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Posts for tag: tooth decay

By Edward C. Smith, DMD, MPH, LLC
August 07, 2019
Category: Oral Health
Tags: tooth decay  
IfYoureOlderbeontheLookoutforRootCavities

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.”

By Edward C. Smith, DMD, MPH, LLC
November 30, 2018
Category: Oral Health
Tags: tooth decay   tooth pain  
DontIgnoreSuddenToothPain-YourTeethmaybeTellingyouSomething

Nothing grabs your attention like a sharp tooth pain, seemingly hitting you out of nowhere while you’re eating or drinking. But there is a reason for your sudden agony and the sooner you find it out, the better the outcome for your oral health.

To understand tooth sensitivity, we need to first look at the three layers of tooth anatomy. In the center is the pulp filled with blood vessels and nerve bundles: it’s completely covered by the next layer dentin, a soft tissue filled with microscopic tubules that transmit sensations like pressure or temperature to the pulp nerves.

The third layer is enamel, which completely covers the crown, the visible part of a tooth. Enamel protects the two innermost tooth layers from disease and also helps muffle sensations so the tooth’s nerves aren’t overwhelmed. The enamel stops at about the gum line; below it the gums provide similar protection and sensation shielding to the dentin of the tooth roots.

Problems occur, though, when the dentin below the gums becomes exposed, most commonly because of periodontal (gum) disease. This bacterial infection caused by dental plaque triggers inflammation, which over time can weaken gum tissues and cause them to detach and shrink back (or recede) from the teeth. This can leave the root area vulnerable to disease and the full brunt of environmental sensations that then travel to the nerves in the pulp.

Tooth decay can also create conditions that cause sensitivity. Decay begins when certain oral bacteria multiply and produce higher than normal levels of acid. The acid in turn dissolves the enamel’s mineral content to create holes (cavities) that expose the dentin. Not treated, the infection can eventually invade the pulp, putting the tooth in danger of being lost unless a root canal treatment is performed to remove the infection and seal the tooth from further infection.

So, if you begin experiencing a jolt of pain while eating or drinking hot or cold foods or beverages, see your dentist as soon as possible to diagnose and treat the underlying cause. And protect your teeth from dental disease by practicing daily brushing and flossing, as well as seeing your dentist for regular dental cleanings and checkups. Don’t ignore those sharp pains—your teeth may be trying to tell you something.

If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”

By Edward C. Smith, DMD, MPH, LLC
June 13, 2018
Category: Oral Health
Tags: tooth decay   toothache  
HeresWhattoDoifYourChildhasaToothache

What should you do if your child complains about a toothache? Before calling our office, try first to learn what you can about the toothache.

You should first ask them where exactly the pain is coming from — one particular tooth or a generalized, dull ache. Also try to find out, as best they can tell you, when they first noticed the pain. Try then to look at the tooth or area where they indicate the pain is coming from: since tooth decay is a prime cause for tooth pain, you should look for any obvious signs of it like brown spots or cavities. You should also look at the gums around the teeth for any redness or swelling, a sign of an abscess or periodontal (gum) disease.

If you notice any of these signs, the pain persists for more than a day, or it has kept the child awake during the night, you should have us examine them as soon as possible. If you notice facial swelling or they’re running a fever, please call and we will see them immediately. If it’s definitely tooth decay, it won’t go away on its own. The longer we wait to treat it, the worse its effects in the mouth.

In the meantime, you should also try to alleviate the pain as best you can. If when looking in the mouth you noticed food debris (like a piece of hard candy) wedged between the teeth, try to gently remove it with dental floss. Give them ibuprofen or acetaminophen in an appropriate dosage for their age to relieve pain, or apply an ice pack on and off for about 5 minutes at a time to the outside of their jaw.

If any of these remedies stops the pain within an hour, you can wait until the next day to call for an appointment. If the pain persists, though, then an abscess could be developing — you should call that day to see us.

Regardless of when the pain stops, or whether you see any abnormal signs, it’s still important your child see us for an accurate diagnosis. Their toothache maybe trying to tell you something’s wrong — and the earlier a problem is found and treated, the better the outcome.

