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.
Tooth loss is a problem that affects many seniors—and since May is Older Americans Month, this is a good time to talk about it. Did you know that more than a quarter of adults over age 75 have lost all of their natural teeth? This not only affects their quality of life but poses a significant health risk.
According to a study in The Journal of Prosthodontics, significant tooth loss is associated with increased risk for malnutrition—and also for obesity. If this seems like a contradiction, consider that when you have few or no teeth, it’s much easier to eat soft, starchy foods of little nutritional value than it is to eat nutritious fresh fruits and vegetables. If all of your teeth are missing, it’s especially critical to replace them as soon as possible.
There are several ways to replace a full set of missing teeth, including removable dentures, overdentures, and fixed dentures:
Removable dentures are the classic replacement teeth that you put in during the day and take out at night. (However, if you suffer from sleep apnea, research has found that keeping dentures in at night may help keep the airway open, so if you have this condition, be sure to mention it to your doctor and dentist it). Dentures have come a long way in terms of how convincing they look, but they still have some disadvantages: For one thing, they take some getting used to—particularly while eating. Also, wearing removable dentures can slowly wear away the bone that they rest on. As that bone gradually shrinks over time, the dentures cease to fit well and require periodic adjustment (re-lining) or a remake.
Overdentures are removable dentures that attach onto a few strategically placed dental implants, which are small titanium posts placed in the bone beneath your gums. Strong and secure, implants prevent the denture from slipping when you wear it. Implants also slow the rate of bone loss mentioned above, which should allow the denture to fit better over a longer period of time. The ability to maintain hygiene is easier because you can remove them for cleaning.
Fixed implant-supported dentures are designed to stay in your mouth all the time, and are the closest thing to having your natural teeth back. An entire row of fixed (non-removable) replacement teeth can usually be held in place by 4-6 dental implants. Dental implant surgery is an in-office procedure performed with the type of anesthesia that’s right for you. After implants have been placed and have integrated with your jaw bone—generally after a few months—you can enjoy all of your favorite foods again without worry or embarrassment.
If you would like more information about tooth-replacement options, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Overdentures & Fixed Dentures” and “Removable Full Dentures.”
It’s a common problem for denture wearers: after years of a comfortable fit, your dentures now seem to be uncomfortably loose. The reason, though, may have more to do with bone loss than the dentures.
Bone is a living tissue with a life cycle — it forms, it ages, and it eventually dies and dissolves (resorbs). It’s replaced with new bone and the cycle repeats. Additionally, the forces generated when we bite or chew are transmitted from the teeth to the jaw, which helps stimulate new bone growth. When the natural teeth are missing, however, the bone no longer receives this stimulus. Resorbed bone isn’t replaced at a healthy rate, which leads over time to bone loss.
Denture construction can also contribute to bone loss. The denture palate rests for support on the bony ridges that once held the teeth. Over time the compressive forces of the dentures apply damages and reduces the volume of gum tissue and eventually does the same to the bone. Combining all these factors, the reduced gum and bone volume will eventually alter the denture fit.
There are a few alternatives for correcting loose dentures. One is to reline them with new plastic, as either a temporary fix performed during an office visit or a more permanent relining that requires sending your dentures to a dental lab. Depending on the rate of bone loss, a patient could go through several denture relinings to accommodate ongoing changes in the jaw. At some point, though, it may be necessary to create a new set of dentures.
A third alternative that’s becoming increasingly useful is to incorporate dental implants into the denture design. Implants can of course be used to replace individual teeth, but a few strategically placed implants (usually of smaller dimension) can serve as a support platform for a removable denture. This relieves some of the compression force of a traditionally worn denture and can slow bone loss.
If you’re having problems with your denture fit, call us for an appointment. We’ll help you decide on the best alternative to improving the fit and making your dentures more comfortable and secure.
If you would like more information on refitting loose dentures, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Loose Dentures.”
