Ok, you’ve just been told you need a filling or a crown at a recent dental visit to fix a cavity. We’ve already discussed How Tooth Decay Happens in a previous SmileByte article. Let’s now discuss what can be done after the cavity has been fixed to prevent future cavities from occurring.
Fillings and or Crowns fix defects or cavities in the teeth caused by tooth decay. However, a filling or crown doesn’t necessarily stop the tooth decay process, it merely removes the decayed tooth structure currently present. If the cause of the tooth decay in the first place is not found then further decay is possible around the brand new restoration. Tooth decay is basically a bacterial infection, and dentists typically refer to this bacterial build up as plague. Plaque is the white film that grows on teeth, and this is what we remove during daily brushing and flossing. It’s the white film that grows on teeth and that film tends to migrate to the spot where the restoration and tooth meet.
Since you have just had a restoration done to treat a cavity is it important to brush and floss daily and see the hygienist on a regular basis. These preventative measures will help to disrupt the plaque colonizing around your brand new restorations. In addition, there has been increasing amounts of research into this process and we are now able to provide each of our patients with a Risk of tooth decay profile ranging from low, moderate, to high. Based on this risk we will then be able to provide recommendations beyond regular brushing and flossing, in terms of dietary coaching, bacteria and saliva testing, hygiene protocols, antibacterial rinses, fluoride rinses and toothpastes, and xylitol gums and candies.
Xylitol is a natural sugar alcohol that reduces the bacteria that causes tooth decay. It is equal in sweetness and volume to sugar and the granular form can be used in many of the ways that sugar is used, including to sweeten cereals and hot beverages and for baking (except when sugar is needed for yeast to rise).
How does xylitol prevent cavities?
Xylitol inhibits the growth of the bacteria that cause cavities. It does this because these bacteria (Streptococcus mutans) cannot utilize xylitol to grow. Over time with xylitol use, the quality of the bacteria in the mouth changes and fewer and fewer decay-causing bacteria survive on tooth surfaces. Less plaque forms and the level of acids attacking the tooth surface is lowered.
Studies show that Streptococcus mutans is passed from parents to their newborn children, thus beginning the growth of these decay-producing bacteria in the child. Regular use of xylitol by mothers has been demonstrated to significantly reduce this bacterial transmission, resulting in fewer cavities for the child.
Many gum and mint manufacturers have jumped on the Xylitol bandwagon and have started using Xylitol as their sweetener of choice. Xylitol gum or mints used 3-5 times daily, for a total intake of 5 grams, is considered optimal. Because frequency and duration of exposure is important, gum should be chewed for approximately 5 minutes and mints should be allowed to dissolve.
We now have tools available to evaluate risk of Tooth Decay. Tooth decay is a bacterial infection just as gum disease is a bacterial infection, they are just different bacteria’s affecting different parts of the mouth. Unfortunately, there are no magic pills to take to get rid of it, but we do now have a strategy to reduce your risk. The goal in reducing your risk is to reduce the factors that allow the bacteria to sit on the tooth surface and excrete acid that decays teeth.
Some people have poor home care, so the bacteria is allowed to pile up on the tooth surfaces and do their damage, these people can immediately lower their risk by adding an electric toothbrush to the mix or shortening their hygiene appointments.
Others have adequate home care but still have yearly fillings because they may have poor salivary flow that doesn’t neutralize the acids excreted by the bacteria.
Others may just have more of the bad bacteria that cause tooth decay. They are mutans streptococci and lactobacilli. Today we have a test that is able to measure the salivary flow and measure the level of mutans streptococci and lactobacilli in the dental office. So now we can measure the three major risk factors that cause tooth decay! Adding these assessments to home care and dietary considerations can help lead to a plan to lower the risk of Tooth Decay!
Tooth decay is caused by certain types of bacteria (mutans streptococci
and lactobacilli) that live in your mouth. When they attach themselves to
the teeth and multiply in dental plaque, they can do damage. The bacteria
feed on what you eat, especially sugars (including fruit sugars) and cooked
starch (bread, potatoes, rice, pasta, etc.). Within just a few minutes after
you eat, or drink, the bacteria begin producing acids as a by-product of their
digesting your food. Those acids can penetrate into the hard substance of
the tooth and dissolve some of the minerals (calcium and phosphate). If the
acid attacks are infrequent and of short duration, your saliva can help to
repair the damage by neutralizing the acids and supplying minerals and fluo-
ride that can replace those lost from the tooth. However, if:
1) your mouth is dry
2) you have many of these bacteria
3) you snack frequently
then the tooth mineral lost by attacks of acids is too great, and cannot be repaired.
