True or false: there’s no cause for concern about tooth decay until your child’s permanent teeth erupt.
False—decayed primary teeth can lead to potentially serious consequences later in life.
Although “baby” teeth last only a few years, they’re essential to future dental health because they act as placeholders and guides for the incoming permanent teeth. If they’re lost prematurely due to decay, other teeth may drift into the empty space intended for the emerging permanent tooth. Because of this, inadequate space will crowd the out of proper alignment.
And because they have thinner enamel than permanent teeth, primary teeth are more susceptible to decay. Once decay sets in, it can spread rapidly in a matter of months.
Fortunately, we may be able to prevent this from happening to your child’s primary teeth with a few simple guidelines. It all begins with understanding the underlying causes of tooth decay.
Tooth decay begins with bacteria: As a result of their digestion, these microorganisms secrete acid that at high levels can erode tooth enamel. The higher the population of bacteria in the mouth, the higher the acidity and potential threat to the teeth.
The first objective then in preventing decay is to remove dental plaque, the thin film of bacteria and food particles on tooth surfaces, through daily brushing and flossing. And because bacteria feed on sugar as a primary food source, you should reduce your child’s sugar consumption by restricting it to only meal times and not sending your child to bed with a bottle filled with a sugary liquid (including formula or breast milk).
To help boost your child’s protection, we can also apply sealants and fluoride to teeth to help protect and strengthen their enamel from acid attack. Because we’ll also monitor for signs of decay, it’s important to begin regular dental visits beginning around age one. If we do detect decay, we can then treat it and make every effort to preserve your child’s primary teeth until they’ve completed their normal life cycle.
By taking these steps, we can help make sure your child’s early teeth go the distance. Their current and future dental health will certainly benefit.
If you would like more information on 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 “Do Babies Get Tooth Decay?”
Most dental procedures today only require local anesthesia to numb just the affected area. It's a safer approach than general anesthesia: the unconscious state created by putting someone "to sleep" can lead to some unpleasant complications.
But patient comfort involves more than preventing physical pain during a procedure. There's also the emotional factor—many people experience nervousness, anxiety or fear during dental visits. It's especially problematic for an estimated 15% of the population whose dental visit anxiety is so great they often try to avoid dental care altogether.
One option is to use general anesthesia for patients with acute anxiety rather than local anesthesia. This removes them consciously from their anxiety, but they must then be monitored closely for complications.
But there's a safer way to relax patients with high anxiety called intravenous or IV sedation. The method delivers a sedative medication directly into a patient's bloodstream through a small needle or catheter inserted into a vein. The sedative places the patient in a relaxed "semi-awake" state, taking the edge off their anxiety while still enabling them to respond to verbal commands.
Coupled with local anesthesia, they won't experience any pain and very little if any discomfort. And many of the sedatives used also have an amnesiac effect so that the patient won't remember the procedures being performed.
IV sedation does require monitoring of vital signs, but the patient won't need help maintaining their breathing or heart function. And although the medication can be adjusted to reduce any lingering after-effects, a patient will still need someone to accompany them to and from their visit.
For lesser anxiety or nervousness, dentists sometimes prescribe an oral sedative to take just before a visit. This can help take the edge off your nerves and help you relax. With either method, though, sedation can help you overcome fear and anxiety and have a more pleasant treatment experience.
If you would like more information on IV sedation, 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 “IV Sedation in Dentistry.”
A recent episode of “America’s Got Talent” featured an engaging 93-year-old strongman called The Mighty Atom Jr. The mature muscleman’s stunt: moving a full-sized car (laden with his octogenarian “kid brother,” his brother’s wife, plus Atom’s “lady friend”) using just his teeth. Grinning for host Howie Mandel, Atom proudly told the TV audience that his teeth were all his own; then he grasped a leather strap in his mouth, and successfully pulled the car from a standstill.
We’re pleased to see that the Atom has kept his natural teeth in good shape: He must have found time for brushing and flossing in between stunts. Needless to say, his “talent” isn’t one we’d recommend trying at home. But aside from pulling vehicles, teeth can also be chipped or fractured by more mundane (yet still risky) activities — playing sports, nibbling on pencils, or biting too hard on ice. What can you do if that happens to your teeth?
Fortunately, we have a number of ways to repair cracked or chipped teeth. One of the easiest and fastest is cosmetic bonding with tooth-colored resins. Bonding can be used to fill in small chips, cracks and discolorations in the teeth. The bonding material is a high-tech mixture of plastic and glass components that’s extremely lifelike, and can last for several years. Plus, it’s a procedure that can be done right in the office, with minimal preparation or discomfort. However, it may not be suitable for larger chips, and it isn’t the longest-lasting type of restoration.
