Although techniques and materials have changed, dentists still follow basic principles for treating tooth decay that date from the late 19th Century. And for good reason: They work. These principles first developed by Dr. G.V. Black—the "father of modern dentistry"—are widely credited with saving millions of teeth over the last century.
One of the most important of these treatment protocols is something known as "extension for prevention." In basic terms, it means a dentist removes not only decayed tooth structure but also healthy structure vulnerable to decay. But although effective in saving teeth, practicing this principle can result in loss of otherwise healthy tissue, which can weaken the tooth.
But with new advances in dentistry, decay treatment is getting an overhaul. While Dr. Black's time-tested protocols remain foundational, dentists are finding new ways to preserve more of the tooth structure in a concept known as minimally invasive dentistry (MID).
Better diagnostic tools. Because tooth decay can ultimately infect and damage the tooth's interior, roots and supporting bone, the best way to preserve more of the tooth structure is to treat it as early as possible. Now, new diagnostic tools like digital x-rays, microscopic magnification and optical scanning are helping dentists detect and treat decay earlier, thus reducing how much tissue is removed.
Better prevention methods. Oral hygiene and regular dental care are our basic weapons in the war with tooth decay. In addition, utilizing topical fluoride in combination with a milk-derived product called CPP-ACP dentists can get more of the cavity-fighting organic compound into the tooth enamel to strengthen it against acid attack.
Better treatment techniques. Using air abrasion (a fine particle spray that works like a miniature sandblaster) and lasers, dentists can now remove decayed structure with less harm to healthy tissue than with a traditional dental drill. And new, stronger dental fillings like those made with composite resins require less structural removal to accommodate them.
With these innovative approaches, dentists aren't just saving teeth, they're preserving more of their structure. And that can improve your overall dental health for the long-term.
If you would like more information on minimally invasive dentistry, 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.”
Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.
That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!
Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.
Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”
One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.
Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.
Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”Â Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
A disease happening in one part of your body doesn’t necessarily stay there. Even a localized infection could eventually affect your general health. Periodontal (gum) disease, a bacterial infection that damages gums, teeth and supporting bone, is a case in point.
There’s now growing evidence that gum disease shares links with some other serious systemic diseases. Here are 4 serious health conditions and how gum disease could affect them.
Diabetes. Gum disease could make managing diabetes more difficult—and vice-versa. Chronic inflammation occurs in both conditions, which can then aggravate the other. Diabetics must deal with higher than normal glucose levels, which can also feed oral bacteria and worsen existing gum disease. On the plus side, though, effectively managing both conditions can lessen each one’s health impact.
Heart disease. Gum disease can worsen an existing heart condition and increase the risk of stroke. Researchers have found evidence that chronic inflammation from gum disease could further damage already weakened blood vessels and increase blood clot risks. Treating gum disease aggressively, on the other hand, could lower blood pressure as much as 13 points.
Rheumatoid Arthritis. The increased inflammatory response that accompanies arthritis (and other diseases like lupus or inflammatory bowel disease) can contribute to a higher risk for gum disease. As with the other conditions previously mentioned, chronic inflammation from a gum infection can also aggravate arthritis symptoms. Treating any form of chronic inflammation can ease symptoms in both arthritis and gum disease.
Alzheimer’s disease. The links of Alzheimer’s disease to gum disease are in the numbers: a recent study found people over 70 who’ve had gum disease for ten or more years were 70% more likely to develop dementia than those with healthy gums. There is also evidence that individuals with both Alzheimer’s and gum disease tended to decline more rapidly than those without gum disease.
From the accumulating evidence, researchers now view gum disease as more than an oral problem—it could impact your total health. That’s why you should adopt a disease prevention strategy with daily brushing and flossing and regular dental visits (or whenever you notice puffy, reddened or bleeding gums). Stopping gum disease could provide you a health benefit well beyond preserving your teeth and gums.
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.”
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