Posts for tag: tooth decay
Advanced tooth decay is a serious dental problem that can threaten an affected tooth's survival. But for decades now dentists have reliably used root canal treatment to better a decayed tooth's odds. This routine procedure performed with dental drill and special hand tools removes infected tissue inside a tooth and replaces the voids with a filling to prevent future infection.
But now there's a new way to perform a root canal—with a surgical laser. Lasers, amplified and focused light beams, aren't new to healthcare—they're an integral feature of many routine medical treatments and surgeries. But their use is relatively new to dentistry, and to endodontics (treating the interior of teeth) in particular.
Lasers can be used in root canal treatment to perform a number of tasks. They can remove diseased tissue and other debris from the innermost tooth pulp. They can be used to clean and shape root canal walls in preparation for filling. And they can also be used to soften and mold the filling material to fit more precisely within a tooth's particular root canal network.
Although laser-assisted root canal therapy isn't yet widespread, laser's limited use to date has given us a fair picture of both their advantages and disadvantages. As with other medical laser applications, lasers are very precise in removing diseased tissue without too much disruption of healthy tissue. There's less need for anesthesia than with dental drills, and lasers are a lot less noisy and jarring. Patients by and large experience less bleeding, as well as less discomfort or infection afterward.
But because laser light can only travel in a straight line, they're difficult to use in many tightly curved root canals. In these cases, the traditional methods are better suited, although a laser can be used in conjunction with other tasks. Temperature with lasers must also be carefully managed lest the high heat that's often generated damages natural tissues.
Although lasers won't be replacing traditional treatment methods for decayed teeth in the foreseeable future, there's hope they'll become more commonplace as technology and techniques continue to advance. Lasers can only improve what already is an effective means of saving teeth.
If you would like more information on treatments for advanced 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 “Laser-Assisted Root Canal Treatment.”
Tooth decay is a destructive oral disease, which along with periodontal (gum) disease is most responsible for tooth loss. And as you age, your disease risk goes up.
One form of decay older people often experience is root cavities. Unlike those occurring in the visible crown, root cavities often occur below the gum line and are especially destructive to tooth structure.
That's because, unlike the crown protected by ultra-hard enamel, the roots are covered by a thin, mineralized material called cementum. Although cementum offers some protection, it can't compare with the decay-resistant capacity of enamel.
The roots also depend on gum coverage for protection. But unfortunately, the gums can shrink back or recede, usually due to gum disease or over-aggressive brushing, and expose some of the root surface. With only the cementum to protect them, the roots can become highly susceptible to decay. If a cavity forms here, it can rapidly advance into the tooth's interior, the pulp, weakening the tooth and increasing its risk of loss.
To stop the decay, we must treat root cavities much like we do with crown cavities: by removing any decayed structure and then filling the cavity. But root cavities are often more difficult to access depending on how far below the gum line they extend. We may need to perform minor gum surgery to expose the cavity to treat it.
But as with any form of tooth decay, the best strategy is to prevent root cavities in the first place. Your first line of defense is a daily hygiene habit of brushing and flossing to remove dental plaque, the main cause for tooth decay. You should also visit your dentist at least twice a year (or more, if recommended) for more thorough cleanings and checkups. Your dentist can also recommend or prescribe preventive rinses, or apply fluoride to at-risk tooth surfaces to strengthen them.
You should also be on the lookout for any signs of gum disease. If you see swollen, reddened or bleeding gums, see your dentist as soon as possible. Stopping possible gum recession will further reduce your risk of root cavities.
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 “Root Cavities: Tooth Decay Near the Gum Line Affects Many Older Adults.”
We’ve been treating one of your decay-prone teeth for some time with one filling after another. Each incident required a little more removal of decayed tooth material until now there isn’t enough structure to support another filling.
We could remove the tooth and replace it with a bridge or a dental implant, both viable restoration options. But keeping the tooth if possible would be more beneficial in the long-run for your gums, bone and remaining teeth. If it still has a healthy and stable root, it’s possible to permanently cover or “cap” the tooth with a life-like crown.
Crowns have been used for decades: the first were mainly composed of metal like gold or silver and later dental porcelain, a ceramic material that could be molded, shaped and oven-fired to resemble a real tooth. The earliest porcelains, though, were brittle, so a hybrid with a metal interior for strength and a fused exterior porcelain layer for appearance came into prominence.
Today, advances in materials have led to all-porcelain crowns strong enough to withstand biting forces. While the metal-porcelain hybrid still account for about 40% of crowns installed annually, the all-porcelain types are steadily growing in popularity.
Regardless of the type, though, the process for fitting any crown is relatively the same. The first step is to reshape the affected tooth so that the future crown will fit over it, followed by an impression mold of the tooth a dental technician will use to form a custom crown. Once the new crown has been prepared, we then permanently bond it to the tooth.
With a crown, you’ll be able to enjoy normal function and have a tooth that looks as healthy and normal as its neighbors. Be aware, though, that your underlying tooth is still subject to decay — so diligent, daily hygiene and regular dental visits are a must. With proper care your newly crowned tooth can continue to serve you and your smile for many years to come.
If you would like more information on dental restoration options, 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 “Crowns & Bridgework.”
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 caviÂties. 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.Â 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.”
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.”