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Posts for tag: tooth decay

By John Leitner DDS
January 30, 2017
Category: Oral Health
Tags: tooth decay  
LessisBetterthe21stCenturyApproachtoToothDecayTreatment

For over a century dentists treated tooth decay by removing both diseased portions of the tooth and healthy structure deemed at risk for future decay. In the 1970s, though, a new approach emerged, known as Minimally Invasive Dentistry (MID). This practice protocol attempts to preserve as much of the healthy structure as possible.

Before MID, dentists followed a decay treatment protocol developed in the 19th Century. A part of this became known as extension for prevention calling for dentists to remove healthy structure considered vulnerable to decay. Besides reducing the tooth's volume, this practice also resulted in, by today's standards, larger than necessary fillings.

It was thought that removing this additional material would make it easier to clean bacterial plaque, the source of decay, but later, research showed the practice couldn't guarantee the teeth wouldn't be reinfected.

Since then we've learned a lot more about teeth and have developed new ways to detect decay at earlier stages. X-ray imaging, for example, has transitioned largely from film to digital technology, providing more detailed images at greater magnification. This, along with laser fluorescence and infrared cameras, has made it easier to detect the first tiny stages of decay.

We can also limit tooth decay damage by boosting enamel strength with fluoride applications and sealants or reducing decay-causing bacteria with anti-bacterial rinses. We've also seen advancement in techniques like air abrasion that remove decayed tooth material while leaving more healthy structure intact better than using a traditional dental drill.

Restoring teeth after treatment has also improved. While dental metal amalgam is still used for some fillings, the main choice is now composite resin. These new tooth-colored dental materials require less tooth preparation (and thus less material loss) and bond well to the remaining structure, resulting in a stronger tooth.

Following a MID protocol leads to less intervention and less time in the dentist's chair. It also means preserving more of a natural tooth, an important aim in promoting long-lasting dental health.

If you would like more information on minimally invasive dentistry, please contact us or schedule an appointment for a consultation.

3ThingstoConsiderforLoweringYourChildsRiskforCavities

From the moment your child's first tooth appears, usually between six and nine months, you need to be concerned about Early Childhood Caries (ECC). This particular form of tooth decay can have a devastating effect on primary (baby) teeth and lead to their premature demise. Losing one before its time could adversely affect how the future permanent tooth comes in.

You can help prevent ECC with daily brushing and cleaning, regular dental visits (beginning around their first birthday) and limiting the sugar they eat. Here are 3 more things to consider for boosting your prevention efforts.

Breastfeeding. Pediatricians generally recommend breastfeeding if possible for a baby's overall health, including dental development. And although breast milk contains fermentable carbohydrates that boost bacterial growth, it no more promotes tooth decay than similar foods and beverages. That said, though, once the child begins to eat and drink other foods and beverages, the combination of sugars in them and breast milk could increase the bacteria that causes ECC. This is another good reason to wean the child from breast milk as they begin to eat more solid foods.

Bottles and pacifiers. It's quite common for parents and caregivers to soothe a fussing or crying baby with a bottle filled with formula, milk or juice for sipping, or even a pacifier dipped in jam, sugar or some form of sweetener. But these practices can create an environment that promotes high acid production from bacteria feeding on the sugars. Instead, avoid giving them a “prop-up” bottle filled with liquids containing sugar and try to limit bottle use to mealtimes. And provide them pacifiers without sugary additives if you use them.

Medicines. Children with chronic illnesses or other needs often take medication containing sugar or with antihistamines that reduce the flow of acid-neutralizing saliva. If the medications can't be altered, then it's extra important for you to practice diligent, daily hygiene to reduce the effect of higher mouth acid.

If you would like more information on dental disease prevention in babies and 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 “Age One Dental Visit: Why it's Important for Your Baby.”

ActorDavidRamseyDiscussesBabyBottleToothDecay

Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.

“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavi­ties. How did this happen?

Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.

While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.  Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.

This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”

Here are some other basics of infant dental care that every parent should know:

  • Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
  • Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
  • Start regular dental checkups by the first birthday.

Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.

“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”

If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”

By John Leitner DDS
April 26, 2016
Category: Oral Health
Tags: tooth decay  
KeepAlerttoTheseSignsofImpendingToothDecay

Although preventable, the occurrences of tooth decay are all too common. Yet decay doesn’t appear out of the blue: certain mouth conditions set the disease in motion.

Here are a few signs of such conditions to watch for — they could be telling you you’re at higher risk for tooth decay.

Visible plaque. Plaque is a thin film of bacteria and food accumulating on tooth surfaces and a prime haven for causing periodontal disease. If you actually see it — a crusty, yellowish film — that means there’s a large, unhealthy amount of it. It’s essential to remove it daily through diligent brushing and flossing and more thorough office cleanings at least twice a year.

Poor saliva flow. One of this bodily fluid’s functions is to neutralize mouth acid, usually thirty minutes to an hour after we eat. If saliva flow is inadequate, though, acid levels may remain high and endanger the enamel. “Dry mouth” can occur from a number of causes, including some medications and chemotherapy treatments. It’s important to alleviate the cause if possible by changing medications or stimulating saliva flow through other means.

Tooth shape and appliances. Largely determined by heredity, your teeth contain unique, tiny grooves known as pits and fissures that could harbor plaque. Certain appliances like retainers, braces or night guards can inhibit saliva flow and cause your teeth to retain more plaque. It’s important then to adjust your hygiene efforts to offset these anatomical or treatment factors.

Acid-producing conditions. Diseases like gastro-esophageal reflux disease (GERD) or eating disorders can introduce stomach acid into the mouth that is highly erosive to tooth enamel. It’s imperative for you or a family member to control these conditions through medication, dietary changes, or — in the case of eating disorders — behavioral therapy.

Eating habits. Sugar and other carbohydrates are a ready food source for bacteria. Likewise, acidic foods and beverages (like coffee, tea, and sports or energy drinks) can cause high acid levels for too long. Cut back on eating and drinking these foods and beverages, especially as snacks, to reduce acid levels that could lead to decay.

If you would like more information on strategies to prevent 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.”

TreatingaBabyToothwithInnerDecaycanbeComplicated-butStillNecessary

Even though a child’s primary (“baby”) teeth eventually give way, it’s still important to treat them if they become decayed. Primary teeth serve as guides for the emerging permanent teeth — if they’re lost prematurely, the permanent tooth may come in misaligned.

If the decay, however, affects the tooth’s inner pulp, it poses complications. A similarly decayed adult tooth would be treated with a root canal in which all the pulp tissue, including nerve fibers and blood vessels, are removed before filling and sealing. Primary teeth, however, are more dependent on these nerves and blood vessels, and conventional filling materials can impede the tooth’s natural loss process. It’s better to use more conservative treatments with primary teeth depending on the degree of decay and how much of the pulp may be affected.

If the decay is near or just at the pulp, it’s possible to use an indirect pulp treatment to remove as much of the softer decay as possible while leaving harder remnants in place: this will help keep the pulp from exposure. This is then followed with an antibacterial agent and a filling to seal the tooth.

If the pulp is partially exposed but doesn’t appear infected, a technique called direct pulp capping could be used to cover or “cap” the exposed pulp with filling material, which creates a protective barrier against decay. If decay in a portion of the pulp is present, a pulpotomy can be performed to remove the infected pulp portion. It’s important with a pulpotomy to minimize the spread of further infection by appropriately dressing the wound and sealing the tooth during and after the procedure.

A pulpectomy to completely remove pulp tissue may be necessary if in the worst case scenario the pulp is completely infected. While this closely resembles a traditional root canal treatment, we must use sealant material that can be absorbed by the body. Using other sealants could inhibit the natural process when the primary tooth’s roots begin to dissolve (resorb) to allow it to eventually give way.

These all may seem like extraordinary efforts to save a tooth with such a short lifespan. But by giving primary teeth a second chance, their permanent successors will have a better chance of future good health.

If you would like more information on treating decay in primary teeth, 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 for Children’s Teeth.”