Tooth decay is one of two dental diseases most responsible for tooth loss (gum disease being the other). In the absence of treatment, what starts as a hole or cavity in a tooth's outer layers can steadily advance toward its interior.
Most people associate cavities with the crown, the part of a tooth you can see. But cavities can also occur in a tooth's roots, especially with older adults. Root cavities pose two distinct difficulties: They can lead to more rapid decay spread than crown cavities within a tooth; and they're harder to detect.
Tooth roots are ordinarily covered by the gums, which protects them from bacterial plaque, the main cause for decay. But roots can become exposed due to receding gums, a common problem with seniors who are more susceptible to gum disease.
Unlike the enamel-covered crowns, tooth roots depend on gum coverage for protection against bacteria and the acid they produce. Without this coverage, the only thing standing between tooth decay and the roots is a thin material called cementum.
If decay does enter a tooth's interior, saving it often requires a root canal treatment to remove decayed tissue in the inner pulp and root canals, and then replacing it with a filling. But if we're able to discover a root cavity in its early stages, we may be able to fill it like a crown cavity.
The best strategy, though, is to prevent root cavities from forming. This starts with a dedicated daily regimen of brushing and flossing to remove dental plaque. If you're at high risk for root cavities, we may also recommend antibacterial mouthrinses and other aids.
Regular dental visits are also a must: a minimum of twice-a-year dental cleanings to remove stubborn plaque and calculus (hardened plaque) deposits. For added protection against root cavities, we can also apply fluoride varnish to strengthen teeth. And regular visits are the best way to detect any cavity in its early stages when treatment is less invasive.
A heightened risk of dental problems like root cavities are a part of the aging process. But partnering together, we can lower that risk and increase the longevity of your teeth.
If you would like more information on root cavities, 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.”
Many people use a mouthrinse as part of their daily oral hygiene. If you’d also like to include a mouthrinse in your regimen, the kind you choose will depend on what you want it to do for you.
If your main desire is fresh breath, then a cosmetic rinse that imparts a minty smell to the mouth should fit the bill. That, however, is all they do — cosmetic mouthrinses don’t contribute to oral health beyond your personal satisfaction that your breath is free of bad odors. But, if you want more — added protection against dental disease, for example — then you’ll need to consider a therapeutic mouthrinse.
Therapeutic mouthrinses are usually described as anti-cariogenic (prevents decay) or anti-bacterial, and include both over-the-counter (OTC) and prescription rinses. Their purpose is to either strengthen teeth or reduce the mouth’s bacterial levels. Of the OTC variety, most contain a small amount of sodium fluoride, which can strengthen tooth enamel. They’ve proven highly effective: a number of studies show using a sodium fluoride mouthrinse in conjunction with brushing and flossing reduces the chances of new cavities forming.
A number of OTC rinses also have an anti-bacterial effect, usually provided by active ingredients such as triclosan, zinc or essential oils like menthol. Even a slight reduction in bacteria can help lessen the chances of gingivitis (gum inflammation), an early form of periodontal (gum) disease. Reducing bacteria levels may also help alleviate bad breath.
Some individuals, though, have higher than normal levels of bacteria, or a systemic weakness in fighting certain bacterial strains. If this is your case, you might benefit from a prescribed mouthrinse intended to lower bacterial levels. Most prescription mouthrinses contain chlorhexidine, which has been amply demonstrated as an effective anti-bacterial control of tooth decay and gum disease. Chlorhexidine prevents bacteria from adhering to the teeth and so disrupts plaque buildup, the main cause of dental disease. Its prolonged use will result in the dark staining of teeth in some people, but this can be removed during dental cleanings and teeth polishing. Long-term use is generally not preferred compared to getting the proper attention from regular cleanings and examinations.
If you would like more advice on adding a mouthrinse to your daily hygiene regimen, especially to help reduce your risk of dental disease, please feel free to discuss this with us at your next checkup. Regardless of which type of mouthrinse you choose, they should always be used as a complement to daily brushing and flossing, along with regular dental cleanings and checkups.
For more information on mouthrinses, 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 “Mouthrinses.”
Whether she’s singing, dancing or acting, Jennifer Lopez is a performer who is known for giving it all she’s got. But during one show, Lopez recently admitted, she gave a bit more then she had planned.
“I chipped my tooth on stage,” she told interviewers from Entertainment Tonight, “and had to finish the show….I went back thinking ‘Can I finish the show like this?’”
With that unlucky break, J-Lo joins a growing list of superstar singers—including Taylor Swift and Michael Buble—who have something in common: All have chipped their teeth on microphones while giving a performance.
