Posts for tag: tooth decay
Nothing grabs your attention like a sharp tooth pain, seemingly hitting you out of nowhere while you’re eating or drinking. But there is a reason for your sudden agony and the sooner you find it out, the better the outcome for your oral health.
To understand tooth sensitivity, we need to first look at the three layers of tooth anatomy. In the center is the pulp filled with blood vessels and nerve bundles: it’s completely covered by the next layer dentin, a soft tissue filled with microscopic tubules that transmit sensations like pressure or temperature to the pulp nerves.
The third layer is enamel, which completely covers the crown, the visible part of a tooth. Enamel protects the two innermost tooth layers from disease and also helps muffle sensations so the tooth’s nerves aren’t overwhelmed. The enamel stops at about the gum line; below it the gums provide similar protection and sensation shielding to the dentin of the tooth roots.
Problems occur, though, when the dentin below the gums becomes exposed, most commonly because of periodontal (gum) disease. This bacterial infection caused by dental plaque triggers inflammation, which over time can weaken gum tissues and cause them to detach and shrink back (or recede) from the teeth. This can leave the root area vulnerable to disease and the full brunt of environmental sensations that then travel to the nerves in the pulp.
Tooth decay can also create conditions that cause sensitivity. Decay begins when certain oral bacteria multiply and produce higher than normal levels of acid. The acid in turn dissolves the enamel’s mineral content to create holes (cavities) that expose the dentin. Not treated, the infection can eventually invade the pulp, putting the tooth in danger of being lost unless a root canal treatment is performed to remove the infection and seal the tooth from further infection.
So, if you begin experiencing a jolt of pain while eating or drinking hot or cold foods or beverages, see your dentist as soon as possible to diagnose and treat the underlying cause. And protect your teeth from dental disease by practicing daily brushing and flossing, as well as seeing your dentist for regular dental cleanings and checkups. Don’t ignore those sharp pains—your teeth may be trying to tell you something.
If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”
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.
Although preventable, the occurrences of tooth decay are all too common. Yet decay doesn’t appear out of the blue: certain mouth conditions set the disease in motion.
Here are a few signs of such conditions to watch for — they could be telling you you’re at higher risk for tooth decay.
Visible plaque. Plaque is a thin film of bacteria and food accumulating on tooth surfaces and a prime haven for causing periodontal disease. If you actually see it — a crusty, yellowish film — that means there’s a large, unhealthy amount of it. It’s essential to remove it daily through diligent brushing and flossing and more thorough office cleanings at least twice a year.
Poor saliva flow. One of this bodily fluid’s functions is to neutralize mouth acid, usually thirty minutes to an hour after we eat. If saliva flow is inadequate, though, acid levels may remain high and endanger the enamel. “Dry mouth” can occur from a number of causes, including some medications and chemotherapy treatments. It’s important to alleviate the cause if possible by changing medications or stimulating saliva flow through other means.
Tooth shape and appliances. Largely determined by heredity, your teeth contain unique, tiny grooves known as pits and fissures that could harbor plaque. Certain appliances like retainers, braces or night guards can inhibit saliva flow and cause your teeth to retain more plaque. It’s important then to adjust your hygiene efforts to offset these anatomical or treatment factors.
Acid-producing conditions. Diseases like gastro-esophageal reflux disease (GERD) or eating disorders can introduce stomach acid into the mouth that is highly erosive to tooth enamel. It’s imperative for you or a family member to control these conditions through medication, dietary changes, or — in the case of eating disorders — behavioral therapy.
Eating habits. Sugar and other carbohydrates are a ready food source for bacteria. Likewise, acidic foods and beverages (like coffee, tea, and sports or energy drinks) can cause high acid levels for too long. Cut back on eating and drinking these foods and beverages, especially as snacks, to reduce acid levels that could lead to decay.
If you would like more information on strategies to prevent 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 “Tooth Decay: How to Assess Your Risk.”
Your teeth’s hard, enamel coating protects them from environmental dangers or disease. But although it’s made of the hardest substance in the human body, enamel isn’t invincible — prolonged exposure to acid can cause dental erosion, a condition in which the enamel’s mineral content permanently dissolves, a process known as de-mineralization.
De-mineralization occurs anytime our mouth environment becomes too acidic due to eating or drinking items with high acid content. Saliva normally neutralizes mouth acid in thirty minutes to an hour after we eat, as well as restores mineral content to the enamel (re-mineralization). Danger arises, though, if the saliva’s buffering action is overwhelmed by chronic acidity, caused mainly by constant snacking or sipping on acidic foods and beverages throughout the day — in this situation, saliva can’t complete the process of buffering and re-mineralization.
As a result, the enamel may permanently lose its mineral content and strength over time. This permanent dental erosion leads to serious consequences: the teeth become more susceptible to decay; the dentin becomes exposed, which causes pain and sensitivity to pressure and temperature changes; and changes in the teeth’s size and color can negatively alter your appearance.
It’s important to take action then before dental erosion occurs. Along with daily oral hygiene, restrict your consumption of acidic foods and beverages to meal times and cut back on between-meal snacks. Rather than a sports drink after exercising, drink nature’s hydrator — water. You should also alter your brushing habits slightly — rather than brush right after you eat, wait thirty minutes to an hour. This gives saliva time to restore the mouth to its normal pH and re-mineralize the enamel. Brushing right after can remove even more of the minerals in softened enamel.
If significant erosion has occurred, there are a number of treatment options we can undertake to preserve remaining tooth structure and enhance your appearance. In moderate cases, we can reshape and cover damaged teeth using dental materials like composite resins or porcelain to fill decayed areas or cover teeth with veneers or crowns.
The key of course, is to identify dental erosion through clinical examination as soon as possible to minimize damage. Your enamel plays a critical role in protecting your teeth from disease — so take the right steps to protect your enamel.
If you would like more information on protecting your enamel, 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 “Dental Erosion.”