More than likely your great-grandparents, grandparents and even your parents had a common dental experience: when one of their teeth developed a cavity, their dentist removed the decayed portion (and maybe a little more) through drilling and then filled the cavity. In other words, treatment was mainly reactive—fix the problem when it occurred, then fix it again if it reoccurred.
You may have had similar experiences—but the chances are good your dentist’s approach is now quite different. Today’s tooth decay treatment is much more proactive: address first the issues that cause tooth decay, and if it does occur treat it with an eye on preventing it in the future.
This approach depends on maintaining equilibrium between two sets of competing factors that influence how your teeth may encounter tooth decay. This is known as the caries balance (caries being another name for tooth decay). On one side are factors that increase the risk of decay, known by the acronym BAD: Bad Bacteria that produce acid that dissolves the minerals in tooth enamel; Absence of Saliva, the body’s natural acid neutralizer; and Dietary Habits, especially foods with added sugars that feed bacteria, and acid that further weakens enamel.
There are also factors that decrease the risk of tooth decay, known by the acronym SAFE: Saliva and Sealants, which focuses on methods to boost low salivary flow and cover chewing surfaces prone to decay with sealant materials; Antimicrobials, rinses or other substances that reduce bad bacteria populations and encourage the growth of beneficial strains; Fluoride, increased intake or topical applications of this known enamel-strengthening chemical; and Effective Diet, reducing the amount and frequency of sugary or acidic foods and replacing them with more dental-friendly choices.
In effect, we employ a variety of techniques and materials that inhibit BAD factors and support SAFE ones. The foundation for prevention, though, remains the same as it was for past family generations—practice effective oral hygiene by brushing and flossing daily and regular dental cleanings and checkups to keep bacterial plaque from accumulating and growing. Your own diligent daily care rounds out this more effective way that could change your family history of tooth decay for you and future generations.
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 cavities. 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. 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.”
Physical pain is never pleasant or welcomed. Nevertheless, it’s necessary for your well-being—pain is your body telling you something isn’t right and needs your attention.
That fully applies to tooth pain. Not all tooth pain is the same—the intensity, location and duration could all be telling you one of a number of things that could be wrong. In a way, pain has its own “language” that can give us vital clues as to what’s truly causing it.
Here are 3 types of tooth pain and what they might be telling you about an underlying dental problem.
Sensitivity to hot or cold. If you’ve ever had a sharp, momentary pain after consuming something hot like coffee or cold like ice cream, this could indicate several causative possibilities. You might have a small area of tooth decay or a loose filling. You might also have an exposed root due to gum recession, which is much more sensitive to temperature or pressure changes. The latter is also a sign of periodontal (gum) disease.
Acute or constant pain. If you’re feeling a severe and continuing pain from one particular area of your teeth (even if you can’t tell exactly which one), this could mean the pulp, the tooth’s innermost layer, has become infected with decay. The pain is emanating from nerves within the pulp coming under attack from the decay. To save the tooth, you may need a root canal treatment to remove the decayed tissue and seal the tooth from further infection. You should see your dentist as soon as possible, even if the pain suddenly stops—that only means the nerves have died, but the decay is still there and threatening your tooth.
Severe gum pain. If there’s an extremely painful spot on your gums especially sensitive to touch, then you may have an abscess. This is a localized area of infection that develops in the gums either as the result of periodontal (gum) disease, or an infection spreading from the tooth pulp into the gum tissues. You’ll need to see a dentist immediately for both pain relief and appropriate treatment (including a possible root canal) to heal the abscessed tissue.
If you would like more information on tooth pain and how to treat it, 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 “Tooth Pain? Don’t Wait!”
Vacationing abroad can be the trip of a lifetime — or a nightmare if you have a medical or dental emergency while traveling. Dental care in many locations around the world can be limited, expensive or even dangerous.
Here are 3 important things you should to do to prepare for a possible dental emergency during that dream vacation in a foreign country.
Have a complete checkup, cleaning and necessary dental work before you leave. Whoever said, “An ounce of prevention is worth a pound of cure,” must have been a traveler. Better to take care of problems beforehand than have them erupt into an emergency far from home. Be sure especially to have decayed or cracked teeth repaired, as well as any planned dental work like root canal treatments before you go. This is especially important if you’re flying — high altitudes can increase pressure and pain for many dental problems.
Research your destination’s available dental and medical care ahead of time. Standards and practices in other countries can differ from those in the United States, sometimes drastically. Knowing what’s available and what’s expected in terms of service and price will help immensely if you do encounter a health emergency while traveling. A good starting place is A Traveler’s Guide to Safe Dental Care, available at www.osap.org.
Know who to contact if you have a dental emergency. While it may be frightening having a dental issue in a strange place, you’re not alone — there are most likely a number of fellow Americans in your location who can help. Have contact information ready for people you know or military personnel living in your locale, as well as contacts to the American Embassy in that country. And if you’re staying in a hotel, be sure to make friends with the local concierge!
It’s always unsettling to have a dental emergency, but especially so when you’re far from home. Doing a little preparation for the possibility will help lessen the stress if it happens and get you the help you need.
If you would like more information on preparing for dental emergencies while traveling, 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 “Traveling Abroad? Tips for Dealing with Dental Emergencies.”
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