CAMBRA — Caries Management By Risk Assessment

Worried about tooth decay? Dental Decay is one of the most common and infectious diseases known to man, but it is also very preventable. Today, it is even possible to determine your risk for getting tooth decay. There are disease indicators and risk indicators that can be assessed and used to determine your chances of getting tooth decay. And more importantly, they can be used to prevent and reverse early decay.

Essentially, the difference between healthy teeth and tooth decay is a matter of balance and keeping the balance tipped toward health. That means controlling the factors that tip it toward health and away from disease. Here's a little about how it works:

Disease indicators, as the name implies, are indicators of disease. For example, the presence of white spots on the enamel of your teeth, early signs of decay, which can be detected by your dentist, your past experience of cavities, and whether you currently have tooth decay.

Today, with a “simple saliva sample,” we can test the bacteria in your mouth to determine your decay risk with a simple meter reading.

There are also certain risk factors for tooth decay that you can change by modifying what you do. The ways in which you can help yourself include:

• Reduce the amount of bacterial plaque (biofilm) build-up on your teeth. If plaque is actually visible on your teeth with the naked eye, it means there is a large amount that needs to be removed professionally. High levels of bacteria leave teeth more susceptible to attack from acid-producing bacteria that cause decay.
• Stop snacking on foods containing sugar between meals. Reducing the number of times your teeth are exposed to sugary snacks, and those that contain high amounts of refined carbohydrates, will help lower your risk of tooth decay. Stop feeding the bacteria sugar, which is turned into acid.
• Use fluoride toothpaste. This toothpaste will help strengthen your teeth, making them more resistant to acid attack. Deep grooves in the biting surfaces of your teeth, which we call pits and fissures, increase the likelihood of tooth decay making it impossible to reach with just a toothbrush. However, sealing these areas with “sealants” will prevent these areas from decaying.
• Always ask your doctors about the potential side effects of all medications. Certain drugs reduce the production of saliva and lead to dry mouth, which is one of the main contributors to tooth decay. Saliva has important buffering properties, neutralizing acids in the mouth, helping to reduce risk of decay.
• If you have an eating disorder, get professional help. People suffering from both bulimia and anorexia frequently vomit after meals, which creates a highly acidic condition in the mouth. Getting control over these conditions can help you also gain control over your risk for tooth decay.

We can further help assess your risk for tooth decay by using low dosage x-rays, microscopes, innovative laser technology, and other modern means. Call our office today to schedule a screening. To learn more about the diagnosis and prognosis of tooth decay, read the exclusive Dear Doctor magazine article “Tooth Decay: How To Assess Your Risk.”

The goal of restorative dentistry is to return the teeth to full form (shape) and function. For years, a key tool for achieving this goal has been through the use of metal amalgams (silver looking dental fillings). However, this technique does have some disadvantages. One is the fact that they can involve removal of healthy tooth structure to retain them. Too much “undercutting” can undermine and weaken a tooth resulting in less resistance to biting forces possibly leading to fatigue fractures and cracked tooth syndrome. Another approach is call “biomimetic” which literally means mimicking life. This approach to dentistry is made possible through the structured use of tooth-like materials such as composite resins. Scientific studies and clinical experience have validated their use as both safe and predictable.

By mimicking life, we rely upon our delicate balance of artistry, experience and expertise to provide you with properly restored teeth that function and wear normally, while appearing indistinguishable from natural teeth. Dental composite are now the most commonly used materials for tooth-colored adhesive restorations and have properties similar to a natural tooth's enamel and dentin. They consist of resin which are plastic and fillers made of silica (a form of glass). The fillers give the composites wear resistance and translucency (see through properties). However, most of the properties of enamel are also mimicked quite well by dental porcelains. Porcelains are a form of ceramic, that are formed by the action of heat. Dental porcelains come in all colors and shades so we can easily and perfectly match the color of virtually any natural tooth. As for longevity, porcelain is typically your best option because it is the closest option in mimicking a natural tooth.

To learn more on this subject, you can continue reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.” Or contact us today to schedule an appointment to discuss your specific questions.

Both diabetes and gum (periodontal) disease are chronic inflammatory diseases that have negative consequences for millions of people worldwide. But before we continue, let's define these two diseases:

Periodontal disease is a condition in which biofilms of dental bacterial plaque stick to teeth near the gum lines causing the gum tissues to become inflamed and infected. If not treated properly and in an early stage, it can cause severe damage to the bone that supports the teeth, resulting in tooth loss. It occurs in the absence of good oral hygiene which includes ineffective daily brushing and flossing and neglecting to see your dentist.

