Over the last century effectively treating a decayed tooth has often required removing any decayed structure with drilling and then filling the remaining cavity. While this approach does save teeth that might otherwise be lost, it can also result in a fair amount of healthy structure removed in the process.
But continuing advances in dentistry are now making possible a new approach to tooth decay treatment that preserves as much of the healthy portions of tooth as possible. This new way is often referred to as minimally invasive dentistry (MID).
The primary goal of MID treatment is to intercept and treat decay as early as possible to minimize tooth damage. It begins with helping patients identify their own individual risk factors for decay such as the presence of disease-causing bacteria, the adequacy of their saliva flow, or their lifestyle and dietary habits. We then recommend changes or preventive measures to reduce those risks.
The next step in MID is using various diagnostic technologies to find decay as early as possible. X-rays continue to play a major role, but dentists are also using dental microscopy to magnify the earliest forms of decay. Many also utilize laser fluorescence, infrared photography and optical scanning to further “see” decay difficult to detect with the naked eye.
In regard to treatments, MID adopts the adage “less is more.” If caught early enough, we can encourage the re-mineralization of enamel that acid has eroded with CPP-ACP, a substance acquired from milk, or strengthen teeth with topical fluoride applications. Instead of the dental drill, many dentists now turn to air abrasion for decay removal, equipment that emits a fine stream of abrasive particles that harms less healthy structure than a drill.
And if lasers continue to develop at their current pace, we’ll be able to use this technology to perform much more precise decay treatment than possible with manual instruments. As a result, we’ll be able to treat decayed teeth with less invasive means to preserve as much healthy structure as possible.
As these and other developments continue, MID promises a bright future for preventing and treating tooth decay. As a result, there’ll be less tooth structure loss and more attractive and healthy smiles.
If you would like more information on the latest techniques for treating 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 “Minimally Invasive Dentistry.”
Watching your kids dress up in cute, spooky costumes and go out trick-or-treating can be a real thrill. But thinking about the dental damage caused by eating all those sweets might just give you the chills. So is it best to act like a witch and take away all the candy from those adorable little ghosts and goblins?
Relax! According to experts like the American Dental Association, it’s OK to let kids enjoy some sweet treats on special occasions like Halloween—especially if they have been taking good care of their oral hygiene all year long, by brushing twice each day and flossing once every day. But to help keep cavities away from those young smiles, there are some things parents (and everyone else) should understand.
Cavities—small holes in the tooth’s outer surface that result from the decay process—get started when bacteria in the mouth feed on sugar and produce acids. The acids eat away at the hard enamel coating of teeth. If left untreated, decay will eventually reach the soft inner core of the tooth, causing even more serious damage.
There are several ways to stop the process of tooth decay. One is to take away the sugar that decay bacteria feed on. Because this ingredient is common in so many foods, it’s hard to completely eliminate sugar from the diet. Instead, it may be more practical to limit the consumption of sweets. For example, if kids are only allowed to eat sugary treats around mealtimes, it gives the mouth plenty of “downtime,” in which healthful saliva can neutralize the bacterial acids. It also helps to avoid sweets that stick to teeth (like taffy or gummy bears) and those that stay in the mouth for a long time (like hard candy).
Another way to help stop tooth decay is by maintaining top-notch oral hygiene. Decay bacteria thrive in the sticky film called plaque that clings stubbornly to the surfaces of teeth. Plaque can be removed by—you guessed it—effective brushing and flossing techniques. While it’s a good start, brushing alone won’t remove plaque from the spaces between teeth and under the gums: That’s why flossing is an essential part of the daily oral hygiene routine. Helping your kids develop good oral hygiene habits is among the best things you can do to fight cavities.
