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AreYouatRiskforToothDecayAnswerTheseQuestionsToFindOut

Tooth decay is a destructive disease that could rob you of your teeth. But it doesn't appear out of nowhere—a number of factors can make it more likely you'll get cavities.

But the good news is you can be proactive about many of these factors and greatly reduce your risk of tooth decay. Here are a few questions to ask yourself to point you in the right direction for preventing this destructive disease.

Do you brush and floss every day? A daily habit of brushing and flossing removes buildup of dental plaque, a bacterial film on teeth that's the top cause for tooth decay and periodontal (gum) disease. Hit or miss hygiene, though, can greatly increase your risk for developing a cavity.

Do you use fluoride? This naturally occurring chemical has been proven to strengthen tooth enamel against decay. Many locations add fluoride to drinking water—if your area doesn't or you want to boost your fluoride intake, use toothpastes, mouthrinses or other hygiene products containing fluoride.

Do you smoke? The nicotine in tobacco constricts blood vessels in the mouth so that they provide less nutrients and antibodies to the teeth and gums. Your mouth can't fight off infection as well as it could, increasing your risk of dental diseases like tooth decay.

Do you have dry mouth? This isn't the occasional bout of “cotton mouth,” but a chronic condition in which the mouth doesn't produce enough saliva. Saliva neutralizes mouth acid, so less of it increases your risk for decay. Chronic dry mouth can be caused by medications or other underlying conditions.

Do you snack a lot between meals? Sugary snacks, sodas or energy drinks can increase oral bacteria and acidity that foster tooth decay. If you're snacking frequently between meals, your saliva's acid neutralizing efforts may be overwhelmed. Coordinate snacking with mealtimes to boost acid buffering.

You can address many of these questions simply by adopting a daily habit of brushing and flossing, regular dental cleanings and checkups, and eating a healthy, “tooth-friendly” diet. By reducing the risk factors for decay, you can avoid cavities and preserve your teeth.

If you would like more information on preventing 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.”

TreatingaBabyToothwithInnerDecaycanbeComplicated-butStillNecessary

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.”

By Eric Romano DDS
April 11, 2020
Category: Oral Health
Tags: tooth decay   sugar  
TooMuchSugarCanWreckMoreThanYourTeeth

You've heard it. Your parents heard it—maybe even your grandparents too. Dentists have been alerting people for more than half a century that high sugar consumption contributes to tooth decay.

That message hasn't changed because the facts behind it are the same in the 2020s as they were in the 1950s: The bacteria that cause tooth decay feast on sugar and other leftover carbohydrates in the mouth. This causes them to multiply and increase their production of acid, which softens and erodes tooth enamel.

What has changed though, especially over the last couple of decades, is a growing understanding of how sugar consumption may affect the rest of the body. Just like the evidence of sugar's relationship to tooth decay, current scientific studies are now showing there are strong links between sugar and diseases like diabetes, heart disease and liver disease.

What's startling about what researchers are finding is that cases of these diseases are growing, Especially in younger people. This is a parallel trend to our skyrocketing increases in per capita sugar consumption: the average American now eats the equivalent of 19.5 teaspoons of added sugar every day. Health experts generally agree we should consume no more than 6 teaspoons a day, and children 4.

This is vastly more than we consumed a generation ago. One reason is because processed food manufacturers have increased sugar in their products, hiding under technical, unfamiliar names in ingredient lists. But it's still sugar, and an estimated 74% of processed foods contain some form of it.

But the real surge in sugar has come from our increasing consumption of sodas, as well as energy and sports beverages. These beverages are high in sugar—you can meet your daily allowance with just one 12-oz can of soda. These beverages are now the leading source of sugar in our diets, and, according to experts, a highly dangerous way to consume it.

In effect, dentists of old were on to something: too much sugar is bad for your teeth. It now turns out that it may be bad for your overall health too. Strictly limiting it in your family's diet could help lower your risk of tooth decay and dangerous diseases like diabetes.

