Posts for tag: tooth decay
Although dental care has made incredible advances over the last century, the underlying approach to treating tooth decay has changed little. Today’s dentists treat a decayed tooth in much the same way as their counterparts from the early 20th Century: remove all decayed structure, prepare the tooth and fill the cavity.
Dentists still use that approach not only because of its effectiveness, but also because no other alternative has emerged to match it. But that may change in the not-too-distant future according to recent research.
A research team at Kings College, London has found that a drug called Tideglusib, used for treating Alzheimer’s disease, appears to also stimulate teeth to regrow some of its structure. The drug seemed to cause stem cells to produce dentin, one of the tooth’s main structural layers.
During experimentation, the researchers drilled holes in mouse teeth. They then placed within the holes tiny sponges soaked with Tideglusib. They found that within a matter of weeks the holes had filled with dentin produced by the teeth themselves.
Dentin regeneration isn’t a new phenomenon, but other occurrences of regrowth have only produced it in tiny amounts. The Kings College research, though, gives rise to the hope that stem cell stimulation could produce dentin on a much larger scale. If that proves out, our teeth may be able to create restorations by “filling themselves” that are much more durable and with possibly fewer complications.
As with any medical breakthrough, the practical application for this new discovery may be several years away. But because the medication responsible for dentin regeneration in these experiments with mouse teeth is already available and in use, the process toward an application with dental patients could be relatively short.
If so, a new biological approach to treating tooth decay may one day replace the time-tested filling method we currently use. One day, you won’t need a filling from a dentist—your teeth may do it for you.
We often don't realize how important something is until it's gone. Like saliva: you're usually not aware that it's cleaning the mouth, neutralizing mouth acid or helping with digestion. But that could change if your saliva flow drops below normal: your health may soon suffer with your mouth taking the brunt.
In particular, reduced saliva flow increases your risk for tooth decay and periodontal (gum) disease. Both diseases are linked to oral bacteria. While many of the myriad strains in the mouth are beneficial, a few bacteria can infect and inflame gum tissues. Bacteria also produce acid, which can soften and erode enamel and make the teeth more susceptible to decay.
Saliva inhibits bacteria in a number of ways. It first clears the mouth of leftover food so not as much stays behind to form bacterial plaque, a thin film of food particles that builds up on teeth. You still need to brush and floss daily to remove plaque, but it's less effective without saliva's cleansing action. Saliva also contains antibodies that destroy disease-causing bacteria and other organisms, which keeps their populations in the mouth low.
One of saliva's most important functions, though, is buffering acid. The mouth's ideal pH level is neutral, but many foods we eat can cause it to become more acidic.Â Even a slight acidic rise after eating can soften the minerals in enamel. But saliva goes to work immediately and usually restores normal pH within a half hour to an hour. It also aids in re-mineralizing the enamel.
For these reasons, it's important for you to find out the cause of chronic dry mouth and treat it. If it's a side effect of your medication, talk to your doctor about an alternative, or drink more water before and after you take your dose. Certain products can also stimulate saliva flow, like chewing gum with xylitol, an alcohol-based sweetener that has dental health-protecting properties too.
Although you often don't notice this unsung bodily fluid swishing in your mouth, it's important that you take care of it. Keeping your saliva flowing will help ensure better oral health.
If you would like more information on the importance of saliva to health, 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 “Saliva: How it is used to Diagnose Disease.”
Even though a child’s primary (“baby”) teeth eventually give way, it’s still important to treat them if they become decayed. Primary teeth serve as guides for the emerging permanent teeth — if they’re lost prematurely, the permanent tooth may come in misaligned.
If the decay, however, affects the tooth’s inner pulp, it poses complications. A similarly decayed adult tooth would be treated with a root canal in which all the pulp tissue, including nerve fibers and blood vessels, are removed before filling and sealing. Primary teeth, however, are more dependent on these nerves and blood vessels, and conventional filling materials can impede the tooth’s natural loss process. It’s better to use more conservative treatments with primary teeth depending on the degree of decay and how much of the pulp may be affected.
If the decay is near or just at the pulp, it’s possible to use an indirect pulp treatment to remove as much of the softer decay as possible while leaving harder remnants in place: this will help keep the pulp from exposure. This is then followed with an antibacterial agent and a filling to seal the tooth.
If the pulp is partially exposed but doesn’t appear infected, a technique called direct pulp capping could be used to cover or “cap” the exposed pulp with filling material, which creates a protective barrier against decay. If decay in a portion of the pulp is present, a pulpotomy can be performed to remove the infected pulp portion. It’s important with a pulpotomy to minimize the spread of further infection by appropriately dressing the wound and sealing the tooth during and after the procedure.
A pulpectomy to completely remove pulp tissue may be necessary if in the worst case scenario the pulp is completely infected. While this closely resembles a traditional root canal treatment, we must use sealant material that can be absorbed by the body. Using other sealants could inhibit the natural process when the primary tooth’s roots begin to dissolve (resorb) to allow it to eventually give way.
These all may seem like extraordinary efforts to save a tooth with such a short lifespan. But by giving primary teeth a second chance, their permanent successors will have a better chance of future good health.
If you would like more information on treating decay in primary teeth, 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 Treatment for Children’s Teeth.”
“Less is more” is a truism for much of life. It’s also an important feature of an emerging approach to treating tooth decay known as minimally invasive dentistry (MID).
MID updates another revolution in dental care that occurred in the early 1900s. Treating decay took a quantum leap thanks to techniques developed by Dr. G. V. Black, considered the father of modern dentistry. Dr. Black’s approach (known as “extension for prevention”) involved not only removing decayed tooth structure, but also adjacent areas deemed vulnerable to decay, which made them easier to clean. On the downside, though, it also created larger than normal fillings.
As the practice prevailed through much of the Twentieth Century another weakness became apparent—the approach could not guarantee a treated tooth would not experience decay again. This became the real impetus toward MID—to find more comprehensive ways to treat decay with as little impact on the tooth structure as possible.
These efforts received a real boost from emerging technology. This was especially true in diagnostics with the rise of new devices like intraoral cameras and techniques like laser fluorescence that can enable dentists to detect decay much earlier. It’s now possible to catch the disease at an earlier stage before substantial damage to the tooth occurs.
MID has also led to new treatments that preserve more of the tooth structure. Traditional drilling is increasingly giving way to air abrasion, the use of a fine particle stream of aluminum oxide, glass beads or baking soda directed precisely at decayed structure and minimizing damage to healthy structure. We’re also using new filling materials like composite resin for restorations after treatment that are strong yet still life-like and attractive.
We also can’t forget the role of the twin daily hygiene practices brushing and flossing to remove bacterial plaque, the main source of dental disease. And regular dental cleanings and checkups round out the MID approach, helping to ensure that decay doesn’t get too far. The end result of this revolutionary approach: your teeth can experience less impact from treatment and remain healthier and more attractive in the long-run.
If you would like more information on minimally invasive dental care, 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.”