Posts for: January, 2018
Since the late 19th Century, dentists have used established protocols to successfully prevent and treat tooth decay. But there've been changes to this approach the last few years to improve its effectiveness, changes we now refer to as Minimally Invasive Dentistry or MID.
The older approach for treating dental caries (tooth decay) follows the protocols established by Dr. G.V. Black, considered the father of modern dentistry. Black advocated removing not only decayed structure but also some of the healthier but vulnerable portions of a tooth, to avoid further decay and make the tooth easier to clean. This resulted in larger fillings, although they've become smaller as dental techniques have advanced.
MID, on the other hand, aims to remove as little tooth structure as possible while still effectively treating and preventing future decay. To achieve that goal we begin first with a complete assessment of a patient's individual decay risk, known as Caries Management By Risk Assessment (CAMBRA).
With CAMBRA, we're looking at other factors besides individual tooth health: a patient's hygiene, lifestyle and dietary habits; the types and amount of bacteria present; and the quality of saliva flow, needed to neutralize mouth acid. With these the results we develop a customized prevention and treatment strategy.
MID also focuses on detecting dental caries as early as possible. Besides traditional x-rays, we're beginning to use other methods like dental microscopes, laser fluorescence, infrared photography or optical scanning. Early detection leads to early intervention, and with techniques that are much less invasive than the traditional approach.
The new approach also changes how we repair decayed teeth. We're increasingly using air abrasion, a technology that uses fine particles in a pressurized air stream to remove softer decayed tooth material and less healthy structure than the traditional dental drill. We're also using composite resin and other advanced materials for filings: these tooth-colored materials are stronger than previous versions and are quickly taking the place of metal amalgam, requiring less structural removal to accommodate them.
MID's core principles are early disease detection, proactive prevention and treatment with less structural removal. With this enhanced approach to effective dentistry, we're keeping your teeth healthy with minimal discomfort, lower costs and less long-term impact.
Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.
First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.
How common is this malady? According to the U.S. Centers for Disease Control, nearly half of allÂ Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.
What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.
Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.” Â If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.
Like other living tissue, your teeth can feel. Dentin, the layer below the enamel, houses fluid-filled conduits that transmit temperature or pressure sensations to a nerve network within the tooth’s inner pulp. It’s so effective that incoming sensations must be buffered — “toned down”— to avoid a painful overload of the nerves. The enamel above the gum line and a bone-like substance called cementum below help do this.
Unfortunately, if teeth lose this protection they can become hypersensitive. This can cause a flash of sharp pain while eating or drinking something cold or hot or just biting down.
There are a number of causes for tooth sensitivity, any of which can influence how we treat it. While you’ll need a dental exam to know for sure, your hypersensitivity will more than likely stem from one of these 3 problems.
Periodontal (gum) disease. This is an infection caused by bacterial plaque, a thin film of bacteria and food particles that accumulates on the teeth due to poor oral hygiene. The inflamed gum tissues weaken and detach from the teeth, causing them to shrink back or recede. This leaves the cementum unprotected, which easily erodes and exposes the dentin to acid and bacteria — and hypersensitivity. Clinically removing the plaque helps the affected gums heal. In extreme cases, the gums may need surgical grafting to regenerate.
Overaggressive brushing. While a lack of oral hygiene can contribute to gum recession, ironically too much hygiene — brushing too hard for too long — can damage your gums and cause them to recede. Brushing really doesn’t require a lot of elbow grease — a gentle scrubbing motion over all tooth surfaces is sufficient to remove plaque. Fine-tuning your brushing will help your gums to recover and heal.
Mouth acid. Although quite strong, enamel has one formidable enemy: acid, which can erode enamel and expose the dentin. Over-indulgence in acidic foods and beverages can make your mouth more acidic; more likely, though, bacterial plaque will again be the culprit, because bacteria excrete an acidic waste product. You can reduce mouth acid with daily brushing and flossing and consuming less acidic foods and beverages.
If you’re experiencing any kind of tooth pain, see us for an examination. We’ll determine the cause and initiate the appropriate treatment to regain your oral health.
If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity: Understanding Your Options.”