Until recently, the standard treatment for tooth decay remained essentially the same for nearly a century: Remove any decayed structure, then prepare and fill the cavity. But that singular protocol has begun to change recently.
Although "drilling and filling" saves teeth, it doesn't fully address the causes of decay. In response, dentists have broadened their approach to the disease—the focus now is on an individual patient's particular set of risk factors for decay and how to reduce those.
At the heart of this new approach is a better understanding of oral bacteria, the true cause of decay. Bacteria produce acid, which can erode tooth enamel and create a gateway into the tooth for decay to advance. We therefore want to lower those risk factors that may lead to bacterial growth and elevated acidity.
One of our major objectives in this newer approach is to reduce plaque, a thin film of food particles used by bacteria for food and habitation. Removing plaque, principally through better oral hygiene, in turn reduces decay-causing bacteria.
Plaque isn't the only mechanism for bacterial growth and acidity. Appliances like dentures or retainers accumulate bacteria if not regularly cleaned. Reduced saliva flow, often due to certain medications or smoking, limits this fluid's ability to buffer acid and acid reflux or acidic beverages like sodas, sports or energy drinks can disrupt the mouth's normal pH and increase the risk for enamel erosion.
Our aim, then, is to develop a long-term strategy based on the patient's individual set of oral disease risk factors. To determine those, we'll need to examine their medical history (including family), current health status and lifestyle habits. From there, we can create a specific plan targeting the identified risk factors for decay.
Some of the elements of such a strategy might include:
- Daily brushing and flossing, along with regular dental cleanings;
- Fluoride dental products or treatments to strengthen enamel;
- Changes in diet and excess snacking, and ceasing from any tobacco use;
- Cleaning and maintaining appliances, as well as monitoring past dental work.
Improving the mouth environment by limiting the presence of oral bacteria and acid can reduce the occurrence of tooth decay and the extent of treatment that might be needed. It's a more nuanced approach that can improve dental health.
If you would like more information on tooth decay prevention and 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 “Tooth Decay: How to Assess Your Risk.”
If you think brushing and flossing and regular dental visits are all you need to do to avoid dental disease, you're missing a key component in your prevention plan. What you eat could also help close the door on tooth decay or gum disease—or open it even wider if you're eating nutritionally deficient foods.
Let's look first at the latter scenario. Like us, the oral bacteria most responsible for dental disease also have to eat to survive and thrive. And, often like us, they have a favorite food—provide them ample amounts of that and they'll continue to multiply and raise your risk of disease.
That favorite bacterial food is simple carbohydrates, particularly refined sugar. A diet heavy in added sugar can increase oral bacteria, which in turn elevates your chances of a gum infection. Bacteria's main by-product, acid, may also increase. That's bad news for your teeth. At high levels, acid contact softens and erodes enamel, the precursor to tooth decay.
Obviously, then, a "tooth-friendly" diet should be low on sugar and other simple carbohydrates like refined breads, pasta or pastries. Soda, energy and sports drinks high in both sugar and acid should also be avoided or restricted to mealtimes. You should also be careful with how much fruit you're eating as their natural sugars can also feed bacteria.
A well-rounded diet, however, isn't simply about avoiding foods—you'll also want to include foods that help you build and maintain healthy teeth and gums. That includes:
- Fiber-rich plant foods: Their fiber reduces the effects of any carbohydrates and they're packed with nutrients;
- Whole grains: Whole grains don't promote decay as refined products do, and chewing them stimulates saliva flow for neutralizing acid;
- Fresh fruits: Eaten in moderation, fruits can provide a bevy of vitamins and minerals. But avoid dried fruits as their sugars are more concentrated;
- Dairy: Milk-based products, particularly cheese, contain nutrients like Vitamin D, calcium and phosphorus, which strengthen teeth against dental disease.
For the most part, a diet that promotes overall well-being will also provide optimum benefits for your dental health. Along with your dental hygiene efforts, eating the right foods can help protect your teeth and gums from both tooth decay and gum disease.
If you would like more information on how better nutrition can boost your dental health, 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 “Nutrition & Oral Health.”
We like to think we're more prone to stress in our modern, fast-paced world than those who lived in "simpler" times, but a finding from the recent discovery of Richard the III's remains in England suggests differently. Investigators noted the king had well-worn teeth, perhaps from grinding them out of stress.
We can't be sure this was the cause for the king's dental problems, or if teeth grinding was common in the 15th Century. But we are sure the problem exists today among adults.
Tooth grinding is the grinding, gnashing or clenching of teeth involuntarily when not engaged in regular dental functions like eating or speaking. It can occur while a person is awake, but most often while they're asleep.
The habit regularly occurs in children, but is not considered a major problem as most outgrow it by adolescence, usually with no lingering damage. Not so with adults: Because the habit generates abnormally high biting forces, teeth grinding can lead to accelerated tooth wear. It can also weaken teeth, making them more susceptible to fracture or disease.
