Posts for tag: tooth decay
Finding out you have a cavity isn't the best of news. But finding out it's a root cavity is even worse: if not treated, the decay can spread more rapidly than a cavity occurring in the tooth's crown surfaces.
Our teeth are basically composed of two parts: the crown, the visible tooth above the gum line, and the roots, the hidden portion beneath the gums. The root in turn fits into a bony socket within the jaw to help hold the tooth in place (along with attached gum ligaments).
A tooth crown is covered by an ultra-hard layer of enamel, which ordinarily protects it from harmful bacteria. But when acid produced by bacteria comes into prolonged contact with enamel, it can soften and erode its mineral content and lead to a cavity.
In contrast to enamel, the roots have a thin layer of material called cementum. Although it offers some protection, it's not at the same performance level as enamel. But roots are also normally covered by the gums, which rounds out their protection.
But what happens when the gums shrink back or recede? This often occurs with gum disease and is more prevalent in older people (and why root cavities are also more common among seniors). The exposed area of the roots with only cementum standing in the way of bacteria and acid becomes more susceptible to cavity formation.
Root cavities can be treated in much the same way as those that occur in the crown. We first remove any decayed tooth structure with a drill and then place a filling. But there's also a scenario in which the cavity is below the gum line: In that case, we may need to gain access to the cavity surgically through the gums.
If you have exposed root areas, we can also treat these with fluoride to strengthen the area against cavity formation. And, as always, prevention is the best treatment: maintain a daily schedule of brushing and flossing and regular dental cleanings to remove bacterial plaque.
Because decay can spread within a tooth, dealing with a root cavity should be done as promptly as possible. But if we diagnose and initiate treatment early, your chances of a good outcome are high.
If you would like more information on treating root cavities and other forms of 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 “Root Cavities.”
Although we've known for some time how tooth decay forms, it's still prevalent across the population—even more so than cancer or heart disease. Along with gum disease, it's a leading cause of tooth loss.
Fortunately, our knowledge about tooth decay has grown considerably, to the point that we now recognize a number of risk factors that make it more likely a person will develop this disease. By first identifying them in individual patients, we can take steps to address them specifically to reduce the chances of this destructive disease.
Genetics. Researchers have identified around 40 to 50 genes that can influence cavity development. The best way to assess your genetic risk is through family history—if numerous close family members contend with tooth decay, your risk may be high. If so, it's important to be extra vigilant with addressing other areas over which you have more control.
Saliva. Cavities are directly caused by oral acid, a byproduct of bacteria, that can erode tooth enamel over prolonged contact. This is minimized, though, through a normal saliva flow that neutralizes acid and helps remineralize enamel. But poor saliva production can slow acid neutralization. You can improve your saliva flow by drinking more water, changing medications or using saliva-boosting products.
Oral hygiene. You can reduce bacteria (and thus acid) by removing their "room and board"—dental plaque. This accumulating film of food particles harbors the bacteria that feed on it. Daily brushing and flossing, accompanied by regular dental cleanings, effectively removes dental plaque, which in turn lowers the levels of oral bacteria and acid.
Dental-friendly diet. Even if you diligently address the previous risk factors, your diet may fight against your efforts. Diets high in processed and refined foods, especially sugar, provide abundant food sources for bacteria. On the other hand, a diet primarily of whole foods rich in vitamins (especially D) and minerals like calcium and phosphorous strengthen teeth against decay.
Preventing tooth decay isn't a "one-size-fits-all" approach. By identifying your own particular risk, we can craft a care strategy that can be your best defense against this destructive dental disease.
The Millennials, those born around the turn of the Millennium in 2000, are entering adulthood. Like any generation, they have their collective promise—and problems. An example of the latter seems to involve their teeth: an estimated one in three people between the ages of 18 and 34 have some form of tooth decay.
If a recent survey is correct, that may be a result of poor oral hygiene practices. The absence of a consistent, daily habit of brushing and flossing to remove disease-causing dental plaque is the number one cause for dental disease. But a survey of 2,000 millennials found only three in ten brushed their teeth at least once a day with many often skipping brushing for two or more days a time.
Interestingly, more than half of the survey also reported an aversion to dental visits. That will likely need to change if these trends in poor hygiene continue, as aging millennials will eventually need extensive treatment for tooth decay and its close counterpart periodontal (gum) disease to save their teeth. Dental professionals recommend a different dental care track: stop dental disease before it develops. And the key to that is a simple but powerful daily brushing and flossing routine.
This routine should involve brushing teeth up to twice and flossing at least once a day. Brushing should be done with gentle strokes, but include all exposed tooth surfaces (about two minutes to perform a thorough job). Flossing is less popular than brushing, but it’s essential for removing plaque between teeth your brush can’t reach. To make it easier, you can use pre-threaded floss or a water flosser that removes plaque with a stream of water.
To round out your prevention strategy, you should see a dentist at least twice a year for professional cleanings of hardened plaque deposits (calculus), as well as overall monitoring of your dental health. And if dental visits make you anxious, your dental professional has a number of ways to help you relax.
One thing’s for sure: like any other generation, millennials prize both good health and an attractive smile. Adopting a solid oral hygiene lifestyle will do the most to achieve both.
If you suffer frequent sinus infections, you might want to talk with your dentist about it. It could be your chronic sinus problems stem from a deeply decayed or infected tooth.
Sinuses are hollow, air-filled spaces in the front of the skull associated with nasal passages. The largest, the maxillary sinuses, are located just behind the cheekbones and above and to the rear of the upper jaw on either side of the face. These sinuses can become painfully congested when infected.
One possible cause for an infection in the maxillary sinus can occur in certain people whose upper back teeth (the molars and premolars) have roots that are close to or even protrude into the sinus. This is normally a minor anatomical feature, unless such a tooth becomes infected.
An infection in teeth with advancing decay or whose nerve tissue has died will eventually reach the root tip through tiny passageways called root canals. If the roots are close to or penetrating the maxillary sinus, the infection could move into the sinus. This is known as Maxillary Sinusitis of Endodontic Origin (MSEO).
A case of MSEO could potentially go on for years with occasional flare-ups of sinus congestion or post-nasal drip. Because of the nature of the infection within the sinus, the affected tooth itself may not show the normal signs of infection like sensitivity or pain. Doctors may attempt to treat the sinus infection with antibiotics, but because the actual source of the infection is within the tooth, this therapy is often ineffective.
If your doctor or dentist suspects MSEO, they may refer you to an endodontist, a specialist in root canals and interior tooth problems. With their advanced diagnostic capabilities, endodontists may have a better chance of accurately diagnosing and locating the source of a tooth-related infection.
As with any non-vital tooth, the likely treatment will be root canal therapy in which the infected tissue within the tooth is removed and the empty spaces filled to prevent future infection. For MSEO, the treatment not only preserves the tooth but may also relieve the infection within the sinus.
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.