When many people think of a dentist, one of the first associations they make has to do with filling cavities. While this has traditionally been one thing dentists are known for, it is far from the complete picture.
Nevertheless, tooth decay is one of the most common diseases world-wide and, if neglected, can become one of the most expensive to treat. Our practice philosphy is that it is far better to prevent a problem from occurring than it is to treat it. For that reason, we feel it is important for you to understand your condition so that you can make informed decisions.
If knowledge is power, then we want you to be able to take control of your dental health with useful and practical information.
After over twenty years of practice I have learned that many patients feel a cavity should hurt before you treat it.. Unfortunately, that can be a formula for disaster. Some time ago, I prepared this short video to explain just why that is.
Consider this article a public service announcement. I really dislike it when patients lose their teeth unnecessarily. My practice philosophy is that if a person has a dental problem, the goal is to handle that difficulty first, but then empower the patient with the correct knowledge that will keep him out of trouble from there on out. Ideally, my hope is that most future visits to my office will only be for routine maintenance.
Unfortunately, and all too often, I encounter new patients with teeth that are so badly decayed there is little hope of salvage. Possibly just as frequently, I find these patients scheduling a checkup – usually after a long absence from dental care – who are surprised to learn that they have any cavities at all. Sometimes they will think they lost a filling when, in fact, a piece of their enamel has broken away.
Why are they surprised? The common denominator seems to be the idea that cavities are supposed to hurt.
Well, sometimes they do hurt. But most of the time – especially in the early stage – they don’t.
In fact, by the time a tooth does start to hurt you it’s usually pretty bad. More often than not, it is so bad that a dentist is evaluating whether it can be treated with endodontic (root canal) therapy or whether it needs to be extracted. A little understanding of basic dental anatomy is helpful here.
Take a look at the illustration below:
The outer layer of the tooth is comprised of enamel. This is the hardest substance in your body. It breaks up your food and is designed to last you a lifetime.
And now, here is the important part for you to understand: it doesn’t contain any nerves.
It is more than ninety-five percent mineral. Water and organic materials make up the balance. And because it doesn’t have nerves, it doesn’t have feeling. This is actually quite practical since it wouldn’t do to have pain every time you bit into something. On the other hand, it also means that it can be decayed without giving you a warning.
In fact, decay can also travel into the supporting layer – the dentin – and still not cause you pain. It usually has to travel pretty close to the inner layer that contains the blood vessels and nerves – the pulp – before you feel it. Of course, by then, the tooth has generally undergone considerable destruction.
Another factor that makes spotting decay difficult is the way it spreads. I have drawn two black triangles into the enamel above. Notice that the narrow point is on the outside of the enamel. The broader base faces the inside of the tooth. This is how decay usually travels. Sometimes, it will undermine the interior of the tooth while the outer, harder enamel still maintains its form . . . until it eventually crumbles because the underlying supporting dentin has been eaten away by decay.
Many cavities also form at the contact point between two teeth. These are areas that you simply cannot see. Even the dentist needs an x-ray to spot these cavities in most cases.
So what does all this really mean? Spotting decay is not always that easy. As dentists, we use visual examination, but we also rely on probes, x-rays, and even laser detection devices to locate cavities. Even then, it can be difficult to find cavities under existing fillings.
Don’t rely on pain to tell you if you have a cavity in your tooth. If you do, you can be assured that your treatment is likely to be more uncomfortable, expensive, and may even result in the loss of a tooth that could have been treated much more easily earlier in the game.
If you have a loved one, who still has their teeth and hasn’t seen a dentist in a while, have them read this article. You may be saving them from quite a bit of discomfort – not to mention time and money – if they catch potential problems before they are hopeless.
Some of you may be thinking, “No big deal. If it’s that bad, I’ll just pull it.” OK, sometimes that is necessary, but therein lies a lesson for another day.
While I believe you can find many useful tips on this site to help you improve your dental health, if there were only ONE thing I might impart to you that may help you achieve a more desirable oral condition – it would be to gain an understanding of the role your diet plays in the formation of tooth decay.
Over the years I have seen patients with good oral hygiene experience little decay and patients with poor oral hygiene experience the same. Conversely, I have seen several patients with excellent hygiene still experience problems with tooth decay. And of course, there are those patients with poor oral hygiene who, as one might expect, experience difficulties. Maybe it is all a matter of your genes, then?
If so, what about my genetically identical patients (twins)? One has virtually no tooth decay, whereas, the other has had a cavity in almost every other tooth in her mouth.
The difference, in virtually all of these cases is diet.
Patients with a tooth-friendly diet experience less decay than those who consume foods that are not good for your teeth. And, frankly, a tooth friendly diet is a body-friendly diet. So this begs the question: is tooth decay a problem of bacteria, or diet?
