If you've ever had a run-in with cavities, you know the drill (no pun intended): After getting a local anesthetic for pain, the dentist removes any decayed dental tissue, as well as some healthy tissue, and then fills the cavity to restore the tooth. It's an effective treatment protocol we've been using for well over a century.
It does, however, have its drawbacks. For one, although necessary, removing healthy dental tissue can weaken the overall tooth structure. The dental drill used during the procedure is also unpleasant to many people: Although it doesn't cause any pain thanks to the anesthetic, the sounds and pressure sensations associated with it can be unsettling.
But advances in dental tools, technology and techniques are addressing these drawbacks in traditional tooth decay treatment. In other words, treating a tooth with cavities today is taking on a lighter touch. Here are 3 reasons why.
Earlier detection. The key to effective treatment is to find tooth decay in its earliest stages. By doing so, we can minimize the damage and reduce the extent of treatment needed. To do this, we're beginning to use advanced diagnostic tools including digital x-rays, intraoral cameras and laser fluorescence to spot decay, often before it's visible to the naked eye.
Re-mineralizing enamel. One of the advantages of early detection is to catch tooth enamel just as it's undergoing loss of its mineral content (demineralization) due to contact with acid. At this stage, a tooth is on the verge of developing a cavity. But we can use minimally invasive measures like topically applied fluoride and CPP-ACP (a milk-based product) that stimulates enamel re-mineralization to prevent cavity formation.
Less invasive treatment. If we do encounter cavities, we no longer need to turn automatically to the dental drill. Air abrasion, the use of fine substance particles under high pressure, can precisely remove decayed material with less loss of healthy tissue than a dental drill. We're also using newer filling materials like composite resins that don't require enlarging cavities as much to accommodate them.
These and other techniques—including laser technology—are providing superior treatment of tooth decay with less invasiveness. They can also make for a more pleasant experience when next you're in the dentist's chair.
If you would like more information on effectively treating dental disease, 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.”
If we were playing word association with the term “oral hygiene,” you'd probably answer “brushing.” And you would be right—brushing cleans tooth surfaces of accumulated bacterial plaque, a thin biofilm most responsible for dental disease.
But brushing is only half of the oral hygiene equation: You also need to remove dental plaque between teeth where brushing can't reach. And, that requires that other practice—flossing.
Unfortunately, brushing is more popular than its hygienic sibling because many people find traditional thread flossing more difficult and messier than brushing. That can make it tempting to skip flossing—but then you're only getting half the benefit of oral hygiene for reducing the risk of tooth decay or gum disease.
There is, however, a way to floss that doesn't involve a roll of thread: oral irrigation. This form of flossing uses a countertop device that directs a pressurized spray of water between teeth through a handheld wand. The directed spray loosens and then flushes away accumulated plaque.
Oral irrigators (also known as water flossers) have been an important tool for decades in dental offices, and have been available for home use since the 1960s. In the last few years, though, the devices have become more compact and easier to use. More importantly, studies have shown they're as effective in removing between-teeth plaque as regular flossing.
These irrigation devices are especially useful for people wearing braces. The attached brackets and wires make it extremely difficult to maneuver flossing thread between teeth. Because of this (as well as similar difficulties in brushing), patients are more susceptible to dental disease while undergoing orthodontic treatment.
But a 2008 study showed that oral irrigators are quite effective for braces wearers in removing between-teeth plaque. It found those who used an irrigator after brushing removed five times the amount of plaque than those that only brushed.
Even if you're not wearing braces, you may still find an oral irrigator to be a useful flossing alternative. Speak with your dentist for recommendations on what to look for in an oral irrigator and tips on how to use it. It could make a positive difference in your dental health.
If you would like more information on how best to keep your teeth and gums clean, 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 “Cleaning Between Your Teeth.”
Chipped a tooth? Don't beat yourself up—this type of dental injury is quite common. In fact, you probably have a favorite celebrity who has chipped one or more of their teeth. The list is fairly long.
Some chipped a tooth away from the limelight, such as Tom Cruise (a hockey puck to the face as a teen), Jim Carrey (roughhousing on the playground) and Paul McCartney (a sudden stop with a moped). Others, though, chipped a tooth while “on the job.” Taylor Swift, Hillary Duff and Jennifer Lopez have all chipped a tooth on stage with a microphone. And chipped teeth seem to be an occupational hazard among professional athletes like former NFL star, Jerry Rice.
Since smiles are an indispensable asset to high-profile celebrities, you can be sure these stars have had those chipped teeth restored. The good news is the same procedures they've undergone are readily available for anyone. The two most common restorations for chipped teeth are dental bonding and veneers.
The least invasive way to fix a chipped tooth is bonding with a material known as composite resin. With this technique, resin is first mixed to match the tooth color and then applied to the chipped area or applied in layers of color to get just the right look. After a bit of shaping, curing and adjustment, we're done—you can walk out with a restored tooth in one visit.