When more of the tooth structure is missing, a crown (or cap) might be needed to restore the tooth’s appearance and function. This involves creating a replacement for the entire visible part of the tooth in a dental lab — or in some cases, right in the office. It typically involves making a model of the damaged tooth and its neighbors, then fabricating a replica, which will fit perfectly into the bite. Finally, the replacement crown is permanently cemented to the damaged tooth. A crown replacement can last for many years if the tooth’s roots are in good shape. But what if the roots have been dislodged?
In some cases it’s possible to re-implant a tooth that has been knocked out — especially if it has been carefully preserved, and receives immediate professional attention. But if a tooth can’t be saved (due to a deeply fractured root, for example) a dental implant offers today’s best option for tooth replacement. This procedure has a success rate of over 95 percent, and gives you a natural looking replacement tooth that can last for the rest of your life.
So what have we learned? If you take care of your teeth, like strongman Atom, they can last a long time — but if you need to move your car, go get the keys.
If you would like more information about tooth restoration, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Crowns & Bridgework.”
While wearing braces is the path to a healthier and more attractive smile, it can be a difficult journey. One of your biggest challenges will be keeping your teeth clean to avoid a higher risk of tooth decay.
Tooth decay starts with dental plaque, a thin film of bacteria and food particles that accumulates on teeth. Daily brushing and flossing clear this accumulation. But the hardware of braces makes it difficult to access all tooth surfaces, and can even become a haven for plaque.
One sign in particular of tooth decay while wearing braces is the appearance of chalk-like spots on the teeth known as white spot lesions (WSLs). WSLs occur because the minerals in the enamel beneath them have begun to break down in response to decay. The spots can eventually cause both structural and cosmetic problems for a tooth.
The best approach to WSLs is to prevent them from developing in the first place. You'll need to be extra vigilant with daily oral hygiene while wearing braces to reduce plaque buildup. To help with the increased difficulty you might consider using a special toothbrush designed to maneuver more closely around orthodontic hardware. You may also find using a water flosser to be a lot easier than flossing thread.
Preventing tooth decay and WSLs also includes what you eat or drink to reduce the effects of enamel de-mineralization. The bacteria that cause decay thrive on sugar, so limit your intake of sweetened foods and beverages. And to avoid excessive demineralization cut back on acidic foods as well.
If despite your best preventive efforts WSLs still form, we can take steps to minimize any damage. For one, we can give your enamel a boost with fluoride applications or other remineralization substances. We can also inject a tooth-colored resin beneath the surface of a WSL that will make it less noticeable.
With any of these and other treatments, though, the sooner we can treat the WSL the better the outcome. Practicing good hygiene and dietary habits, as well as keeping an eye out for any WSL formations, will do the most to protect your new and improved smile.
If you would like more information on preventing dental disease while wearing braces, 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 “White Spots on Teeth During Orthodontic Treatment.”
Root canal therapy is the unsung "hero" of dentistry. Although often falsely maligned as an unpleasant experience, millions of decayed teeth have been saved thanks to this routine treatment.
But although root canal therapy can save your tooth, we can't guarantee it won't be affected by another infection. There are other factors to consider how long a treated tooth will remain healthy.
Root canal therapy stops and limits the damage from tooth decay that has infected the inner pulp and root canals. A dentist or endodontist (a root canal specialist) drills into the tooth to gain access to the pulp. They remove the diseased pulp tissue and then fill the empty pulp chamber and root canals with a specialized filling called gutta percha. The tooth is then sealed and later crowned to protect it against future fracture or infection.
The probability of that occurring may depend on when a dentist performs the root canal in the disease progression—and the earlier the better. If decay has already infected the underlying bone, the tooth's long-term prognosis even with root canal therapy could be dim. That's why you should see a dentist as soon as possible for any tooth pain, even if it goes away.
The type of tooth could impact long-term health. Teeth with single roots are usually easier to treat. But those with multiple roots and an intricate root canal network can be more difficult to treat, and require specialized equipment and techniques.
Age can also impact root canal therapy longevity. The older a root canal-treated tooth is, the more brittle and susceptible to fracture it can become, which can pose complications. That's why we typically place crowns on treated teeth to protect them from both future infection and undue stress created while biting and chewing.
To help mitigate these possible factors, you should see your dentist regularly for checkups and at the first sign of pain or other abnormalities for the earliest treatment possible. And for more complex tooth issues, your dentist may refer you to an endodontist to perform your root canal. With early intervention and attentive care, your root canaled tooth could enjoy many years of life.
If you would like more information on root canal treatment, 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: How Long Will It Last?”
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