Posts for: October, 2018
Drilling teeth is an essential part of repairing and restoring the damage caused by tooth decay. For generations dentists have relied on the dental drill with its rotating burr to remove decayed and damaged tooth material.
But while the dental drill is effective it also has its disadvantages. In the process of removing decayed material it inadvertently removes healthy structure near the target material. It often requires anesthesia to deaden the work area. And its noise and vibration are often unsettling to patients.
There is a growing alternative, though: air abrasion, a technology that's been around since the mid-20th Century. But recent advances in controlling the dust created by using abrasion, as well as new tooth-colored bonding materials to replace tooth structure, have sparked new interest among dentists and patients alike.
Also known as particle abrasion, this drill alternative uses a pressurized stream of fine particles to remove decayed material. Using a hand wand a dentist can precisely aim the stream of particles (usually aluminum oxide) to the specific areas of decay or softened material that need to be removed. As a result, it removes only a fraction of healthy tooth structure compared to traditional drilling. Air abrasion has also proven effective for removing staining without harming enamel.
Air abrasion also eliminates the sound and vibration associated with dental drills, and may not always require local anesthesia. On the other hand, it does have some limitations. For one, it's not as effective with larger cavities or working around older fillings. The tooth or teeth to be worked on must be carefully isolated from the rest of the mouth to keep the patient from swallowing the abrasive particles. And without a high-volume suction pump and good isolation protocols, the particles can produce something of a “sandstorm” in the treatment room.
But as air abrasion continues to advance, we may see improvements in these limitations. In a future time, the traditional dental drill may go the way of the horse and buggy.
If you would like more information on air abrasion as an alternative to drilling, 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 “Air Abrasion Technology.”
During your lifetime you’ll eat thousands of meals — and generate a lot of force from chewing over the years. But thanks to a support system of gum tissues and bone, your teeth can normally handle it.
What your teeth can’t handle, though, are higher than normal chewing forces on a continual basis. This can happen if you grind your teeth, which can produce 20-30 times the normal force. The habit often arises in adults because of high stress and often occurs during sleep.
These abnormal forces can stretch the periodontal ligaments that hold teeth in place, cause the teeth to become loose and at increased risk for loss. The best treatment strategy is to reduce clenching with, for example, muscle relaxants or anti-inflammatory drugs or lower the effects with a mouth guard that won’t allow the teeth to make solid contact during clenching.
Your teeth can also become loose even with normal chewing forces if you have advanced periodontal (gum) disease. Gum disease arises from dental plaque, a thin film of bacteria and food particles left on teeth due to poor oral hygiene. As it builds up, it causes inflammation of the gum tissues resulting in bone loss and causing the gums to detach from the teeth, increasing pocket depth.
Our first step in this case is to treat the gum disease by removing plaque and calculus (tartar) from all tooth and gum surfaces. This includes infected areas below the gum line and around the roots, a circumstance that could require surgical access.
As treatment progresses in either of these scenarios the gum tissues heal and often regain their attachment to the teeth. But that can take time, so we may need to stabilize any loose teeth in the short term. The most common way is to splint them to other secure teeth. This is done by using a clear acrylic bonding material to join the loose teeth together with a strip of metal or other rigid material (like joining pickets in a fence).
When symptoms arise, quick action is the key to preventing lost teeth. If you notice swollen, painful or bleeding gums or especially loose teeth, don’t delay — contact us so we can begin treatment as soon as possible.
If you would like more information on the causes and treatments for loose 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 “Loose Teeth.”
Saliva is a true workhorse among bodily fluids — it breaks down food for digestion, keeps harmful bacteria in check and neutralizes acid that is destructive to tooth surfaces. So when saliva flow is chronically diminished, it’s more serious than the uncomfortable feeling of “dry mouth” — it can have a detrimental effect on your overall health.
It’s normal to experience temporary mouth dryness: in the morning (because saliva flow slows during sleep), when we’re under stress, or after smoking or consuming certain foods and beverages like onions or coffee. But chronic dry mouth (“xerostomia”) is different — the mouth remains dry for extended periods, leading to problems like tooth decay caused by inadequate acid neutralization.
Medications are one of the most common causes for xerostomia. According to the Surgeon General, there are over 500 medications — both prescription and over-the-counter — that can cause it, including antihistamines, diuretics and antidepressants. Radiation or chemotherapy used for cancer treatment may also cause dry mouth, sometimes permanently. There are also systemic conditions that affect saliva flow like diabetes, Parkinson’s disease, cystic fibrosis, and many autoimmune diseases.
Treating chronic dry mouth will of course depend on the underlying cause. If drug-related the first approach should be to find a substitute medication that won’t as readily cause reduced saliva flow. If that’s not possible, then it’s helpful to drink more water when taking the medication (a few sips before and a full glass afterward). You can also cut back on caffeinated, acidic or sugary foods and drinks as well as alcohol, and refrain from tobacco use.
A saliva stimulant might also help. Besides prescription medication, there are other products like xylitol, a natural alcohol sugar found in chewing gum, toothpaste or rinses, that help increase saliva flow — and xylitol also inhibits the growth of decay-causing bacteria.
The most important thing for chronic dry mouth is maintaining consistent daily hygiene through brushing and flossing and regular dental cleanings and checkups. Helping to increase your saliva flow and making every effort to prevent dental disease will help keep this condition from harming your teeth and gums.
If you would like more information on the causes and treatment of dry mouth, 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 “Dry Mouth.”