Posts for: January, 2019
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.”
In your search for the right toothpaste, you’re inundated with dozens of choices, each promising whiter teeth, fresher breath or fewer cavities. Cutting through the various marketing claims, though, you’ll find most toothpaste brands are surprisingly alike, each containing the same basic ingredients. Taken together, these ingredients help toothpaste perform its primary task — removing daily bacterial plaque from tooth surfaces.
Here, then, are some of the ingredients you’ll find — or want to find — in toothpaste.
Abrasives. A mild abrasive increases your brushing effectiveness removing sticky food remnants from teeth. And unlike the burnt, crushed eggshells of the ancient Egyptians or the brick dust used by 18th Century Brits, today’s toothpaste abrasives — hydrated silica (from sand), calcium carbonate or dicalcium phosphates — are much milder and friendlier to teeth.
Detergents. Some substances in plaque aren’t soluble, meaning they won’t break down in contact with water. Such substances require a detergent, also known as a surfactant. It performs a similar action as dishwashing or laundry soaps breaking down grease and stains — but the detergents used in toothpaste are much milder so as not to damage teeth or irritate gum tissues. The most common detergent, sodium lauryl sulfate, is gentle but effective for most people. If it does cause you irritation, however, you may want to look for a paste that doesn’t contain it.
Fluoride. This proven enamel strengthener has been routinely added to toothpaste since the 1950s, and is regarded as one of the most important defenses against tooth decay. If you’re checking ingredients labels, you’ll usually find it listed as sodium fluoride, stannous fluoride or sodium monofluorosphosphate (MFP). And since it inhibits bacterial growth, fluoride toothpastes don’t require preservative additives.
Humectants, binders and flavoring. Humectants help toothpaste retain moisture, while binders prevent blended ingredients from separating; without them your toothpaste would dry out quickly and require stirring before each use. And, without that sweet (though without added sugar) and normally mint flavoring, you wouldn’t find the average toothpaste very tasty.
The ADA Seal of Approval. Although not an ingredient, it’s still sound advice to look for it on toothpaste packaging. The seal indicates the product’s health claims and benefits are supported by the research standards set by the American Dental Society; and all ADA approved toothpastes will contain fluoride.
If you would like more information on toothpaste and other oral hygiene products, 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 “Toothpaste: What’s in it?”
While tooth decay seems to get most of the “media attention,” there’s another oral infection just as common and destructive: periodontal (gum) disease. In fact, nearly half of adults over 30 have some form of it.
And like tooth decay, it begins with bacteria: while most are benign or even beneficial, a few strains of these micro-organisms can cause gum disease. They thrive and multiply in a thin, sticky film of food particles on tooth surfaces called plaque. Though not always apparent early on, you may notice symptoms like swollen, reddened or bleeding gums.
The real threat, though, is that untreated gum disease will advance deeper below the gum line, infecting the connective gum tissues, tooth roots and supporting bone. If it’s not stopped, affected teeth can lose support from these structures and become loose or out of position. Ultimately, you could lose them.
We can stop this disease by removing accumulated plaque and calculus (calcified plaque, also known as tartar) from the teeth, which continues to feed the infection. To reach plaque deposits deep below the gum line, we may need to surgically access them through the gums. Even without surgery, it may still take several cleaning sessions to remove all of the plaque and calculus found.
These treatments are effective for stopping gum disease and allowing the gums to heal. But there’s a better way: preventing gum disease before it begins through daily oral hygiene. In most cases, plaque builds up due to a lack of brushing and flossing. It takes only a few days without practicing these important hygiene tasks for early gingivitis to set in.
You should also visit the dentist at least twice a year for professional cleanings and checkups. A dental cleaning removes plaque and calculus from difficult to reach places. Your dentist also uses the visit to evaluate how well you’re doing with your hygiene efforts, and offer advice on how you can improve.
Like tooth decay, gum disease can rob you of your dental health. But it can be stopped—both you and your dentist can keep this infection from ruining your smile.