This is the start of tooth decay and leads to cavities.
Porcelain veneers are a very thin layer of beautiful ceramic that is bonded over teeth to change the shape, color and contour. Typically veneers require a minimal tooth preparation, usually less that 1mm of tooth needs to be removed to place a porcelain veneer. Sometimes there is virtually no preparation required. When a majority of the preparation remains in enamel, the veneers have the best bond possible, therefore increased longevity.
Benefits of Porcelain Veneers 
• Very lifelike
• Preservation of tooth structure
• Can permanently change color
• Close spaces
• Make small alignment changes
• Rejuvenate worn or chipped teeth
Disadvantages of Porcelain Veneers
• Usually have to remove tooth structure
• Probably will not last forever, but should get 15-20 years
• It is possible to have breakage
• Since they are bonded on it is possible to de-bond off
Porcelain Veneers are not for everybody, but for those that are concerned about worn or chipped teeth, permanent color changes, spaces between the teeth and other issues, veneers may be the answer for you!
With the news of the recent Hepatitis B,C and HIV exposure of 40,000 patients at the Endoscopy Center of Las Vegas, our office has received a few calls from patients concerned about our health and safety because of their possible exposure. Over the past 20 years our office has maintained universal precautions. Every treatment room is cleaned and all surfaces are treated with agents that have been proven to kill potential pathogens. All instruments cleaned and sterilized in our Steri-Center utilizing the latest in sterilization techniques. If you ever have questions about our techniques and protocols please don’t hesitate to ask, we’d be happy to give you a tour!
Recently, our practice has added a CO2 soft tissue laser to our practice. This is very exciting news because of what it means to patient care.
The CO2 laser is:
• Non-Invasive Surgery
• Minimal Pain
• Better Treatment
• Optimal Results
• Less Anesthesia
• Complete Sterilization
The above photos demonstrate the use of the CO2 laser in removing a irritation fibroma, the image on the right hand side is 4 days after removal of the Fibroma.
What are the Advantages of Lasers?
This technology assures a more patient friendly treatment with considerably less post-operative pain, discomfort, and swelling. In many cases, sutures are not required. All laser procedures assure a totally sterile environment of the surgical site, which in turn decreases potential for post-operative infections.
Are Lasers Safe?
The latest generation of dental lasers is absolutely safe for all patients. This technology enables us to use it also on patients with pre-existing conditions such as Pregnancy, Pace-Makers, High Blood Pressure, Diabetes, Parkinson’s, Hemophilia, and many more.
On your next visit Ask about the Laser Use in conjunction with:
• Smile Design
• Implants
• Periodontal Pocket Therapy
• Veneers and Crowns
34000 people on average will be diagnosed with Oral Cancer this year and 8000 will die from Oral Cancer, killing roughly 1 person per hour, 24 hours per day. The death rate for oral cancer is higher than that of cervical cancer, Hodgkins disease, cancer of the brain, liver, testes, kidney, or skin cancer (malignant melanoma). The death rate from oral cancer is so high because often times it has often metastasized to another location.(Data courtesy:http://www.oralcancerfoundation.org/) Fortunately, researchers from the British Columbia Cancer Agency and the MD Anderson Cancer Center have developed a unique tool that allows us to better determine whether or not an oral lesion is potentially dangerous or not. The Velscope is a special light that causes the tissues in the mouth to fluoresce… Normal healthy tissues fluoresce and those that are potentially dangerous do not, they appear as dark shadows. Our office is now proud to offer the Velscope as part of the oral cancer screening process!
BECAUSE YOUR SMILE IS IMPORTANT TO US. We now offer Care Credit. A convenient, interest free program for 3, 6, or 12 months. Also, an extended low monthly payment program for your entire family specifically designed to pay for your dental care. Applying for CareCredit is quick and easy. Simply choose the option you prefer. You can go on line @ http://www.carecredit.com or use the automated phone application by calling 800-365-8295. Have a healthy and beautiful smile today!
Updating your health history at every appoinment lets us know of any changes going on with your general health. When we know that you are now taking blood thinners we understand to expect the possibility of slightly more bleeding during your cleaning appointment. If you have recently had an artificial heart valve or joint placed, we know that you will need to premedicate with antibiotics before any dental treatment can be done. If you happen to be taking any of the oral osteoporosis medications we know that it is imperative that your periodontal is carefully monitored as these medications have been known to disrupt the healing potential of the bone that holds the teeth in place. There are all sorts of medical conditions that help us understand your dental health and to treat you in the most appropriate way.
Creating Smiles
for You!