I believe both play their role. But you can control your diet and, to that degree, what you eat is most likely the very key to your dental health. Click on the links above to read about foods that are good for your teeth and those that are not.
Cosmetic dentistry isn’t always just about good looks. Many of these treatments can improve various oral problems, such as correcting your bite. They are also not necessarily restricted to the teeth. Some people encounter problems with gum pigmentation or uneven gums. Periodontal procedures exist that address these difficulties as well.
Generally, cosmetic dental procedures include whitening, bonding, crowns, veneers, and the reshaping and contouring of teeth. If you have a cosmetic concern, it is a good idea to have heart-to-heart talk with your dentist and ask lots of questions. Among them:
What can I expect the changes will look like?
What should I experience throughout the course of treatment?
What type of maintenance will be required by me or by the dentist?
Television has certainly popularized cosmetic dentistry with such shows as Extreme Makeover and, at times, it can be as complex as a total smile reconstruction. At other times, cosmetic dentistry may be as simple as correcting the appearance of a single tooth. In short, it is what is right for you, what fits your budget, and makes you feel better about your smile!
Many of my patients have seen me use a dental instrument called a Diagnodent in the office. It is one of the latest diagnostic tools in dentistry.
No more poking and prodding. No additional radiation. No waiting until the film develops. A laser now detects cavities. And it may do it more accurately than conventional x-rays in many cases. How does it do it? It measures the amount of enamel and dentin lost and assigns a number using a special scale. The number helps the dentist decide if the tooth needs a filling or should just be checked again in several months. Small amounts of decay can disappear if the tooth hardens the softened enamel, a process called remineralization.
It gives you such accurate readings that if you decide to watch a tooth, six months down the road, you’ll rescan the tooth and check the reading. Sometimes we may find the numbers get smaller.
The device (the Diagnodent) is painless, and very safe. It does not necessarily find more decay. It helps us decide if it’s true decay. If small cavities are detected, patients can take steps that will help to remineralize the tooth and may avoid a filling entirely.
This new laser cavity detection system does not replace all x-ray technology. But it is one more tool we have to help keep your cavities small and your dental bill smaller.
From time to time we may mention a dental product designed to address a particular dental condition. We also realize it isn’t always easy to keep track of all those products. For that reason we have compiled a list of various items we may have discussed in one convenient location. If it is something we feel can help with dental or general health and we can provide you with access, you may find it there. If, on the other hand, there is something we talked about that you can’t find referenced here, please don’t hesitate to email us for more information. We’ll do our best to get back to you in a timely manner. Click HERE to view the ToothWiz Health Store.
Update: November 7, 2023. The ToothWiz Store is currently in the process of being updated. At this time we are featuring just a few core products. Please stand by as we bring our offerings up to date. Thanks for your patience.
theyIll-fitting dentures have about four dentist-related remedies and two patient-related ones.
Let’s look at the latter category first:
When patients experience loose dentures, they typically try an adhesive to stabilize them. The use of adhesives for well-fitting dentures is generally not a problem. Even a perfectly made denture can dislodge under certain circumstances. Sneezing, for example, can cause a denture to come loose. The added security provided by an adhesive gives people confidence that they won’t experience an embarrasing moment.
The second patient-remedy for a poor fit is that many people simply stop wearing them — especially the lower denture.
As one might imagine, its not much of a solution.
On the dentist’s side, here are the most common remedies:
Adjustment: If an irritation is minor, this may be the simplest appropriate solution.
Reline: When a denture is still in good condition, but your mouth has changed — as can occur even with losing or gaining weight — it can often be re-fitted to the current shape of your palate or lower ridge.
Re-make: Sometimes, the best solution is a new set of dentures. Too many adjustments, relines or repairs can so compromise the fit that it opens the door to new problems. Unfortunately, many people hold on to old dentures like an old pair of shoes. They don’t fit well, they will visibly move while speaking and eating — and yet the person becomes so used to this, it can be difficult for the individual to part with their “old friend”.
Implants: A loose lower denture can be secured to either two conventional implants or four mini-implants. You will typically require an evaluation to determine which is right for you. Many patients have considered this procedure to be a “life-changer” for them, transforming a set of dentures that simply could not be worn because of inadequate support, to comfortable, retentive dentures that allow for eating, speaking and good appearance.
Check with your dentist to see which solution is right for you.
Dr. Richard Walicki is a dentist practicing general and cosmetic dentistry. While we hope you find the information contained herein interesting and useful, this blog is for informational purposes and is not intended to diagnose any oral disease. Dental conditions should be evaluated by your dental health professional or a qualified specialist.
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