Teeth lost to tooth decay can have devastating consequences for a child’s dental health. Not only can it disrupt their current nutrition, speech and social interaction, it can also skew their oral development for years to come.
Fortunately, we have a number of preventive tools to curb decay in young children. One of the most important of these, dental sealants, has been around for decades. We apply these resin or glass-like material coatings to the pits and crevices of teeth (especially molars) to help prevent the buildup of bacterial plaque in areas where bacteria tend to thrive.
Applying sealants is a simple and pain-free process. We first brush the coating in liquid form onto the teeth’s surface areas we wish to protect. We then use a special curing light to harden the sealant and create a durable seal.
So how effective are sealants in preventing tooth decay? Two studies in recent years reviewing dental care results from thousands of patients concluded sealants could effectively reduce cavities even four years after their application. Children who didn’t receive sealants had cavities at least three times the rate of those who did.
Sealant applications, of course, have some expense attached to them. However, it’s far less than the cost for cavity filling and other treatments for decay, not to mention future treatment costs resulting from previous decay. What’s more important, though, is the beneficial impact sealants can have a child’s dental health now and on into adulthood. That’s why sealants are recommended by both the American Dental Association and the American Academy of Pediatric Dentistry.
And while sealants are effective, they’re only one part of a comprehensive strategy to promote your child’s optimum dental health. Daily brushing and flossing, a “tooth-friendly” diet and regular dental cleanings and checkups are also necessary in helping to keep your child’s teeth healthy and free of tooth decay.
As in other parts of medicine, lasers are beginning to change the way we provide dental care. More and more dentists are using lasers to make earlier diagnoses of dental disease or provide surgical treatment. One area prime for change is the treatment of teeth with deep decay and in danger of being lost.
For decades now, the best way to save teeth in this condition is with root canal treatment. In this common procedure we access the pulp, remove the infected tissue with specialized hand instruments, and then fill and seal the pulp chamber and root canals with a special filling.
We can now potentially improve the efficiency and increase the success rate of this treatment with laser technology. With their focused light, lasers emit a concentrated burst of energy that's extremely precise. In many instances laser energy can remove the target diseased tissue without damaging nearby healthy tissue.
In this form of root canal treatment, we use lasers to remove tissue and organic debris within the pulp and then shape the root canal walls to better receive the filling. We can also utilize the heat from laser energy to soften and mold the filling, so that it better conforms within the walls of the root canals.
Using lasers in root canal treatments may require less local anesthesia than the traditional approach and also eliminates disturbing or discomforting sounds and vibrations. Dentists who've used the new technology also report less bleeding during the procedure and less pain and occurrences of infection afterwards.
But there are a couple of disadvantages for using lasers in root canal treatment. For one, light travels in a straight line — and many root canal networks are anything but straight. More complex root canal networks may still require the traditional approach. Laser energy could also increase the tooth's inner temperature, which could potentially damage tissues even on the tooth's outer surfaces.
Used in the right circumstances, though, lasers can be an effective means to treat diseased teeth. Â As laser technology continues to advance and becomes a mainstay in dental care, you may soon find it part of your next dental procedure.
Can you have healthy teeth and still have gum disease? Absolutely! And if you don’t believe us, just ask actor David Ramsey. The cast member of TV hits such as Dexter and Arrow said in a recent interview that up to the present day, he has never had a single cavity. Yet at a routine dental visit during his college years, Ramsey’s dentist pointed out how easily his gums bled during the exam. This was an early sign of periodontal (gum) disease, the dentist told him.
“I learned that just because you don’t have cavities, doesn’t mean you don’t have periodontal disease,” Ramsey said.
Apparently, Ramsey had always been very conscientious about brushing his teeth but he never flossed them.
“This isn’t just some strange phenomenon that exists just in my house — a lot of people who brush don’t really floss,” he noted.
Unfortunately, that’s true — and we’d certainly like to change it. So why is flossing so important?
Oral diseases such as tooth decay and periodontal disease often start when dental plaque, a bacteria-laden film that collects on teeth, is allowed to build up. These sticky deposits can harden into a substance called tartar or calculus, which is irritating to the gums and must be removed during a professional teeth cleaning.
