May is National Save Your Tooth Month, and tooth decay is a leading cause of lost teeth. It all begins with oral bacteria growing rapidly in built-up deposits of dental plaque, and in turn producing high levels of acid. At these levels, acid can erode the minerals in tooth enamel to create holes (“cavities”) that allow bacteria to enter the tooth and infect it.
If at all possible, we need to try to stop tooth decay early by disinfecting and filling these cavities. If not, decay can spread through the teeth to the underlying nerve (pulp) tissue, following passageways known as root canals. If this happens, the chances for saving the tooth are extremely low.
But if the decay does reach the tooth’s innermost layer—the pulp—filling the cavities won’t be enough. Decay this advanced requires a procedure known as root canal therapy, or a root canal for short.
If you winced a little, it’s understandable: Root canals have gained an unfair reputation as an unpleasant experience. In reality, a root canal performed by a skilled dentist or endodontist (a specialist in root canals) isn’t painful. In fact, if you come in with a painful tooth, you’re very likely to leave after the procedure without any pain.
Root canal procedures can vary depending on the type of tooth and the intricacy of its root canal network. Essentially, though, we remove the diseased pulp tissue, and then clean and fill the empty pulp chamber and root canals. This stops the infection and, along with sealing and crowning the tooth, helps prevent a future re-infection.
How do you know if you need a root canal? You may find out from us if we discover advanced decay during a checkup or cleaning appointment. But you may encounter signs yourself like a throbbing toothache, pain during and after eating and drinking, or gum tenderness around a tooth. These are all possible indications of tooth decay.
If you experience any of these signs, you should see us as soon as possible for an examination. And don’t cancel your appointment if the pain goes away—this could simply mean the nerves in the pulp have died and are no longer transmitting pain signals. The infection, though, could still be there and continuing its rampage beyond the tooth and into the surrounding bone tissue.
Root canal therapy may not seem glamorous, but it’s an excellent option for a diseased tooth that would otherwise have to be removed. A root canal could get rid of your pain and give your troubled tooth a new lease on life!
If you would like more information about treating advanced tooth decay, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Root Canal Treatment: What You Need to Know.”
The sooner you get treated for tooth decay, the less likely you'll lose your tooth. That could mean a simple filling—or you might need a root canal treatment if decay has reached the inner pulp.
There's also another procedure for advanced decay called pulp capping. It's a bit more involved than filling a cavity but less so than a root canal. We can use it if decay has exposed or nearly exposed the pulp, but not yet infected it—otherwise, you may still need a root canal treatment to remove the diseased pulp tissue.
There are two types of pulp capping methods, direct and indirect. We use direct pulp capping if the pulp has been exposed by decay. After isolating the tooth to protect other teeth from contamination, we remove all of the decayed dentin up to the pulp. This may cause some bleeding, which we'll stop, and then clean and dry the tooth area.
We'll then apply a protective biocompatible material directly over the pulp to promote healing and protect it from further infection. We then restore the tooth's appearance and function with a life-like filling.
We use the indirect method, a two-part process separated by six to eight months, when the pulp tissue is close to the surface but not yet exposed. We initially remove the majority of decayed tooth structure, but leave some of it in place next to the pulp chamber. Although this remaining dentin is softened and decayed, we'll treat it with antibacterial chemicals, then cover it with a biocompatible material and a temporary filling.
Over the next several months the treated structure has a chance to re-mineralize as it heals. We then remove the temporary filling and assess the level of healing progress. If the regenerated dentin appears healthy, we can then remove any remaining decay and restore the teeth as we would after a direct pulp capping.
At the very least, pulp capping could buy your affected tooth time before a root canal will finally be needed. Under the right circumstances, it's an effective way to save an otherwise lost tooth.
If you would like more information on tooth decay treatments, 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 “Pulp Capping: A Procedure that may Save a Decayed Tooth.”
There are a number of lifestyle changes you can make if you want to reduce your risk of oral cancer, with quitting a tobacco habit at the top of the list. You should also moderate your alcohol consumption and practice safe sex to prevent the spread of the human papilloma virus (HPV 16) linked to oral cancer.
And there's one other area that might be ripe for change—your diet. The foods we consume can work both ways in regard to cancer: some, especially processed products with certain chemicals, increase your cancer risk; more natural foods, on the other hand, can help your body fight cancer formation.
Although how cancer forms and grows isn't fully understood, we do know some of the mechanisms involved. One major factor in cancer growth is damage to DNA, the molecule that contains all the instructions for normal cell growth. Certain chemicals called carcinogens cause much of this DNA damage.
