Posts for: July, 2018
Tooth decay is a primary cause of tooth damage and loss, with annual treatment costs in the billions of dollars. It arises mainly from oral bacteria, which proliferates in the absence of effective oral hygiene. There are, however, other risk factors besides poor hygiene that could make you more susceptible to this disease.
Many people, for example, have genetically inherited deeper grooves (fissures) and depressions (pits) than the average tooth anatomy. These may be harder to reach with a toothbrush and can become havens for bacterial plaque. Others may have health conditions that indirectly affect the mouth: bulimia or anorexia, psychological conditions that involve self-induced vomiting, or GERD, gastro-esophageal reflux disease, in which stomach acid could regurgitate into the mouth. These conditions could result in a highly acidic mouth environment.
Some medical and — ironically — dental treatments could also increase your tooth decay risk. Some medications can reduce saliva flow, which inhibits acid neutralization and re-mineralization of enamel. Retainers, braces, bite guards or other dental appliances may also reduce the saliva wash over teeth, and can make brushing and flossing more difficult.
There are also risk factors that result from our lifestyle choices. Eating a lot of foods rich in sugars and other carbohydrates, for example, or acidic beverages like soda, energy or sports drinks contributes to the rise of bacteria in our mouths.
There are ways to reduce the effects of these risk factors. In addition to a daily habit of effective brushing and flossing, you should also include semi-annual cleanings and checkups at our office a part of your routine. If you have genetic, medical or dental issues that are out of your control, we can discuss solutions, such as alternatives to medications or different techniques for cleaning around dental appliances. For lifestyle-related factors, you should consider removing the habit or modifying it: for example, snacking at specific times or drinking acidic beverages only at mealtime.
While tooth decay is a serious, destructive disease, it is highly preventable. Addressing all your risk factors, not just hygiene, will reduce your chances of having it.
If you would like more information on tooth decay prevention, 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 Decay: How to Assess Your Risk.”
If you’re seeing your dentist regularly, that’s great. But if that’s all you’re doing to stay ahead of dental disease, it’s not enough. In fact, what you do daily to care for your teeth is often the primary factor in whether or not you’ll maintain a healthy mouth.
Top of your oral care to-do list, of course, is removing daily plaque buildup from teeth and gums. This sticky film of bacteria and food particles can cause both tooth decay and periodontal (gum) disease. You do that with effective daily brushing and flossing.
Effective brushing starts with the right toothbrush—for most people a soft-bristled, multi-tufted brush—and fluoride toothpaste. As to technique, you should first avoid brushing too hard or too often (more than twice a day). This can damage your gums and cause them to recede, exposing the tooth roots to disease. Instead, use a gentle, scrubbing motion, being sure to thoroughly brush all tooth surfaces from the gumline to the top of the teeth, which usually takes about two minutes.
The other essential hygiene task, flossing, isn’t high on many people’s “favorite things to do list” due to frequent difficulties manipulating the floss. Your dentist can help you with technique, but if it still proves too difficult try some different tools: a floss threader to make it easier to pull floss through your teeth; or a water flosser, a handheld device that directs a pressurized water stream on tooth and gum surfaces to loosen and flush away plaque.
And don’t forget other tooth-friendly practices like avoiding sugary snacks between meals, drinking plenty of water to avoid dry mouth, and even waiting to brush or floss about an hour after eating. The latter is important because acid levels rise during eating and can temporarily soften enamel. The enzymes in saliva, though, can neutralize the acid and re-mineralize the enamel in about thirty minutes to an hour. Waiting to brush gives saliva a chance to do its job.
Lastly, keep alert for anything out of the ordinary: sores, lumps, spots on the teeth or reddened, swollen, bleeding gums. All these are potential signs of disease. The sooner you have them checked the better your chances of maintaining a healthy mouth.
If you would like more information on caring for your teeth at home, 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 “10 Tips for Daily Oral Care at Home.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, 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.”