Diabetes is a chronic condition in which blood glucose (sugar) levels become excessive. Glucose is the body's main source of sugar for energy. The hormone insulin, among other mechanisms, normally controls glucose. Prolonged elevated blood sugar levels are harmful and ultimately can even be life threatening if left untreated. With type 1 diabetes, insulin injections (shots) are required to maintain the proper blood sugar levels because the body no longer produces its own blood sugar. Type 2 diabetes is generally less severe and can usually be treated with a combination of diet and medication.

And while both of these diseases share the same common enemy, you, there is scientific evidence revealing links between the two. Diabetes increases the risk factor for developing periodontitis, and conversely, periodontal disease makes it more difficult for diabetics to control blood glucose levels.

Want To Learn More?

Learn more about these two diseases and their relationship by reading, “Diabetes & Periodontal Disease.” Or if you have diabetes but haven't had a dental exam and cleaning in a long time, contact us today to schedule a consultation. You can also use this consultation to discuss any questions or concerns you have about your oral health and its relationship to your diabetes.

Root canal, or endodontic (“endo” – inside; “dont” – tooth) treatment, is often wrongly perceived as a highly unpleasant experience and one that causes tremendous pain. However, the truth is that the procedure actually relieves the pain being caused by an infected and inflamed tooth pulp (inside of the tooth). Advances in dentistry have made treatment virtually pain free and it can be completed relatively quickly, usually in a single visit. Left untreated, infection can spread into the bone immediately around the tooth's root, so prompt attention is the best course of action.

If the term “root canal” still sends shivers down your spine, don't despair. Here is some information that should help put your mind at ease.

• Root canal treatment is necessary when deep decay or trauma has caused the inside (pulp) of the tooth to become inflamed or infected. Symptoms of infection can include sharp pain when biting down, lingering pain after consuming very hot or cold foods, a dull ache and feeling of pressure near the infected tooth, and tender gum tissue surrounding the infected tooth.
• After a local anesthetic is administered to numb the infected tooth and its surrounding area, we will make a small opening on the chewing surface of the tooth. This will allow us to remove dead and dying tissue from the pulp and to then clean and disinfect the root canals. Using small instruments, we will shape the canals and seal them with biocompatible filling materials.
• You may feel slight tenderness at the treated site for a few days, but this is quite manageable and can be relieved with over-the-counter (OTC) non-steroidal, anti-inflammatory pain relievers such as aspirin or ibuprofen. You should refrain from chewing on the treated tooth until your follow-up appointment. A crown or other restoration may be needed to protect the tooth and restore it to full function.

If you think you might be a candidate for a root canal treatment, schedule an appointment as soon as possible. If you would like to learn more about the process of root canal treatment, please read the Dear Doctor magazine article “Common Concerns About Root Canal Treatment.”

Christie Brinkley's world-famous smile has graced the covers of countless magazines for over 30 years. In fact, in her own words from an interview with Dear Doctor magazine, the supermodel said, “I think my smile was really my passport to success in the modeling industry.” And while most of her smile's appeal comes naturally, Christie does give it a boost with good oral hygiene, regular dental checkups and tooth whitening. As Christie says, “When it comes to teeth, keep it as natural as possible. Do not go overboard on whitening. You want your teeth to compliment your face…your friends should not be required to wear sunglasses when you smile!”

Aside from some potential minor side effects such as tooth sensitivity, whitening teeth through bleaching is a relatively inexpensive way to brighten your smile conservatively and successfully. There are three common methods, as described below:

• An external or vital approach where “vital” (living) teeth are bleached through direct contact to the tooth's surface.
• An internal or non-vital approach where the tooth is whitened from the inside during a root canal treatment.
• A combination approach in which both internal and external bleaching techniques are used.

But what causes teeth to become discolored?

Tooth discoloration can be caused by a traumatic blow to your teeth resulting in nerve tissue (pulp) death. However, there can be many other causes: consuming or using products that stain the teeth such as coffee, tea, cola, tobacco products and red wine, to name just a few. Aging is another factor, as it results in changes in the mineral structure of the tooth as the enamel, the outermost layer, loses its beautiful and youthful translucency. Other causes include exposure to high levels of fluoride; tetracycline, an antibiotic, administered during childhood; inherited developmental disorders and jaundice in childhood; and tooth decay.

The good news is that we routinely brighten smiles through tooth whitening. To learn more about brightening your smile, continue reading the Dear Doctor magazine article “Teeth Whitening.” Or if you are ready to have your teeth professionally whitened, contact us today to schedule an appointment so that we can conduct a thorough examination and discuss your whitening treatment options. And if you want to read the entire feature article on Christie Brinkley, continue reading “The Secret Behind Christie Brinkley's Supermodel Smile.”