discomfort, lower costs and less long-term impact.
Allergic reactions aren't necessarily bad: they're your body's responses to possible threats from foreign substances. But the response can go too far and cause a reaction as minor as a skin rash or as life-threatening as a multi-system shutdown called anaphylaxis.
Anything can cause an allergy: animal fur, food, chemicals — or metals. Because metals play such a large role in dental care, it's only natural we're alert to the possibility of allergic reactions from a procedure.
But don't postpone your implants or other dental work just yet — the threat isn't nearly that ominous. Here are a few facts about dental metal allergies to help you sort it out.
Allergic reactions are rare for metals used in medical and dental procedures. Although reactions to metals in joint replacements or coronary stents leading to failure do happen, actual occurrences are rare. Most metal allergies manifest as a skin reaction to jewelry or clothing. It's less likely with medical or dental metals because they're chosen specifically for their compatibility with living tissue.
Amalgam fillings account for most dental work reactions. Dentists have used this multi-metal alloy for fillings and other restorations for well over a century. Tooth-colored resins are now used for most fillings, but amalgam is still used in less visible back teeth. It's very rare for a person to experience a reaction to amalgam, but when it does occur it usually results in minor inflammation or a rash.
Implant titanium isn't just bio-compatible — it's also osteophilic. Titanium is the perfect choice for implants not only because it's tissue friendly, but also because it's bone friendly (osteophilic). Once implanted in the jaw, bone cells naturally grow and adhere to it to create a more durable bond. Not only does the body usually tolerate titanium, it welcomes it with open arms!
While it's still possible for you to have an allergy to implant titanium, the chances are remote. In one recent study involving 1,500 implant patients, titanium allergies occurred in less than 1%. So the chances are high a metal allergy won't stop you from obtaining a smile-transforming restoration with dental implants.
If you would like more information on allergies and dental work, 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 “Metal Allergies to Dental Implants.”
Refined sugar is a prime food source for disease-causing oral bacteria. As bacteria consume sugar they produce high levels of acid that over time can erode enamel and leave a tooth vulnerable for decay.
The solution to stopping this vicious process is simple: cut back on eating refined sugar. The reality, though, is a bit more complicated. Many of us seem genetically hard-wired with a “sweet tooth,” perhaps a remnant of our early ancestors' sense that sweet foods were a safe means to obtain energy.
Food manufacturers likewise don't help with making this dietary change — the number of items with added sugar has ballooned over the last several decades. We can trace a lot of this back to the unintended consequences of past government guidelines that called for removing fat from processed foods. But this also removed flavor, so manufacturers began adding sugar (under a myriad of names) to compensate.
Sugar consumption is now a hot health topic for its suspected connection with inflammatory diseases like diabetes and cardiovascular disease, as well as dental health. We now have a love-hate relationship with sugar — we want to show it the door but we can't quite bring ourselves to let it go.
The situation has created a market for artificial sweeteners. The amount and types of sugar alternatives has exploded since saccharine first emerged in the early 1960s. With these increased choices, though, there have also been increased concerns over their health impact, including in the mouth.
This concern has prompted numerous research studies. The conclusion: artificial sweeteners don't adversely affect the health of most people. And, from a dental perspective, artificial sweeteners can have a positive impact on teeth and gum health because unlike refined sugar they don't promote oral bacterial growth.
In fact, one particular sweetener may be even more beneficial to your teeth: xylitol. This sweetener, which comes from a sugar alcohol that oral bacteria can't digest, is often found in chewing gums, hard candies or mints. Â In effect, xylitol “starves out” bacteria to help prevent tooth decay.
From a dental perspective, replacing sugar with an artificial sweetener (especially xylitol) can be advantageous. And less sugar could mean more good news after your next dental checkup.
If you would like more information on artificial sweeteners, 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 “Artificial Sweeteners.”
The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.
The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.
Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces). Some people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.
Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.
After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.
Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.
If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”
Tooth decay is a destructive oral disease, which along with periodontal (gum) disease is most responsible for tooth loss. And as you age, your disease risk goes up.
One form of decay older people often experience is root cavities. Unlike those occurring in the visible crown, root cavities often occur below the gum line and are especially destructive to tooth structure.
That's because, unlike the crown protected by ultra-hard enamel, the roots are covered by a thin, mineralized material called cementum. Although cementum offers some protection, it can't compare with the decay-resistant capacity of enamel.
The roots also depend on gum coverage for protection. But unfortunately, the gums can shrink back or recede, usually due to gum disease or over-aggressive brushing, and expose some of the root surface. With only the cementum to protect them, the roots can become highly susceptible to decay. If a cavity forms here, it can rapidly advance into the tooth's interior, the pulp, weakening the tooth and increasing its risk of loss.
To stop the decay, we must treat root cavities much like we do with crown cavities: by removing any decayed structure and then filling the cavity. But root cavities are often more difficult to access depending on how far below the gum line they extend. We may need to perform minor gum surgery to expose the cavity to treat it.
But as with any form of tooth decay, the best strategy is to prevent root cavities in the first place. Your first line of defense is a daily hygiene habit of brushing and flossing to remove dental plaque, the main cause for tooth decay. You should also visit your dentist at least twice a year (or more, if recommended) for more thorough cleanings and checkups. Your dentist can also recommend or prescribe preventive rinses, or apply fluoride to at-risk tooth surfaces to strengthen them.
You should also be on the lookout for any signs of gum disease. If you see swollen, reddened or bleeding gums, see your dentist as soon as possible. Stopping possible gum recession will further reduce your risk of root cavities.
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 “Root Cavities: Tooth Decay Near the Gum Line Affects Many Older Adults.”
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