Basketball isn't a contact sport—right? Maybe once upon a time that was true… but today, not so much. Just ask New York Knicks point guard Dennis Smith Jr. While scrambling for a loose ball in a recent game, Smith's mouth took a hit from an opposing player's elbow—and he came up missing a big part of his front tooth. It's a type of injury that has become common in this fast-paced game.
Research shows that when it comes to dental damage, basketball is a leader in the field. In fact, one study published in the Journal of the American Dental Association (JADA) found that intercollegiate athletes who play basketball suffered a rate of dental injuries several times higher than those who played baseball, volleyball or track—even football!
Part of the problem is the nature of the game: With ten fast-moving players competing for space on a small court, collisions are bound to occur. Yet football requires even closer and more aggressive contact. Why don't football players suffer as many orofacial (mouth and face) injuries?
The answer is protective gear. While football players are generally required to wear helmets and mouth guards, hoopsters are not. And, with a few notable exceptions (like Golden State Warriors player Stephen Curry), most don't—which is an unfortunate choice.
Yes, modern dentistry offers many different options for a great-looking, long lasting tooth restoration or replacement. Based on each individual's situation, it's certainly possible to restore a damaged tooth via cosmetic bonding, veneers, bridgework, crowns, or dental implants. But depending on what's needed, these treatments may involve considerable time and expense. It's better to prevent dental injuries before they happen—and the best way to do that is with a custom-made mouthguard.
Here at the dental office we can provide a high-quality mouthguard that's fabricated from an exact model of your mouth, so it fits perfectly. Custom-made mouthguards offer effective protection against injury and are the most comfortable to wear; that's vital, because if you don't wear a mouthguard, it's not helping. Those "off-the-rack" or "boil-and-bite" mouthguards just can't offer the same level of comfort and protection as one that's designed and made just for you.
Do mouthguards really work? The same JADA study mentioned above found that when basketball players were required to wear mouthguards, the injury rate was cut by more than half! So if you (or your children) love to play basketball—or baseball—or any sport where there's a danger of orofacial injury—a custom-made mouthguard is a good investment in your smile's future.
If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”
Although not high on the glamour scale, saliva is nonetheless an important ingredient in a healthy life. This "multi-tasker" fluid helps break down your food for better digestion and supplies antibodies to thwart threatening microorganisms coming in through the mouth.
But perhaps its most important role is to neutralize mouth acid that can erode tooth enamel. Without this buffering action, you're at much greater risk for tooth decay and possible tooth loss.
That's why chronic dry mouth is much more than just an unpleasant feeling. If you're not producing enough saliva, your risk for developing tooth decay (and periodontal disease too) skyrocket.
Here are 3 things you can do to avoid dry mouth and promote healthier saliva flow.
Watch what goes in your mouth. Some foods, beverages and other substances can interfere with saliva production. Caffeine in coffee, sodas and other beverages can cause your body to lose water needed to produce adequate saliva. So can alcohol, which can also further irritate dry tissues. And any type of tobacco use can decrease saliva production and heighten the dry mouth effect, another good reason to kick the habit.
Drink more water. Water is the main ingredient in saliva, so keeping yourself hydrated throughout the day helps ensure a ready supply. Drinking water also helps dilute acid concentrations and washes away leftover food particles that could become a food source for oral bacteria, the main source for mouth acid.
Ask questions about your medications. Many medications can trigger chronic dry mouth including drugs to treat cancer, high blood pressure, depression or allergies. If you have chronic dry mouth, talk with your physician about the medications you're taking and ask if there are any alternatives that have less of an effect. If not, drink more water, especially while taking oral medication.
You can also reduce dry mouth symptoms by using a humidifier while you sleep or using products that boost saliva production. And be sure you're brushing and flossing daily to further reduce your risk of dental disease. Managing dry mouth won't just make your mouth feel better—it will help your teeth and gums stay healthier too.
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