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.”
Braces are a common experience among teens and pre-teens. And although the treatment can be a major financial undertaking, more and more families pursue it to help their child attain a straighter, more attractive smile.
But orthodontics isn’t first and foremost a cosmetic treatment. Although an improved appearance is a benefit, the main reason for treatment is therapeutic—it can improve your child’s current and future dental health.
The teeth’s relationship to the jaws and gums makes moving them possible. Rather than simply being fixed within their jawbone socket, teeth are actually held in place by a strong, elastic tissue called the periodontal ligament. The ligament lies between the teeth and jawbone and attaches to both with tiny extending fibers. This attachment secures the teeth in place.
But the ligament also has a dynamic quality—it can reshape itself when necessary and allow teeth to move gradually into new positions. This is most necessary during the early years of mouth and jaw development, but it can also occur throughout life. Orthodontics takes advantage of this mechanism by applying precise pressure to the teeth in the direction of desired movement. The periodontal ligament does the rest by reshaping and allowing the teeth to move in response to this pressure.
The result is straighter teeth and a more normal bite. With the teeth now where they should be, it’s also easier to clean them of disease-causing dental plaque, whereas misaligned teeth are more prone to plaque accumulation that can be difficult to remove. And because the whole mouth including teeth are involved when we talk, teeth positioned in a more normal bite will improve speech.
Orthodontics is a long-term process, often encompassing more than the actual time wearing braces. Both orthodontists and pediatric dentists recommend a bite evaluation by an orthodontist around the age of 6. If it does appear an abnormal bite is forming, it may be possible to intervene and stop or at least slow the development. This could have a more positive impact on any future treatment.
Braces and other treatments can make a difference in your child’s self-image and social relationships. But the main beneficiary will be their dental health.
If you would like more information on orthodontic treatment, 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 “Moving Teeth With Orthodontics.”
The internet has transformed how we get information. Where you once needed to find an encyclopedia, telephone directory or library, you can now turn to your handy smartphone or tablet for the same information.
But this convenience has a dark side: A lot of material online hasn’t undergone the rigorous proofreading and editing published references of yesteryear once required. It’s much easier now to encounter misinformation—and accepting some of it as true could harm your health. To paraphrase the old warning to buyers: “Viewer beware.”
You may already have encountered one such example of online misinformation: the notion that undergoing a root canal treatment causes cancer. While it may sound like the figment of some prankster’s imagination, the idea actually has a historical basis.
In the early 20th Century, a dentist named Weston Price theorized that leaving a dead anatomical part in the body led to disease or major health problems. In Price’s view, this included a tooth that had undergone a root canal treatment: With the vital pulp removed, the tooth was, in his view, “dead.”
Price amassed enough of a following that the American Dental Association rigorously investigated his claims in the 1950s and found them thoroughly wanting. For good measure, a Journal of the American Medical Association (JAMA Otolaryngology—Head & Neck Surgery) published a study in 2013 finding that not only did canal treatments not increase cancer, but they might even be responsible for decreasing the risk by as much as forty-five percent.
Here’s one sure fact about root canal treatments—they can save a tooth that might otherwise be lost. Once decay has infiltrated the inner pulp of a tooth, it’s only a matter of time before it spreads through the root canals to the bone. Removing the infected pulp tissue and filling the resulting empty space and root canals gives the tooth a new lease on life.
So, be careful with health advice promoted on the internet. Instead, talk to a real authority on dental care, your dentist. If they propose a root canal treatment for you, they have your best health interest—dental and general—at heart.
If you would like more information on root canal treatment, 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 Safety: The Truth About Endodontic Treatment and Your Health.”
When die-hard music fans hear that their favorite performer is canceling a gig, it’s a big disappointment—especially if the excuse seems less than earth-shaking. Recently, British pop sensation Dua Lipa needed to drop two dates from her world tour with Bruno Mars. However, she had a very good reason.
“I’ve been performing with an awful pain due to my wisdom teeth,” the singer tweeted, “and as advised by my dentist and oral surgeon I have had to have them imminently removed.”
The dental problem Lipa had to deal with, impacted wisdom teeth, is not uncommon in young adults. Also called third molars, wisdom teeth are the last teeth to erupt (emerge from beneath the gums), generally making their appearance between the ages of 18-24. But their debut can cause trouble: Many times, these teeth develop in a way that makes it impossible for them to erupt without negatively affecting the healthy teeth nearby. In this situation, the teeth are called “impacted.”
A number of issues can cause impacted wisdom teeth, including a tooth in an abnormal position, a lack of sufficient space in the jaw, or an obstruction that prevents proper emergence. The most common treatment for impaction is to extract (remove) one or more of the wisdom teeth. This is a routine in-office procedure that may be performed by general dentists or dental specialists.
It’s thought that perhaps 7 out of 10 people ages 20-30 have at least one impacted wisdom tooth. Some cause pain and need to be removed right away; however, this is not always the case. If a wisdom tooth is found to be impacted and is likely to result in future problems, it may be best to have it extracted before symptoms appear. Unfortunately, even with x-rays and other diagnostic tests, it isn’t always possible to predict exactly when—or if—the tooth will actually begin causing trouble. In some situations, the best option may be to carefully monitor the tooth at regular intervals and wait for a clearer sign of whether extraction is necessary.
So if you’re around the age when wisdom teeth are beginning to appear, make sure not to skip your routine dental appointments. That way, you might avoid emergency surgery when you’ve got other plans—like maybe your own world tour!
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
Your child's permanent teeth come in gradually, starting just as they begin losing their primary ("baby") teeth and not ending until late adolescence or early adulthood. That's when the third molars or "wisdom teeth" close out the process.
Because of their late arrival, wisdom teeth have a high potential for dental problems. With a greater chance of crowding or obstruction by other teeth, wisdom teeth often get stuck fully or partially below the gums and bone (impaction) or erupt out of position. In one study, 7 in 10 people between the ages of 20 and 30 will have at least one impacted wisdom tooth at some time in their lives.
It's not surprising then that wisdom teeth are among the most extracted teeth, to the tune of about 10 million per year. Besides those already diseased or causing bite problems, many are removed preemptively in an attempt to avoid future problems.
But wisdom teeth usually require surgical extraction by an oral surgeon, which is much more involved than a simple extraction by a general dentist. Given the potential consequences of surgical extraction, is it really necessary to remove a wisdom tooth not creating immediate problems?
That's not an easy question to answer because it's often difficult to predict a wisdom tooth's developmental track. Early on it can be disease-free and not causing any problems to other teeth. But as some researchers have found, one in three wisdom teeth at this stage will later develop disease or create other issues.
For many dentists, the best approach is to consider extraction on a case by case basis. Those displaying definite signs of problems are prime for removal. But where there are no signs of disease or other issues, the more prudent action may be to keep a watchful eye on their development and decide on extraction at some later date.
More than likely, your dentist will continue to have an ongoing discussion with you about the state of your child's wisdom teeth. While extraction is always an option, wisdom teeth that aren't yet a problem to dental health may be best left alone.
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