Bonding works well with slight to moderate chips, but it could be less durable when there is more extensive damage. For that, you may want to consider porcelain veneers. Veneers are thin wafers of dental porcelain that are bonded to the front of teeth to mask blemishes like stains, slight gaps or, yes, chips. Veneers can be so lifelike that you won't be able to tell the veneered tooth from your other teeth. They are fashioned to match the color and shape of an individual's teeth. Because of the time and design detail involved, veneers are more expensive than bonding, yet still within an affordable range for many.
Teeth require some alteration before applying traditional veneers because otherwise the teeth can appear bulky when the veneer is bonded to the existing tooth. To compensate, we remove a little of the tooth enamel. Because this loss is permanent, you'll need to wear veneers or have some other form of restoration for the tooth from then on. For many people, though, that's a small price to pay for a smile without chips.
Your first step to repairing a chipped tooth is to come in for an examination. From there, we'll recommend the best option for your situation. And regardless of which, bonding or veneers, we can change your smile for the better.
If you would like more information about restoring injured teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Porcelain Veneers: Strength and Beauty as Never Before.”
If you're intrigued by the strange and bizarre, here's one to pique your interest: geographic tongue. It's a rare condition that causes the appearance of red patches on the tongue surface, surrounded by grayish-white borders, and which look a lot like continents on a map (hence the name). But although it may look odd, geographic tongue won't harm your health.
The condition is also known as benign migratory glossitis, so named because it's not cancerous and the patches seem to move or “migrate” around the tongue surface. The most common causes are thought to be stress or hormonal disruptions in those predisposed to the condition. Many researchers believe zinc or vitamin B deficiencies in the body contribute to its occurrence. It also seems more prevalent among non-smokers and pregnant women, as well as occurring as a family trait.
The red patches are created by the temporary disappearance of some of the papillae, tiny bumps on the tongue's top surface. The patches can abruptly appear during a flareup and then disappear just as suddenly. But as “angry” as the patches may look, geographic tongue is not considered a health danger. It isn't normally painful, although people can experience stinging or numbing sensations emanating from the patches that can be mildly uncomfortable.
Because it's also rare, you're not likely to encounter it personally. But if you or a loved one does begin to notice red patches on the tongue, there are a few things you can do to lessen any accompanying irritation. For one, cut out foods like tomatoes, citrus fruits, eggplant, mint or highly spicy or acidic foods, all of which have been known to increase discomfort. You might also avoid astringents like alcohol or mouthwashes that likewise irritate the patches when they occur.
Although geographic tongue can't be cured, your dentist can help you manage symptoms when they arise with the help of prescribed anesthetic mouthwashes, antihistamines or steroid lozenges. These not only can help lower any discomfort or irritations, they may also lessen the duration of a flareup.
For the most part, geographic tongue usually causes more embarrassment than physical discomfort. But with a little help from your dentist, you can keep it to a minimum. Geographic tongue may be odd, but it's nothing to worry about.
If you would like more information on geographic tongue, 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 “Geographic Tongue: No Cause For Alarm.”
Dental implants are widely considered by both dentists and patients as the premier choice for replacing missing teeth. Unfortunately, implants aren’t the appropriate choice for teenagers with missing teeth.
That’s because their jaws won’t fully finish most of their growth and development until early adulthood. An implant placed too early could become misaligned as the jaw matures. The best approach for a teenager is a temporary restoration until they’re old enough for an implant.
There are a couple of good options. One is a removable partial denture (RPD), prosthetic (false) teeth set in an acrylic base that mimics gum tissue at the locations of the missing teeth. RPDs, which stay in place by way of metal clips that fit over other teeth, are easy to wear and maintain.
On the downside, an RPD can break if you bite into something too hard. They can lose their fit and may need to be replaced with a new one. And, some teens aren’t quite keen on wearing a “denture.”
Another option is a bonded or Maryland bridge, a kind of fixed bridge. We bond dental material to the back of a prosthetic tooth with portions of the material extending out from either side of it.Â We then bond these extending tabs to the back of the teeth on either side of the prosthetic tooth to hold it in place. Unlike traditional bridges, we can eventually remove it without any permanent alterations to the teeth it’s attached to.
Before we undertake a bonded bridge, though, we must make sure the gums and bone of the surrounding teeth are free from periodontal (gum) disease and are healthy and strong enough to support the bridge. We also need to be sure the patient doesn’t have a deep bite or a teeth grinding habit, which could cause the teeth to make contact with the tabs and break them.
The patient also needs the maturity to responsibly perform diligent oral hygiene: this type of bridge has a tendency to build up disease-causing plaque, so brushing twice and flossing once every day is critical. Not doing so increases the risk of tooth decay or periodontal (gum) disease, which could complicate a future implant.
We can discuss these options after a thorough dental examination of your teenager. Either way, we’ll be able to restore your teen’s smile until we can undertake a more permanent restoration.
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