The basics for treating tooth decay have changed little since the father of modern dentistry Dr. G.V. Black developed them in the early 20th Century. Even though technical advances have streamlined treatment, our objectives are the same: remove any decayed material, prepare the cavity and then fill it.
This approach has endured because it works—dentists practicing it have preserved billions of teeth. But it has had one principle drawback: we often lose healthy tooth structure while removing decay. Although we preserve the tooth, its overall structure may be weaker.
But thanks to recent diagnostic and treatment advances we’re now preserving more of the tooth structure during treatment than ever before. On the diagnostic front enhanced x-ray technology and new magnification techniques are helping us find decay earlier when there’s less damaged material to remove and less risk to healthy structure.
Treating cavities has likewise improved with the increased use of air abrasion, an alternative to drilling. Emitting a concentrated stream of fine abrasive particles, air abrasion is mostly limited to treating small cavities. Even so, dentists using it say they’re removing less healthy tooth structure than with drilling.
While these current advances have already had a noticeable impact on decay treatment, there’s more to come. One in particular could dwarf every other advance with its impact: a tooth repairing itself through dentin regeneration.
This futuristic idea stems from a discovery by researchers at King’s College, London experimenting with Tideglusib, a medication for treating Alzheimer’s disease. The researchers placed tiny sponges soaked with the drug into holes drilled into mouse teeth. After a few weeks the holes had filled with dentin, produced by the teeth themselves.
Dentin regeneration isn’t new, but methods to date haven’t been able to produce enough dentin to repair a typical cavity. Tideglusib has proven more promising, and it’s already being used in clinical trials. If its development continues to progress, patients’ teeth may one day repair their own cavities without a filling.
Dr. Black’s enduring concepts continue to define tooth decay treatment. But developments now and on the horizon are transforming how we treat this disease in ways the father of modern dentistry couldn’t imagine.
Gum disease is a bigger problem than you might think. More than half of all adults over age 30 have it, and that figure jumps to 70% of adults over 65. If left untreated, gum (periodontal) disease can eventually loosen teeth and cause them to fall out. It can also cause health issues outside of the mouth, including an increased risk of heart disease and other systemic health conditions.
But the good news is that gum disease can be treated—and even better, prevented! Since September is National Gum Care Month, it’s a good time to answer some frequently asked questions about gum disease:
What causes gum disease?
Gum disease is caused by certain types of harmful oral bacteria that live in a sticky film called dental plaque that collects on teeth both above and below the gum line. If this film is not cleaned effectively each day, it can eventually harden into a substance called tartar that can only be removed by a dental professional. As your body tries to fight the bacteria and the toxins they produce, your gums can become inflamed and may start to pull away from the teeth. Eventually, bone beneath the gums can start to break down and with continued bone loss, the teeth could be lost.
How do I know if I have it?
Gum disease doesn’t always produce symptoms—especially in smokers. Smoking hides the symptoms of gum disease because nicotine reduces blood flow to the area. However, there are things you should look out for. Gingivitis, a mild form of gum disease, can produce red and/or puffy gums that bleed when you brush or floss. Signs of periodontitis, a more serious form of the disease, include gum recession, bad mouth odors or tastes, and tooth looseness. But the only way to truly know if you have gum disease is to come in for an exam.
What can I do about it?
If you have gingivitis, a professional teeth cleaning and a renewed commitment to oral hygiene at home—including daily flossing and rinsing with antibacterial mouthwash—may be all you need to turn the situation around. Periodontitis may require a variety of treatments, ranging from special cleaning procedures of the tooth root surfaces to gum surgery. The first step toward controlling gum disease is visiting the dental office for an exam.
How can I prevent it?
Regular professional teeth cleanings and meticulous oral hygiene at home are your best defenses against gum disease. Avoid sugary drinks and snacks—which feed the disease-causing bacteria in your mouth—and tobacco in all forms. If you have diabetes, do your best to manage it well because uncontrolled diabetes can worsen periodontal disease.
Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.
Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!
Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…
While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!
When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.
If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”
Find out more about these commonly used tooth-shaped restorations in Andover.
Did one of our Andover, MA, dentists - Dr. Nicholas Papapetros, Dr. Jhon Giraldo, and Dr. Leo Kharin - recently tell you that you need a dental crown? Are you dealing with a weak, damaged, or cosmetically flawed tooth? If so, this is most likely why you need a dental crown. Sure, teeth are amazingly strong, but even they can fall victim to damage. When cracks, chips, or fractures occur, it’s always comforting to know that you can get a dental crown to protect the tooth from further damage.
A crown, as you might imagine, is made to mimic the look of a natural crown of a tooth. This dental “cap” is a permanent restoration that is custom-made to fit over a tooth to not just improve its appearance but also to restore functionality and strength. So why would a dental crown need to be used? If a tooth has become damaged by direct injury (such as a crack or chip) or if the tooth has been weakened by extensive decay or an infection you may also benefit from this restoration.
If you need to get a root canal to get rid of bacteria that has infected the inside of the tooth, more often than not a crown will be placed over the tooth after root canal treatment in order to restore and protect the tooth so it doesn’t become brittle and begin to fracture and crack. A crown provides the ultimate in protection for a tooth to prevent further damage.
A dental crown is also instrumental in treating tooth loss. For example, a crown is placed over natural teeth to support a dental bridge (false tooth or teeth) to replace one or two missing teeth in a row. A crown is also placed over the top of a dental implant to permanently replace a single missing tooth. So, as you can see, these tooth-shaped caps are pretty amazingly versatile and can improve the look of your smile while also restrengthening and even rebuilding damaged and toothless smiles.
Dentistry by Design in Andover, MA, prides itself on providing the very best in restorative dentistry. No matter whether you want to discuss your treatment options or you need to just schedule a routine dental cleaning, we are here for you.
What do a teenager with a poor bite, a senior citizen with multiple missing teeth or a middle-aged person with a teeth grinding habit all have in common? They may all depend on a dental appliance for better function or appearance.
There’s a wide variety of removable dental appliances like clear aligners or retainers for orthodontic treatment, dentures for tooth loss or night guards to minimize teeth grinding, just to name a few. But while different, they all share a common need: regular cleaning and maintenance to prevent them from triggering dental disease and to keep them functioning properly.
The first thing to remember about appliance cleaning is that it’s not the same as regular oral hygiene, especially if you have dentures. While they look like real teeth, they’re not. Toothpaste is a no-no because the abrasives in toothpaste designed for tooth enamel can scratch appliance surfaces. These microscopic scratches can develop havens for disease-causing bacteria.
Instead, use liquid dish detergent, hand soap or a specific cleaner for your appliance with a different brush from your regular toothbrush or a specialized tool for your particular appliance. Use warm but not very hot or boiling water: while heat indeed kills bacteria, the hot temperatures can warp the plastic in the appliance and distort its fit. You should also avoid bleach—while also a bacteria killer, it can fade out the gum color of appliance bases.
Be sure you exercise caution while cleaning your appliance. For example, place a towel in the sink basin so if the appliance slips from your hands it’s less likely to break hitting the soft towel rather than the hard sink. And while out of your mouth, be sure you store your appliance out of reach of small children and pets to avoid the chance of damage.
Cleaning and caring for your appliance reduces the risk of disease that might affect your gums or other natural teeth. It will also help keep your appliance working as it was designed for some time to come.
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