If you would like more information on sugar and your health, please contact us or schedule an appointment for a consultation.

By Eric Romano DDS
February 11, 2020
Category: Oral Health
Tags: tooth decay  
ManageTheseRiskFactorstoReduceYourRiskofToothDecay

Tooth decay doesn't occur out of thin air, but is the end result of bacteria feeding on sugar, multiplying and producing acid. High acidity erodes tooth enamel and creates an environment for cavity development.

Modern dentistry can effectively treat cavities and often save the tooth from further damage. But you don't have to wait: You can reduce your chances of cavities by managing risk factors that contribute to decay.

Here are 4 top risk factors for tooth decay and what you can do about them.

Poor saliva flow. Saliva neutralizes acid and helps restore minerals to enamel after acid contact. But your enamel may not have full protection against acid if you have diminished saliva flow, often due to certain medications. You can help increase your saliva by consulting with your doctor about drug alternatives, drinking more water or using a saliva boosting product. Smoking can also inhibit saliva, so consider quitting if you smoke.

Eating habits. High sugar content in your diet can increase bacterial growth and acid production. Reducing your overall sugar consumption, therefore, can reduce your risk of decay. Continuous snacking can also increase your decay risk, preventing saliva from bringing your mouth back to its normal neutral pH. Instead, limit your snack periods to just a few times a day, or reserve all your eating for mealtimes.

Dental plaque. Daily eating creates a filmy buildup on the teeth called dental plaque. If not removed, plaque can then harden into a calcified form called calculus, an ideal haven for bacteria. You can help curtail this accumulation by thoroughly brushing and flossing daily, followed by dental cleanings at least every six months. These combined hygiene practices can drastically reduce your cavity risk.

Your genetics. Researchers have identified up to 50 specific genes that can influence the risk for cavities. As a result, individuals with similar dietary and hygiene practices can have vastly different experiences with tooth decay. Besides continuing good lifestyle habits, the best way to manage a genetic disposition for dental disease is not to neglect ongoing professional dental care.

If you would like more information on managing your tooth decay risk factors, 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 “What Everyone Should Know About Tooth Decay.”

TakingtheRightStepstoPreventEarlyToothDecayinChildren
TakingtheRightStepstoPreventEarlyToothDecayinChildren

While the prevention and treatment of tooth decay has improved dramatically over the last half century, it continues to be a major health issue, especially for children. One in four children 5 and younger will develop some form of the disease.

Although tooth decay in children stems from the same causes as in adults — the presence of decay-causing bacteria in plaque, unprotected teeth and the right mix of carbohydrates like sugar left in the mouth — the means by which it occurs may be different. We even define tooth decay differently in children as Early Childhood Caries (ECC), “caries” the dental profession’s term for tooth decay.

ECC highlights a number of cause factors specific to young children, such as: continuous use of a bottle or “sippy cup” filled with juice or other sweetened beverages; at-will breast-feeding throughout the night; use of a sweetened pacifier; or regular use of sugar-based oral medicine to treat chronic illness.

If you noticed sugar as a common denominator in these factors, you’re right. As a primary food source for bacteria, refined sugar is a major trigger for the disease especially if it constantly resides in the mouth from constant snacking or sipping. In fact, it’s the primary driver for a particular pattern of decay known as Baby Bottle Tooth Decay (BBTD). This pattern is specifically linked to sleep-time bottles filled with juice, milk, formula or other sweetened beverages, given to an infant or toddler to help soothe them through the night or during naps.

All these factors cause a cycle of decay. To interrupt that cycle, there are some things you as a parent should do: perform daily hygiene with your child to reduce decay-causing bacteria; reduce the amount and frequency of carbohydrates in the diet, particularly sugar; and protect the teeth by having us apply fluoride or sealants directly to the teeth.

Early tooth decay could affect your child's oral health for years to come. With a little care and vigilance, you improve your chances of avoiding that encounter.

If you would like more information on preventing tooth decay in children, 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 “Dentistry & Oral Health for Children.”