But it’s not just celebs who have accidental dental trouble. Chips are among the most common dental injuries—and the front teeth, due to their position, are particularly susceptible. Unfortunately, they are also the most visible. But there are also a number of good ways to repair chipped, cracked or broken teeth short of replacing them.
For minor to moderate chips, cosmetic bonding might be recommended. In this method, special high-tech resins, in shades that match your natural teeth, are applied to the tooth’s surface. Layers of resin, cured with a special light, will often restore the tooth to good appearance. Best of all, the whole process can often be done in just one visit to the dental office, and the results can last for several years.
For a more permanent repair—or if the damage is more extensive—dental veneers may be another option. Veneers are wafer-thin shells that cover the entire front surface of one or more teeth. Strong, durable and natural-looking, they can be used to repair moderate chips, cracks or irregularities. They can also help you get a “red-carpet” smile: brilliant white teeth with perfectly even spacing. That’s why veneers are so popular among Hollywood celebs—even those who haven’t chipped their teeth!
Fortunately, even if the tooth is extensively damaged, it’s usually possible to restore it with a crown (cap), a bridge—or a dental implant, today’s gold standard for whole-tooth replacement. But in many cases, a less complex type of restoration will do the trick.
Which tooth restoration method did J-Lo choose? She didn’t say—but luckily for her adoring fans, after the microphone mishap she went right back up on stage and finished the show.
If you have a chipped tooth but you need to make the show go on, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
It's a sad fact: Many people postpone needed dental treatment because of their finances. There's no doubt that treatments for many tooth and gum problems can be expensive. But delaying treatment can make matters worse—and when they do see their dentist to address the issue, the costs can skyrocket.
The thriftiest way to manage your dental health is to prevent disease before it occurs or seek treatment as early as possible. You may incur some initial expense, but you'll pay less in the long-run and have better health to boot.
Here's a common sense approach for easing the impact of dental care on your budget.
Form a customized care plan. The key to keeping your dental expenses in check is to be proactive, not reactive with your care. Don't wait until you begin noticing problems—instead, invest in regular dental visits where your dentist can assess your ongoing individual risk for dental disease. Using that assessment, your dentist and you can then create a care plan that lowers your disease risk and promotes optimal health.
Adopt sound hygiene practices. A simple toothbrush and a roll of floss could save you thousands in dental care costs over a lifetime. Using them daily removes dental plaque, the top cause for both tooth decay and gum disease. Couple that with regular dental cleanings and your risk for costly dental disease will go down significantly.
Try less expensive, short-term restorations. Even with the best prevention strategy, there's always a chance you'll encounter a problem with your teeth or gums. Unfortunately, the best permanent fix may be more than your budget can handle. In that case, consider a less expensive restoration (like resin or glass-based fillings) to protect and restore your problem teeth until you can afford a better permanent solution.
Talk with your dentist about long-term financing. Spreading out the bill for dental treatment over several payments can help you manage unforeseen costs. Talk with your dentist about treatment financing options they offer or sponsor. If possible, have a contingency plan for payment in place before you need it—just in case.
Any kind of dental care, even preventive maintenance, can cost you. But if you manage your care wisely, you can keep that cost to a minimum.
Over 26 million Americans have diabetes, a systemic condition that interferes with maintaining safe levels of blood sugar in the bloodstream. Over time, diabetes can begin to interfere with other bodily processes, including wound healing—which could affect dental care, and dental implants in particular.
Diabetes affects how the body regulates glucose, a basic sugar derived from food digestion that's the primary source of energy for cell development and function. Our bodies, though, must maintain glucose levels within a certain range — too high or too low could have adverse effects on our health. The body does this with the help of a hormone called insulin that's produced as needed by the pancreas to constantly regulate blood glucose levels.
There are two types of diabetes that interfere with the function of insulin in different ways. With Type I diabetes the pancreas stops producing insulin, forcing the patient to obtain the hormone externally through daily injections or medication. With Type II diabetes, the most common form among diabetics, the body doesn't produce enough insulin or doesn't respond adequately to the insulin that's present.
As mentioned, one of the consequences of diabetes is slow wound healing. This can have a profound effect on the body in general, but it can also potentially cause problems with dental implants. That's because implants once placed need time to integrate with the bone to achieve a strong hold. Slow wound healing caused by diabetes can slow this integration process between implant and bone, which can affect the entire implantation process.
The potential for those kinds of problems is greater if a patient's diabetes isn't under control. Patients who are effectively managing their diabetes with proper diet, exercise and medication have less trouble with wound healing, and so less chance of healing problems with implants.
All in all, though, it appears diabetics as a group have as much success with implants as the general population (above 95 percent). But it can be a smoother process if you're doing everything you can to keep your diabetes under control.
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