And speaking of habits, there are a few others that can help—or hurt—your oral health. For example, drinking plenty of water keeps the body hydrated and benefits oral health; but regularly drinking soda and other sweetened or acidic beverages greatly increases the risk of tooth decay. And seeing your dentist on a regular basis for professional cleanings and routine checkups is one of the most beneficial habits of all. Working together, we can help keep tooth decay from turning into a scary situation for kids—and adults too.
If you have questions about cavity prevention or oral hygiene, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “How to Help Your Child Develop the Best Habits for Oral Health” and “Tooth Decay—How to Assess Your Risk.”
A “gummy” smile, in which the upper gums are too prominent, is a common condition. There are several causes for gummy smiles — determining which one is the first step to having your appearance changed.
Although perceptions vary from person to person, most dentists agree a gummy smile shows 4 mm or more of gum tissue, and the amount is out of proportion with the length of the crown (the visible tooth). Teeth normally erupt through the gums during childhood and continue development until early adulthood, shrinking back from the tooth until stabilizing in place.
This typically produces a crown length of about 10 mm, with a “width to length” ratio of about 75-85%. But variations can produce differences in the relationship between teeth and gums and the width to length ratio of the teeth. The teeth may appear shorter and the gums more prominent. Worn teeth, caused by aging or grinding habits, may also appear shorter.
If tooth to gum proportionality is normal, then the cause may be upper lip movement. When we smile, muscles cause our lips to retract 6-8 mm from the lip’s resting position. If the amount of movement is greater (meaning the lip is hypermobile), it may show too much of the gums. The upper jaw can also extend too far forward and cause the gums to appear too prominent.
There are a number of ways to improve gummy smiles, depending on the cause. Periodontal plastic surgery known as crown lengthening removes and reshapes excess gum tissue to reveal more of the tooth. Lip hypermobility can be reduced with Botox injections (to paralyze the muscles) or in some cases with surgery to reposition the muscle attachments. Orthognathic surgery can be used to surgically reposition an overextended upper jaw. Other cosmetic enhancements such as orthodontics, bonding or porcelain restorations can also prove effective.
The first step is to obtain an accurate diagnosis for your gummy smile. From there, we can devise the best treatment approach to bring your smile back into a more attractive proportion.
If you would like more information on minimizing a gummy smile, 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 “Gummy Smiles.”
While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.
“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.
Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.
Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).
For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.
Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.
If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”
A relatively easy and inexpensive way to improve your smile is to whiten your teeth. In fact, you may even be able to do it yourself at home. Although there are differences between at-home and professional whitening, the former can still be effective.
That effectiveness, though, might be dependent on how well you understand what home whitening can do and what it can’t. So before you purchase your kit, here are a few things to know about DIY teeth whitening.
Home kits are safe—when used as directed. Although nothing in life is completely risk-free, home whitening kits are relatively safe. But only if you follow the directions: If you overuse the bleaching solution beyond its intended use, you could wind up with permanent damage to your tooth enamel that can be costly to treat.
Bleaching solutions are relatively mild. Nearly all home kits use carbamide peroxide, a form of hydrogen peroxide, as their bleaching agent. Home kits usually contain no more than 10% of this agent, much lower than professional solutions. Used as directed, this amount of bleaching agent poses little to no risk to dental or general health. On the other hand, the weaker home kit solution does limit the extent of brightness you can achieve compared to stronger professional treatments.
For top results (or certain conditions), consider professional whitening. While you can obtain good results with a home whitening kit, professional whitening provides more precise brightness control and range, and may possibly last longer. That’s because your dentist has more advanced techniques and equipment, as well as stronger bleaching solutions. And, if your discoloration originates inside your teeth, a home kit won’t help—only a dentist can address that kind of discoloration.
Even if you decide to “go solo,” your dentist can still give you advice on what to look for in a home kit, as well as tips for the actual procedure. But whether you whiten at home or let your dentist do it, teeth whitening can take years off your smile and give you a more attractive look.
If you would like more information on teeth whitening, 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 Whitening Safety Tips: Are Bleaching Products Safe?”
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