Brushing teeth is one way to remove soft plaque, but it is not effective at reaching bacteria or food debris between teeth. That’s where flossing comes in. Floss can fit into spaces that your toothbrush never reaches. In fact, if you don’t floss, you’re leaving about a thirdÂ to half of your tooth surfaces unclean — and, as David Ramsey found out, that’s a path to periodontal disease.
Since then, however, Ramsey has become a meticulous flosser, and he proudly notes that the long-ago dental appointment “was the last we heard of any type of gum disease.”
Let that be the same for you! Just remember to brush and floss, eat a good diet low in sugar, and come in to the dental office for regular professional cleanings.
If you would like more information on flossing or periodontal disease, please contact us today to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”
Because the mouth is one of the most sensitive areas of the body, we go to great lengths to eliminate pain and discomfort associated with dental work. Anesthesia, both local and general, can achieve this during the actual procedure—but what about afterward while you’re recuperating?
While a few procedures may require prescription opioids or steroids to manage discomfort after a procedure, most patients need only a mild over-the-counter (OTC) pain reliever. There are several brands available from a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like aspirin or ibuprofen work by blocking the release of prostaglandins into the body, which cause inflammation in tissues that have been damaged or injured.
Unlike their stronger counterparts, NSAIDs have fewer side-effects, cost less and aren’t addictive. And unlike opioids NSAIDs don’t impair consciousness, meaning patients can usually resume normal activities more quickly.
But although they’re less dangerous than opioids or steroids, NSAIDs can cause problems if taken at too strong a dose for too long. Its major side effect is interference with the blood’s clotting mechanism, known as “thinning the blood.” If a NSAID is used over a period of weeks, this effect could trigger excessive external and internal bleeding, as well as damage the stomach lining leading to ulcers. Ibuprofen in particular can damage the kidneys over a period of time.
To minimize this risk, adults should take no more than 2400 milligrams of a NSAID daily (less for children) and only for a short period of time unless directed otherwise by a physician. For most patients, a single, 400 milligram dose of ibuprofen can safely and effectively relieve moderate to severe discomfort for about 5 hours.
Some patients should avoid taking a NSAID: pregnant women, those with a history of stomach or intestinal bleeding, or heart disease (especially if following a daily low dose aspirin regimen). If you have any of these conditions or similar concerns, be sure you discuss this with your dentist before your procedure for an alternative method for pain management.
If you would like more information on managing discomfort after dental procedures, 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 “Treating Pain with Ibuprofen.”
Porcelain veneers are a great way to enhance an unattractive smile. But are they appropriate for teenagers? The answer usually depends on a patient’s current development stage and the type of veneer used.
Veneers are thin layers of porcelain bonded to the front of teeth. But even though quite thin, they can appear bulky if we don’t first remove some of the tooth’s enamel surface. This is irreversible, so the tooth may require a restoration from then on.
This could be a major issue for teens whose permanent teeth are still developing. During this period the tooth’s central pulp is relatively large and the dentin layer not fully developed. As a result, the pulp’s nerves are often closer to the surface than in an adult tooth. This increases risk of nerve damage during veneer preparation; if nerve damage occurs, the tooth could ultimately require a root canal treatment to save it.
On the other hand, some types of veneers don’t require tooth alteration (or only very little) beforehand. These “no-prep” or “minimal prep” veneers are best for certain situations like abnormally small teeth, so we must first determine if using such a veneer would be appropriate for your teen.
In effect, we’ll need to weigh these and other factors before determining if veneers are a safe choice for your teen. That being the case, it may be more advisable to consider more conservative cosmetic techniques first. For example, if enamel staining is the main issue, you could consider teeth whitening. Although the often amazing results eventually fade, whitening could still buy some time until the teeth have matured to safely apply veneers.
Slight deformities like chipping can often be corrected by bonding tooth-colored composite material to the tooth. In artistic hands it’s even possible to create a full veneer effect with very little if any tooth preparation. How much we can apply, though, depends on tooth size, and it won’t be as durable as a porcelain veneer.
With that said, veneers could be the right solution to enhance your teen’s smile. But, we’ll need to carefully consider their dental situation to ensure their new smile remains a healthy one.
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