For several decades, dentists have been saving teeth from tooth decay following a few basic guidelines: 1) Identify decay as soon as possible; 2) Thoroughly remove decayed tooth structure; and 3) Fill any cavities. With millions of diseased teeth rescued, observing these simple steps have proven a rousing success.
But as with most things, even this successful protocol isn't perfect. For one, some healthy tissue gets removed along with the diseased portions. The average percentage of "collateral damage" has dropped over the years, but it still happens—and a reduction in healthy tissue can make a tooth less structurally sound.
Another drawback, at least from the patient's perspective, is the dental drill used for removing decay and preparing cavities for filling. Many people find drilling unpleasant, whether from its vibrations in the mouth or its high-pitched whine. The drill's burr head design also contributes to greater healthy tissue loss.
But those weaknesses have lessened over the last few years, thanks to innovations on a number of fronts.
Better risk management. Tooth decay doesn't occur out of thin air—it arises out of risk factors unique to an individual patient like personal hygiene, bacterial load, saliva production or even genetics. Taking the time to identify a patient's "tooth decay risk score" can lead to customized treatments and practices that can minimize the occurrence of decay.
Earlier detection. Like other aspects of dental health, the sooner we detect decay, the less damage it causes and the more successful our treatment. X-rays remain the workhorse for detecting decay, but now with improvements like digital film and better equipment. We're also using newer technologies like laser fluorescence and infrared technology that can "see" decay that might otherwise go undetected.
Less invasive treatment. The dental drill is now being used less with the advent of air abrasion technology. Air abrasion utilizes a concentrated spray of particles to remove diseased tooth structure more precisely than drilling. That means less healthy tissue loss—and a more pleasant (and quieter!) experience for the patient.
In effect, "less is more" could describe these improvements to traditional decay treatment. They and other methods promise healthier teeth and happier patients.
If you would like more information on current treatments for 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 “Minimally Invasive Dentistry: When Less Care is More.”
We're all interested in how our toothpaste tastes, how it freshens breath or how it brightens teeth. But those are secondary to its most important function, which is how well our toothpaste helps us remove dental plaque, that thin bacterial film on teeth most responsible for both tooth decay and gum disease.
Daily brushing and flossing clear away dental plaque, resulting in a much lower risk for dental disease. But while the mechanical action of brushing loosens plaque, toothpaste helps complete its removal. It can do this because of two basic ingredients found in nearly every brand of toothpaste.
The first is an abrasive (or polishing agent), a gritty substance that boosts the effectiveness of the brushing action (which, by the way, alleviates the need for harmful aggressive brushing). These substances, usually hydrated silica, hydrated alumina or calcium carbonate, are abrasive enough to loosen plaque, but not enough to damage tooth enamel.
The other ingredient, a detergent, works much the same way as the product you use to wash greasy dishes—it breaks down the parts of plaque that water can't dissolve. The most common, sodium lauryl sulfate, a safe detergent found in other hygiene products, loosens and dissolves plaque so that it can be easily rinsed away.
You'll also find other ingredients to some degree in toothpaste: flavorings, of course, that go a long way toward making the brushing experience more pleasant; humectants to help toothpaste retain moisture; and binders to hold bind all the ingredients together. And many toothpastes also contain fluoride, a naturally-occurring chemical that strengthens tooth enamel.
You may also find additional ingredients in toothpastes that specialize in certain functions like reducing tartar buildup (hardened plaque), easing tooth or gum sensitivity or controlling bacterial growth. Many toothpastes also include whiteners to promote a brighter smile. Your dentist can advise you on what to look for in a toothpaste to meet a specific need.
But your first priority should always be how well your toothpaste helps you keep your teeth and gums healthy. Knowing what's in it can help you choose your toothpaste more wisely.
If you would like more information on oral hygiene products and aids, 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 “Toothpaste: What's in It?”
For over three decades, Celine Dion has amazed audiences and fans with her powerful singing voice. Best known for her recording of "My Heart Will Go On," the theme song for the movie Titanic, Dion has amassed global record sales topping 200 million. In her early singing days, though, she struggled with one particular career obstacle: an unattractive smile.
The Canadian-born performer had a number of dental defects including crooked and discolored teeth, and—most prominent of all—abnormally large cuspid or "canine" teeth (located on either side of the four front incisors). They were so noticeable that one Quebec celebrity magazine gave her the unflattering nickname "Canine Dion."
This isn't an unusual problem. Since human canines are already the longest teeth in the mouth, it doesn't take much for them to stand out. Our ancient hunter-gatherer ancestors needed these large, pointed teeth to survive. But with the evolution of agriculture and industry, canine teeth have become gradually smaller—so much so that when they're abnormally large, they don't look right in a smile.
So, what can be done if your canines embarrassingly stand out from the rest? Here are some of the options to consider.
