Posts for tag: tooth decay
Although we've known for some time how tooth decay forms, it's still prevalent across the population—even more so than cancer or heart disease. Along with gum disease, it's a leading cause of tooth loss.
Fortunately, our knowledge about tooth decay has grown considerably, to the point that we now recognize a number of risk factors that make it more likely a person will develop this disease. By first identifying them in individual patients, we can take steps to address them specifically to reduce the chances of this destructive disease.
Genetics. Researchers have identified around 40 to 50 genes that can influence cavity development. The best way to assess your genetic risk is through family history—if numerous close family members contend with tooth decay, your risk may be high. If so, it's important to be extra vigilant with addressing other areas over which you have more control.
Saliva. Cavities are directly caused by oral acid, a byproduct of bacteria, that can erode tooth enamel over prolonged contact. This is minimized, though, through a normal saliva flow that neutralizes acid and helps remineralize enamel. But poor saliva production can slow acid neutralization. You can improve your saliva flow by drinking more water, changing medications or using saliva-boosting products.
Oral hygiene. You can reduce bacteria (and thus acid) by removing their "room and board"—dental plaque. This accumulating film of food particles harbors the bacteria that feed on it. Daily brushing and flossing, accompanied by regular dental cleanings, effectively removes dental plaque, which in turn lowers the levels of oral bacteria and acid.
Dental-friendly diet. Even if you diligently address the previous risk factors, your diet may fight against your efforts. Diets high in processed and refined foods, especially sugar, provide abundant food sources for bacteria. On the other hand, a diet primarily of whole foods rich in vitamins (especially D) and minerals like calcium and phosphorous strengthen teeth against decay.
Preventing tooth decay isn't a "one-size-fits-all" approach. By identifying your own particular risk, we can craft a care strategy that can be your best defense against this destructive dental disease.
Tooth decay is more prevalent than diseases like cancer, heart disease or influenza. It doesn't have to be—brushing with fluoride toothpaste, flossing, less dietary sugar and regular dental cleanings can lower the risk of this harmful disease.
Hygiene, diet and dental care work because they interrupt the disease process at various points. Daily hygiene and regular dental cleanings remove dental plaque where oral bacteria flourish. Reducing sugar eliminates one of bacteria's feeding sources. With less bacteria, there's less oral acid to erode enamel.
But as good as these methods work, we can now take the fight against tooth decay a step further. We can formulate a prevention strategy tailored to an individual patient that addresses risk factors for decay unique to them.
Poor saliva flow. One of the more important functions of this bodily fluid is to neutralize mouth acid produced by bacteria and released from food during eating. Saliva helps restore the mouth's ideal pH balance needed for optimum oral health. But if you have poor saliva flow, often because of medications, your mouth could be more acidic and thus more prone to decay.
Biofilm imbalance. The inside of your mouth is coated with an ultrathin biofilm made up of proteins, biochemicals and microorganisms. Normally, both beneficial and harmful bacteria reside together with the “good” bacteria having the edge. If the mouth becomes more acidic long-term, however, even the beneficial bacteria adapt and become more like their harmful counterparts.
Genetic factors. Researchers estimate that 40 to 50 hereditary genes can impact cavity development. Some of these genes could impact tooth formation or saliva gland anatomy, while others drive behaviors like a higher craving for sugar. A family history of tooth decay, especially when regular hygiene habits or diet don't seem to be a factor, could be an indicator that genes are influencing a person's dental health.
To determine if these or other factors could be driving a patient's higher risk for tooth decay, many dentists are now gathering more information about medications, family history or lifestyle habits. Using that information, they can introduce other measures for each patient that will lower their risk for tooth decay even more.
If you would like more information on reducing your risk 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 “What Everyone Should Know About Tooth Decay.”
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.”
Tooth decay is as relentless as it is destructive, and it makes little distinction between age, gender, ethnicity or social status. Although risk levels vary from person to person, we’re all potentially in the crossfire for this harmful disease. Getting ahead of it early could save your teeth.
Tooth decay begins with oral bacteria. While feeding on dental plaque that accumulates on the teeth, bacteria multiply and produce acid as a by-product. Too much acid softens and erodes tooth enamel, which enables decay to advance deeper into the tooth.
If it isn’t stopped, decay can eventually infect and weaken the roots and bone, and ultimately lead to a lost tooth. By stopping it as early as possible before it reaches the inner pulp and root canals, we can greatly limit the damage.
Regular dental care is crucial for early detection. Here’s how we can stay ahead of developing decay during dental visits.
Visible inspection. There are visible signs a trained dentist may notice that point to tooth decay. Besides an already formed hole or cavity, we might also pick up on other unusual appearances like white spot lesions: these slight blemishes often occur in the areas of contact with other teeth, which we can treat with topical fluoride.
X-rays. This tried and true diagnostic tool has been a mainstay of dental care for nearly a century. The images they produce can indicate decay as darker spots or areas on or within the tooth that may not yet be visible to the eye. And with advances in digital processing and more streamlined equipment, we can effectively do this with a very low dosage of radiation exposure.
Advanced technology. We’ve developed other means for better disease detection that complement x-rays and visual inspections. Specialized microscopes and lasers are now important tools for analyzing suspected areas of early decay.
Even if decay gets a foothold we can effectively stop it and restore a tooth with a root canal treatment or a similar procedure. The best outcome, though, is to not allow this destructive disease to get that far. With dedicated oral hygiene and regular dental visits that uncover early decay, chances are good your teeth can remain healthy for a lifetime.
If you would like more information on fighting 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.”
Humanity has been waging war against tooth decay for millennia — with this relentless opponent often getting the better of us.
Over the last century, however, significant treatment advances have turned the tide of battle in our favor. Perhaps the greatest of these advancements is our deeper grasp of the disease process — new understandings that have altered our treatment strategy. Rather than wait for cavities to occur and then repair the damage, we now focus on stopping the damage from occurring in the first place.
Prevention starts by reducing factors that contribute to tooth decay. We can signify these detrimental factors with the acronym BAD:
Bad Bacteria. Millions of bacteria inhabit our mouths at any one time, but only a few strains produce the acid that causes decay. We want to reduce their population by removing dental plaque (where they feed and grow) through daily brushing and flossing, and, at a minimum, semi-annual office cleanings.
Absence of Saliva. This important fluid neutralizes acid and strengthens tooth enamel. Some people, however, suffer from reduced saliva flow. We want to find the cause (for example, a side effect of certain prescription drugs) and then improve saliva flow.
Dietary Habits. A diet heavy in sugar and acid (particularly sodas and soft drinks) gives bacteria a ready food source and increases the mouth’s acidic level. Chronic high acid levels in particular are often too great for normal saliva flow to overcome and neutralize. Reducing the amount and frequency of these food items creates a healthier oral environment.
Reducing BAD factors is only half of our prevention focus. We also want to promote SAFE factors that enhance tooth health and strength: Sealants, especially for children, that shield tooth surfaces from decay; Antimicrobial rinses that target and rid the mouth of acid-producing bacteria and give healthy bacteria room to develop; Fluoride, a proven enamel-strengthening chemical available in dental products, many drinking water systems and as a topical application in dental offices; and an Effective diet that’s rich in nutrients and low in sugar and acid as already mentioned.
Keeping the focus on reducing BAD factors and promoting SAFE factors will greatly increase your chances of personally winning the war against tooth decay.
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 “Tooth Decay: How to Assess Your Risk.”