One example of these dangerous chemicals are nitrosamines, found in substances used to preserve meats like bacon or ham. Nitrosamines also occur in beer during the brewing process, some fish and fish products, processed cheese and foods pickled with nitrite salt. It's believed long-term consumption of foods with these chemicals can increase the risk of cancer.
On the other hand, there are foods with substances called antioxidants that help our bodies resist cancer. Antioxidants protect cells from unstable molecules called free radicals that can also damage DNA. You'll find antioxidants in abundance in fresh fruits and vegetables, especially those high in fiber. Vitamins like C and E found in many natural foods also have antioxidant properties.
So, to help keep your risk of cancer and other diseases low, make sure your diet includes mostly fresh fruits and vegetables, along with plant-based fats found in nuts or olive oil. At the same time minimize your consumption of processed foods with preservatives and other chemicals, along with animal and saturated fats.
A change in eating not only reduces your cancer risk, it can also improve your overall health and well-being. You'll also find a healthy diet can be dental-friendly—it can help keep your teeth and gums disease-free and healthy.
If you would like more information on dental-friendly nutrition practices, 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 “Diet and Prevention of Oral Cancer.”
Singer and actor Demi Lovato has a new claim to fame: formidable martial artist. When she is not in the recording studio, on stage or in front of the camera, Lovato can often be found keeping in shape at Jay Glazer's Hollywood (California) gym. Glazer, who is best known as a sports journalist, also runs conditioning programs for professional athletes and celebrities based on mixed martial arts. On March 6, Glazer got more than he bargained for when 5'3" Lovato stepped into the ring and knocked out his front tooth.
Glazer reportedly used super glue to put his tooth back together. Not a good idea! While it may not be convenient to drop everything and get to the dental office, it takes an expert to safely treat a damaged tooth. If you glue a broken tooth, you risk having to undergo major work to correct your temporary fix—it's no easy task to "unglue" a tooth, and the chemicals in the glue may damage living tooth tissue as well as the surrounding gum and bone.
Would you know what to do in a dental emergency? Here are some guidelines:
- If you chip a tooth, save the missing piece if possible. We may be able to reattach it.
- If your tooth is cracked, rinse your mouth with warm water, but don't wiggle the tooth around or bite down on it. If it's bleeding, hold clean gauze to the area and call our office.
- If your tooth is knocked loose or is pushed deeper into the socket, don't force the tooth back into position on your own. Immediate attention is very important.
- If your tooth is knocked out, there's a chance it can be reattached. Pick up the tooth while being careful not to touch the root. Then rinse it off and have either someone place into its socket, or place it against the inside of your cheek or in a glass of milk. Please call the office immediately or go to a hospital.
What's the best thing to do in an emergency? Call us right away, and DON'T super glue your tooth! You can prevent worse problems by letting a professional handle any dental issues. And if you've been living with a chipped, broken or missing tooth, call us to schedule an appointment for a consultation—there are several perfectly safe ways to restore your smile. Meanwhile, if you practice martial arts to keep in shape, think twice before getting into the ring with Demi Lovato!
Drugs play an indispensable role in treating disease. For example, life without antibiotics would be much more precarious—common infections we think nothing of now would suddenly become life-threatening.
But even the most beneficial drug can have disruptive side effects. Antibiotics in particular can cause a rare but still disturbing one: a growth on the tongue that at first glance looks like dark hair. In fact, it's often called "black hairy tongue."
It isn't hair—it's an overgrowth of naturally occurring structures on the tongue called filiform papillae. These tiny bumps on the tongue's upper surface help grip food while you're chewing. They're normally about a millimeter in length and tend to be scraped down in the normal course of eating. As they're constantly growing, they replenish quickly.
We're not sure how it occurs, but it seems with a small portion of the population the normal growth patterns of the papillae become unbalanced after taking antibiotics, particularly those in the tetracycline family. Smoking and poor oral hygiene also seem to contribute to this growth imbalance. As a result, the papillae can grow as long as 18 millimeters with thin shafts resembling hair. It's also common for food debris and bacteria to adhere to this mass and discolor it in shades of yellow, green, brown or black.
While it's appearance can be bizarre or even frightening, it's not health-threatening. It's mostly remedied by removing the original cause, such as changing to a different antibiotic or quitting smoking, and gently cleaning the tongue everyday by brushing it or using a tongue scraper you can obtain from a pharmacy.
One word of caution: don't stop any medication you suspect of a side effect without first discussing it with your prescribing doctor. While effects like black hairy tongue are unpleasant, they're not harmful—and you don't want to interfere with treatments for problems that truly are.
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