People who grind their teeth will typically awaken with sore jaws or the complaints of family members about the loud chattering noise emitted during an episode. If you suspect a problem, you should see your dentist for a definitive diagnosis, and to learn how to reduce its occurrence and effects.
Treatments for the habit vary depending on underlying causes. They may involve lifestyle changes like quitting tobacco, limiting alcohol or altering your use of certain drugs or medications. Because stress is often a major factor, learning better relaxation techniques through meditation, group therapy or biofeedback may also help reduce teeth grinding.
These treatments, though, can take time, so you may also need ways to minimize the effects of the habit in the meantime. One of those ways is for your dentist to create an occlusal guard that you wear while you sleep. The guard prevents the teeth from making solid contact, thus reducing the potential biting forces.
It's important, then, to see your dentist as soon as possible if you suspect you're grinding your teeth. Finding out as early as possible and then taking positive steps to stop or reduce its effect can save your teeth from a good deal of harm.
If you would like more information on teeth grinding, 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 “Teeth Grinding.”
It's been a rough year for all of us, but especially for Simon Cowell. The famous entrepreneur and brutally honest talent judge on American Idol and America's Got Talent underwent emergency back surgery in August after an accident on a new electric bike. But the good news is he's well on his way to recovery—and well enough in October to undergo another, less-stressful, procedure: a smile makeover with dental veneers.
This latest trip to the dentist wasn't Cowell's first experience with the popular restoration, wanting this time to update his smile to more closely resemble what he had when he was younger. He even brought along some older photos for reference.
Veneers aren't exclusive to celebrities like Simon Cowell, as thousands of people who get them every year can attest. These thin wafers of porcelain bonded to teeth can mask a wide range of defects, from chips, wear or discoloration to slight tooth gaps or misalignments. And every veneer is custom-made to match an individual patient's dental dimensions and coloring.
If you're thinking about a smile upgrade, here are a few reasons to consider dental veneers.
More bang for your buck. Compared to other transformative cosmetic options, veneers are relatively affordable, with the cost dependent largely on the extent of your dental needs. Still, dental veneers are an investment that can give long-lasting yields of a more attractive smile and even a completely new look.
Little to no tooth alteration. In most veneer cases, we need only remove a small amount of enamel so the veneers don't appear bulky (the alteration is permanent, though, so you'll need a veneer on the tooth from then on). It's also possible to get “no-prep” veneers requiring little to no alteration.
Durable and long-lasting. Continuing improvements in porcelain and other dental ceramics have led to stronger forms that can better withstand the biting forces your teeth encounter every day. Although you'll still need to be careful biting into hard items, your veneers can last for several years.
Easy to maintain. Veneer cleaning and maintenance is much the same as with natural teeth—daily brushing and flossing, and regular dental cleanings and checkups. Outside of that, you'll need to watch what you chomp down on: Veneers are strong, but not indestructible, and they can break.
As Simon Cowell knows, getting veneers isn't difficult. It starts with an initial visit so we can evaluate your dental health and needs. From there, we can present options on how to update your smile.
If you would like more information about dental veneers, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “No-Prep Porcelain Veneers.”
Although getting an implant requires surgery, it's usually a minor affair. Chances are good that after just a few days recuperation you'll be back completely to your normal activities.
But like many other minor surgeries, an implant procedure does pose a slight risk of post-op infection. That's especially so with any dental procedure like implant surgery, since the mouth harbors numerous strains of bacteria that could escape into the bloodstream. For most people, though, a post-op infection doesn't pose a major problem since their immune system kicks in immediately to defeat it.
But some patients with less than robust immune systems or other health problems can have serious complications from an infection. Among other things, infected tissues around an implant may not heal properly, putting the implant at significant risk for failure.
If you have a condition that makes a post-op infection problematic, your dentist or physician may recommend you take an antibiotic before your procedure. Known as prophylactic (preventive) antibiotic treatment, it's intended to give a weakened immune system a head-start on any potential infection after a procedure.
Using antibiotics in this way has been a practice for several decades, and at one time were recommended for a wide list of conditions. That's changed in recent years, though, as evidence from numerous studies seems to show the risk to benefit ratio isn't significant enough to warrant its use in all but a handful of conditions.
Both the American Dental Association and the American Heart Association recommend prophylactic antibiotics for patients with prosthetic heart valves, past infective endocarditis, a heart transplant and some congenital heart conditions. Some orthopedists may also recommend it for patients with prosthetic joints.
Even if you don't fall into these particular categories, prophylactic antibiotics may still be beneficial if you have a compromised immune system or suffer from a disease like diabetes or lung disease. Whether or not a prophylactic antibiotic is a prudent step given your health status is a discussion you should have with both your physician and your dentist.
If they feel it's warranted, it can be done safely in recommended doses. If your health isn't as robust as it could be, the practice could give you a little added insurance toward a successful implant outcome.
If you would like more information about dental implant surgery, 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 “Implants & Antibiotics.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.