Reduce their size. If your canines are just a tad too long, it may be possible to remove some of the enamel layer in a procedure called contouring. Using this technique, we can reduce a tooth's overall size, which we then re-shape by bonding composite resin to the tooth. It's only a good option, though, if your canines have an ample and healthy layer of enamel.
Repair other teeth. The problem of prominent canine teeth may actually be caused by neighboring teeth. When the teeth next to the canines are crooked, the canines can appear more prominent. Alternatively, other teeth around the canines may be abnormally small. Braces or clear aligners can correct crooked incisors, and applying porcelain veneers to smaller teeth could help normalize their length.
Apply dental crowns. In some instances, we can reduce the canines in size and then bond porcelain crowns to them. This is the option that Dion ultimately chose. The natural teeth are still intact, but the crowning process transforms them into properly proportioned, life-like teeth. There is, however, one caveat: The alteration to these teeth will be permanent, so they will need a crown from then on.
Besides crowning her canine teeth, Dion also underwent other dental work to straighten and whiten her other teeth. As a result, this superstar performer now has a superstar smile to match and so can you if your teeth are less than perfect. These or other cosmetic enhancements can give you the look you truly desire. All it takes is an initial visit with us to start you on the road to a transformed smile.
If you would like more information about various cosmetic solutions for your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Dental Crowns.”
More than one parent has wakened in the middle of the night to an unnerving sound emanating from their child's bedroom. Although it might seem like something from the latest horror flick is romping around in there, all that racket has a down-to-earth cause: teeth grinding.
Teeth grinding is the involuntary habit of gnashing the teeth together when not engaged in normal functions like eating or speaking. It can occur at any time, but frequently with children while they sleep. Adults may also grind their teeth, but it's more prevalent among children.
While stress seems to be the main reason for adult teeth grinding, many health providers believe the habit in children is most often caused by an overreactive response of the neuromuscular system for chewing, which may be immature. Other conditions like asthma, sleep apnea or drug use may also play a role.
Fortunately, there doesn't appear to be any lasting harm from young children grinding their teeth, although they may encounter problems like headaches, earaches or jaw pain in the short term. Most, though, will outgrow the habit and be no worse for wear.
But if it persists beyond childhood, problems can escalate. Adults run the risk of serious cumulative issues like chronic jaw pain, accelerated tooth wear or tooth fracturing. It's similar to finger sucking, a nearly universal habit among young children that poses no real harm unless it persists later in life.
And as with finger sucking, parents should follow a similar strategy of carefully monitoring their child's teeth grinding. If the habit continues into later childhood or adolescence, or noticeable problems like those mentioned previously begin to appear, it may be time to intervene.
Such intervention may initially include diagnosis and treatment for underlying problems like upper airway obstruction, asthma or stress. For short term protection against dental damage, your dentist can also fashion a custom mouthguard for your child to wear while they sleep. Made of pliable plastic, the guard prevents the teeth from making solid contact with each other during a grinding episode.
Outside of some lost sleep, there's little cause for alarm if your child grinds their teeth. But if it seems to go on longer than it should, you can take action to protect their long-term dental health.
If you would like more information on teeth grinding, 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 “When Children Grind Their Teeth.”
Here's some good news: Teenagers are less likely than adults to lose teeth to dental disease. But there's also a flip side. Teens can still lose teeth, more likely from traumatic injury.
Fortunately, there are several options for replacing lost teeth like dentures or bridges. But the choice considered best by most dentists and patients is a dental implant. An implant tooth looks and functions like the real thing—and it's durable, capable of lasting for years, if not decades.
But there's a hitch with teens getting an implant: Even though they may have all their permanent teeth by adolescence, their jaws are still growing and developing. Natural teeth, with their attachment to the jaws by way of a periodontal ligament, can keep pace with this growth—but implants can't.
That's because an implant doesn't have this attachment to gum tissue like natural teeth, but to the jawbone alone. Hence, an implant tooth can't keep up with jaw development, and may eventually look like it's "sunk" into the gums in relation to the teeth around it.
It's best, then, to wait until a teen's jaws have fully developed before attempting an implant. In the meantime, though, they don't have to endure a smile marred by missing teeth, but can replace them with a temporary restoration. The two most common options are a partial denture or a modified bridge.
The partial denture is a lightweight version that's quite affordable. Although not as durable as other types of dentures, the appliance is only intended to last until the patient is old enough for a permanent implant.
The modified bridge is a prosthetic tooth with strips of dental material extending behind it that are bonded to the backs of the teeth on either side to hold it in place. It's likewise not as durable as a traditional bridge, but it can fill the bill until time to place an implant.
Although this adds an additional step in a teen's restorative journey after losing a tooth, it's necessary—waiting to place an implant after jaw maturity will help ensure a long-lasting result. In the meantime, a temporary tooth replacement will help them to enjoy a normal smile.
If you would like more information on dental restorations for teens, 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 “Dental Implants for Teenagers.”
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