Although techniques and materials have changed, dentists still follow basic principles for treating tooth decay that date from the late 19th Century. And for good reason: They work. These principles first developed by Dr. G.V. Black—the "father of modern dentistry"—are widely credited with saving millions of teeth over the last century.
One of the most important of these treatment protocols is something known as "extension for prevention." In basic terms, it means a dentist removes not only decayed tooth structure but also healthy structure vulnerable to decay. But although effective in saving teeth, practicing this principle can result in loss of otherwise healthy tissue, which can weaken the tooth.
But with new advances in dentistry, decay treatment is getting an overhaul. While Dr. Black's time-tested protocols remain foundational, dentists are finding new ways to preserve more of the tooth structure in a concept known as minimally invasive dentistry (MID).
Better diagnostic tools. Because tooth decay can ultimately infect and damage the tooth's interior, roots and supporting bone, the best way to preserve more of the tooth structure is to treat it as early as possible. Now, new diagnostic tools like digital x-rays, microscopic magnification and optical scanning are helping dentists detect and treat decay earlier, thus reducing how much tissue is removed.
Better prevention methods. Oral hygiene and regular dental care are our basic weapons in the war with tooth decay. In addition, utilizing topical fluoride in combination with a milk-derived product called CPP-ACP dentists can get more of the cavity-fighting organic compound into the tooth enamel to strengthen it against acid attack.
Better treatment techniques. Using air abrasion (a fine particle spray that works like a miniature sandblaster) and lasers, dentists can now remove decayed structure with less harm to healthy tissue than with a traditional dental drill. And new, stronger dental fillings like those made with composite resins require less structural removal to accommodate them.
With these innovative approaches, dentists aren't just saving teeth, they're preserving more of their structure. And that can improve your overall dental health for the long-term.
If you would like more information on minimally invasive dentistry, 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.”
Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
Pregnancy is an exciting time in a woman’s life — but it can also generate a lot of questions about both the mother’s and the baby’s health. The realm of dental care is no exception.
Here are a few of the questions we frequently hear from expectant mothers, along with our answers.
Does the baby’s tooth calcium come from my teeth?
This question is frequently asked by mothers who may have had dental issues and are worried they’ll pass on these problems to their baby. Simply put, no — a baby developing in the womb derives minerals like calcium for their teeth and bones from the mother’s diet, not her teeth. What an expectant mother can do is be sure to eat a healthy, balanced diet rich in nutrients and minerals like calcium.
Am I at heightened risk for dental disease during pregnancy?
Pregnancy does cause significant increases in your body’s hormones, particularly estrogen. This can cause changes in the gum tissue’s blood vessels that may make you more susceptible to periodontal (gum) disease (commonly called “pregnancy gingivitis”). It’s also possible later in pregnancy to develop non-cancerous overgrowths of gum tissues called “pregnancy tumors.” The heightened risk for gum disease during pregnancy calls for increased vigilance in monitoring gum health.
What should I do to take care of my teeth?
It’s important to brush your teeth thoroughly twice a day with ADA-approved fluoridated toothpaste to remove plaque, a thin layer of bacteria and food remnants that adhere to teeth. You should also floss daily and consider using an anti-plaque/anti-gingivitis mouthrinse. And, of course, you should see us for regular office cleanings and checkups, or if you notice swollen, tender or bleeding gums, or other abnormalities.
Should I take prenatal fluoride supplements?
This sounds appealing as a way to give your baby a head start on strong tooth development. Studies on its effectiveness, however, remain slim and somewhat inconclusive — we simply don’t have enough data to make a recommendation. What does have a solid research record is the application of fluoride to teeth in young children just after they appear in the mouth — studies involving over a thousand teeth have shown 99% cavity-free results using topical fluoride applications with sealants.
If you would like more information on dental care during pregnancy, 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 “Expectant Mothers.”
When you’re buying a tool or appliance, you compare brands for the best quality you can afford. There’s another important item that deserves the same level of scrutiny: your toothbrush. Choosing the right one for you can make a huge difference in your oral hygiene effectiveness.
But a visit to your store’s dental care aisle can dim your enthusiasm. You have plenty of options involving all manner of shapes, sizes and features. Perhaps too many: After a while, the sheer number of choices can paralyze your decision-making process.
You can streamline this selection process by concentrating on a few important toothbrush basics. First up for consideration: the bristles. While you may think a good stiff brush would be best, it’s actually the opposite—most dental professionals recommend softer bristles. That’s because hard bristles can potentially damage your teeth and gums over time.
Softer bristles are gentler on your teeth and just as effective for removing plaque, if you use the right technique and thoroughly brush all tooth surfaces. And look for rounded bristles, which are friendlier to your gums.
Next, look for a brush that feels right in your hand. If you have problems with manual dexterity, look for one with an oversized handle. Some brushes come with angled necks and tapered heads, which you may find effective in reaching less accessible back teeth. This might mean trying different brushes until you get one that’s right for you. Don’t worry, though, you’re not buying a brush for life—in fact, you should change out your brush every three to six months.
You’ll also rarely go wrong buying a toothbrush with the American Dental Association Seal of Acceptance on the packaging. This seal signifies the toothbrush has undergone testing and met the ADA’s standards for hygiene effectiveness. While some manufacturers of effective brushes don’t pursue this seal, you can be sure one with it has passed the test of quality.
It makes all the difference in the world having the right tool for the job. Be sure your toothbrush is the right one for you.
If you would like more information on toothbrushes and other dental care products, 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 “Sizing up Toothbrushes: How to Choose the Right Brush for Optimal Oral Health.”
Today’s crowns, the visible part of a tooth replacement system, can effectively mimic the shape and color of natural teeth. But not all crowns are equal — so it’s best to be well-informed before you undergo a restoration on your natural teeth such as a single crown or bridgework — or if you need a crown on a dental implant that replaces a missing tooth.
To give you a starting point, here are 3 things to keep in mind about crowns as you consider a dental restoration.
Material composition. Most crowns in years past were made of a precious metal, most notably gold. What it lacked in appearance, it made up for in performance and durability. In recent years, dental porcelain has become the popular choice because of its ability to mimic the appearance and translucent color of natural teeth. Today’s porcelains are much stronger and are used more frequently for back teeth than in years past. A common recommendation for back teeth is a hybrid crown using metal and porcelain. Metal is incorporated beneath the porcelain in this type of crown to create a strong foundation and is also used along biting surfaces for strength. Porcelain is used in the more visible areas for esthetics.
The dental technician’s level of artistry. Most dentists sub-contract crown fabrication to dental laboratory technicians who may have varying levels of experience and artistic ability. A highly skilled technician can produce a crown that blends seamlessly with the patient’s remaining natural teeth.
Take a “test drive” of your future smile. Although we as dentists adhere to certain aesthetic principles, beauty is ultimately subjective — “in the eye of the beholder.” The final product must meet your expectations and level of comfort. If available, then, consider wearing temporary “trial smile” crowns as a preview of your new smile while your permanent set is under construction. This allows you to “try out” your future smile ahead of time, so you can make recommendations and sign off on the final set before it’s finished.
Undertaking any dental restoration is an important life step, both for your health and appearance. Being well-informed — especially about the crowns that you and others will see — will help you make wise choices that lead to a satisfying outcome.
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