If you would like more information on dental problems in young children, 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 “A Child’s Toothache.”

By Edward C. Smith, DMD, MPH, LLC
November 22, 2017
Category: Oral Health
Tags: tooth decay  
ToothDecaycanbeLessofaProblemwithMinimallyInvasiveDentistry

“Less is more” is a truism for much of life. It’s also an important feature of an emerging approach to treating tooth decay known as minimally invasive dentistry (MID).

MID updates another revolution in dental care that occurred in the early 1900s. Treating decay took a quantum leap thanks to techniques developed by Dr. G. V. Black, considered the father of modern dentistry. Dr. Black’s approach (known as “extension for prevention”) involved not only removing decayed tooth structure, but also adjacent areas deemed vulnerable to decay, which made them easier to clean. On the downside, though, it also created larger than normal fillings.

As the practice prevailed through much of the Twentieth Century another weakness became apparent—the approach could not guarantee a treated tooth would not experience decay again. This became the real impetus toward MID—to find more comprehensive ways to treat decay with as little impact on the tooth structure as possible.

These efforts received a real boost from emerging technology. This was especially true in diagnostics with the rise of new devices like intraoral cameras and techniques like laser fluorescence that can enable dentists to detect decay much earlier. It’s now possible to catch the disease at an earlier stage before substantial damage to the tooth occurs.

MID has also led to new treatments that preserve more of the tooth structure. Traditional drilling is increasingly giving way to air abrasion, the use of a fine particle stream of aluminum oxide, glass beads or baking soda directed precisely at decayed structure and minimizing damage to healthy structure. We’re also using new filling materials like composite resin for restorations after treatment that are strong yet still life-like and attractive.

We also can’t forget the role of the twin daily hygiene practices brushing and flossing to remove bacterial plaque, the main source of dental disease. And regular dental cleanings and checkups round out the MID approach, helping to ensure that decay doesn’t get too far. The end result of this revolutionary approach: your teeth can experience less impact from treatment and remain healthier and more attractive in the long-run.

If you would like more information on minimally invasive dental 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 “Minimally Invasive Dentistry: When Less Care is more.”

By Edward C. Smith, DMD, MPH, LLC
March 18, 2017
Category: Oral Health
Tags: tooth decay  
FactorsBesidesOralHygienethatInfluenceYourRiskforToothDecay

Tooth decay is one of the world's most prevalent diseases — and one of the most preventable. We've known the primary prevention recipe for decades: brushing and flossing daily, and dental cleanings and checkups at least twice a year.

But consistent oral hygiene isn't enough — you should also pay attention to your overall health, diet and lifestyle habits. Each of these areas in their own way can contribute to abnormally high mouth acid, which can soften enamel and open the door to tooth decay.

Lower saliva production is one such problem that can arise due to issues with your health. Among its many properties, saliva neutralizes acid and helps maintain the mouth's optimum neutral pH level. But some health conditions or medications can reduce saliva flow: less saliva means less neutralization and chronic acidity.

You can also inhibit saliva flow with one particular lifestyle habit — smoking. Tobacco smoke can damage salivary glands. Nicotine, tobacco's active ingredient, constricts blood vessels, leading to fewer antibodies delivered by the blood stream to mouth tissues to fight disease.

A diet heavy on acidic foods and beverages can also increase mouth acidity. It's not only what you're eating or drinking — it's also how often. If you're constantly snacking or sipping on something acidic, saliva doesn't have a chance to complete the neutralizing process.

In addition to your daily oral hygiene practice, you should also make changes in these other areas to further lower your risk of tooth decay. If you're taking medications that cause dry mouth, see if your doctor can prescribe a different one or try using products that stimulate saliva. Quit smoking, of course, as much for your mouth as for the rest of your health.

On the dietary front, reduce your intake of acidic foods and beverages, especially sodas, energy or sports drinks. If you've counted on the latter for hydration, switch to water instead. And limit acidic foods to mealtime rather than throughout the day.

It's all about maintaining a healthy pH level in your mouth. Doing so along with good oral hygiene will help you better avoid destructive tooth decay.

If you would like more information on preventing 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.”