For over a century dentists treated tooth decay by removing both diseased portions of the tooth and healthy structure deemed at risk for future decay. In the 1970s, though, a new approach emerged, known as Minimally Invasive Dentistry (MID). This practice protocol attempts to preserve as much of the healthy structure as possible.
Before MID, dentists followed a decay treatment protocol developed in the 19th Century. A part of this became known as extension for prevention calling for dentists to remove healthy structure considered vulnerable to decay. Besides reducing the tooth's volume, this practice also resulted in, by today's standards, larger than necessary fillings.
It was thought that removing this additional material would make it easier to clean bacterial plaque, the source of decay, but later, research showed the practice couldn't guarantee the teeth wouldn't be reinfected.
Since then we've learned a lot more about teeth and have developed new ways to detect decay at earlier stages. X-ray imaging, for example, has transitioned largely from film to digital technology, providing more detailed images at greater magnification. This, along with laser fluorescence and infrared cameras, has made it easier to detect the first tiny stages of decay.
We can also limit tooth decay damage by boosting enamel strength with fluoride applications and sealants or reducing decay-causing bacteria with anti-bacterial rinses. We've also seen advancement in techniques like air abrasion that remove decayed tooth material while leaving more healthy structure intact better than using a traditional dental drill.
Restoring teeth after treatment has also improved. While dental metal amalgam is still used for some fillings, the main choice is now composite resin. These new tooth-colored dental materials require less tooth preparation (and thus less material loss) and bond well to the remaining structure, resulting in a stronger tooth.
Following a MID protocol leads to less intervention and less time in the dentist's chair. It also means preserving more of a natural tooth, an important aim in promoting long-lasting dental health.
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”
One of the health issues pregnant women should be concerned about is a higher risk of periodontal (gum) disease. But you don’t have to be pregnant to have an increased risk — you also may be more susceptible to dental disease if you’re taking certain birth control pills.
Gum disease is a bacterial infection caused by plaque, food debris that builds up on tooth and gum surfaces due to poor oral hygiene. If left untreated gum disease can eventually lead to the breakdown of connective gum tissue and cause tooth loss.
Pregnant women are at greater risk because of an increased level of female hormones (estrogen) in their blood stream. This causes a change in the blood vessels that supply the gums, making them more susceptible to the effects of bacteria. A number of birth control options also increase estrogen levels, causing much of the same effect. To heighten the effect, you may also have a predisposition toward gum disease by your genetics or a high stress level.
There are some things you can do, however, to help lower your risk if you’re taking birth control medication. First and foremost, practice a consistent, daily habit of brushing and flossing. If you’re unsure if your technique is effective, we can provide guidance and training to make sure you’re performing these tasks properly. You should also visit us at least twice a year for office cleanings and checkups: no matter how effective you are with brushing and flossing, plaque can still accumulate in hard to reach places and form hardened deposits known as calculus.
You should also be on the lookout for signs of disease like gum redness, swelling or bleeding. If you see any of these signs, contact us as soon as possible for a thorough examination. As with many other issues involving health, the sooner we begin treatment for gum disease the better your chances of stopping it before it does too much harm.
If you would like more information on the relationship between gum disease and pregnancy or birth control, 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 “Pregnancy & Birth Control.”
While dental implants have become the most popular restoration among both dentists and patients, it’s primarily a tooth replacement — either for a missing tooth or a tooth beyond repair that must be extracted. But what if your tooth is still viable beneath its unattractive exterior? From an oral health standpoint, it’s usually wise to preserve it.
Even so, you still have options for making a tooth that’s spoiling your smile more attractive. One of the most effective solutions happens to be one of the oldest in dentistry: a crown. In effect, a crown is a life-like replica made of metal or dental porcelain that’s bonded over a tooth. And with today’s advanced materials and methods a crown can not only enhance the appearance of the tooth it covers, it can also be made to blend with the color and symmetry of adjacent teeth.
Here are a few dental situations where a crown could provide both protection for a tooth and a more attractive appearance.
Chipped, Damaged or Abnormally Developed Teeth. Teeth often take the brunt of mouth injuries, resulting in chips or even fractures. Also, teeth sometimes don’t erupt fully or develop a normal shape. A crown can effectively cover these missing or abnormal parts of a tooth and restore a more natural appearance.
Following Root Canal Treatment. Trauma or deep decay can damage the interior of a tooth - the pulp and root canals - and endanger its survival. A root canal treatment cleans out and repairs these areas, filling them with a special filling to prevent further infection. A crown is usually necessary to both protect the tooth and restore its appearance.
Discoloration. There’s a difference between outward staining of the enamel, which can usually be brightened with whitening solutions, and staining deep within the tooth from various causes. While there are techniques to bleach “intrinsic” staining, a crown provides another option for covering a heavily discolored tooth for a more attractive appearance.
Excessive Wear. We all experience some teeth wearing as we age; but grinding or clenching habits can accelerate that wear and shorten teeth, resulting in a prematurely aged look. Crowns restore worn teeth to a more normal length that can take “years” off your smile.
If you would like more information on crown restorations, 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 “Crowns & Bridgework.”
The classic movie Willie Wonka & the Chocolate Factory, starring Gene Wilder, still brings back sweet memories of childhood to people everywhere. Recently, the news broke that a remake of the beloved 1971 film is in now development in Hollywood. But at a reunion of the original cast members a few years ago, child star Denise Nickerson revealed that her role as gum-chewing Violet Beauregard caused a problem: she ended up with 13 cavities as a result of having to chew gum constantly during the filming!
It should come as no surprise that indulging in sugary treats can lead to cavities: The sugar in your diet feeds harmful bacteria that can cause tooth decay and other dental problems. Yet lots of kids (not to mention the child inside many adults) still crave the satisfaction that gum, candy and other sweets can bring. Is there any way to enjoy sweet treats and minimize the consequences to your oral health?
First, let’s point out that there are lots of healthy alternatives to sugary snacks. Fresh vegetables, fruits and cheeses are delicious options that are far healthier for you and your kids. Presenting a variety of appealing choices—like colorful cut-up carrots, bite-sized cheese bits and luscious-looking fruits and berries can make it easier (and more fun) to eat healthy foods. And getting kids off the sugar habit is a great way to help them avoid many health problems in the future.
For those who enjoy chewing gum, sugarless gum is a good option. In fact, chewing sugarless gum increases the flow of healthful saliva in the mouth, which can help neutralize the bacteria-produced acids that cause cavities. Gums that have the ADA (American Dental Association) Seal of Acceptance have passed clinical tests for safety and effectiveness.
But if you do allow sugary snacks, there are still a few ways to minimize the potential damage. Restrict the consumption of sweets to around mealtimes, so the mouth isn’t constantly inundated with sugar. Drink plenty of water to encourage saliva flow, and avoid sugary and acidic beverages like soda (even diet soda) and “sports” or “energy” drinks. Brush twice daily with fluoride toothpaste and floss once a day. And don’t forget to visit our office regularly for routine checkups and cleanings. It’s the best way to get a “golden ticket” to good oral health.
If you would like more information about sugar, cavities and oral health, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Nutrition & Oral Health” and “The Bitter Truth About Sugar.”
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