As we age we become more susceptible to dental diseases. A common but often initially unnoticed problem for seniors is root decay.
We’re all familiar with tooth decay in the crown, the visible tooth above the gum line. Bacteria feeding on leftover sugar in the mouth produce acid, which at high levels erodes the teeth’s protective enamel. This forms cavities and, if untreated, deeper infection within the tooth that could reach the bone via the root canals.
But decay can also directly attack a tooth’s roots below the gum line. Roots are made of dentin and covered by a very thin layer of mineralized tooth structure called cementum. Cementum, which is much softer than enamel, is often lost because of its thinness, thus exposing the root’s dentin. This can make the area more susceptible to decay than the enamel-covered crown. Normally, though, the roots also have the gums covering them as added protection against bacterial infection.
But gum recession (shrinkage), a common experience for people in their later years, can expose the root surfaces. As a result, the roots become much more susceptible to decay. And an ensuing infection could spread more quickly into the interior of the tooth than decay originating in the crown.
That’s why it’s important to remove the decayed material and fill the root cavity to prevent the infection’s spread. While similar to a crown filling, the treatment can be more difficult if the root cavity extends below the gum line. In this case, we may need to perform a surgical procedure to access the cavity.
There are other things we can do to help prevent root cavities or limit their damage. We can apply fluoride varnish to strengthen the teeth and provide extra protection against cavities, or prescribe a fluoride rinse for use at home. We can also keep an eye out and treat periodontal (gum) disease, the main cause for gum recession.
The most important thing, though, is what you do: brush and floss thoroughly each day to remove bacterial plaque and limit sugary or acidic foods in your diet. Preventing decay and treating cavities as soon as possible will help ensure you’ll keep your teeth healthy and functional all through your senior years.
For over a century dentists treated tooth decay by removing both diseased portions of the tooth and healthy structure deemed at risk for future decay. In the 1970s, though, a new approach emerged, known as Minimally Invasive Dentistry (MID). This practice protocol attempts to preserve as much of the healthy structure as possible.
Before MID, dentists followed a decay treatment protocol developed in the 19th Century. A part of this became known as extension for preventioncalling for dentists to remove healthy structure considered vulnerable to decay. Besides reducing the tooth’s volume, this practice also resulted in, by today’s standards, larger than necessary fillings.
It was thought that removing this additional material would make it easier to clean bacterial plaque, the source of decay, but later, research showed the practice couldn’t guarantee the teeth wouldn’t be reinfected.
Since then we’ve learned a lot more about teeth and have developed new ways to detect decay at earlier stages. X-ray imaging, for example, has transitioned largely from film to digital technology, providing more detailed images at greater magnification. This, along with laser fluorescence and infrared cameras, has made it easier to detect the first tiny stages of decay.
We can also limit tooth decay damage by boosting enamel strength with fluoride applications and sealants or reducing decay-causing bacteria with anti-bacterial rinses. We’ve also seen advancement in techniques like air abrasion that remove decayed tooth material while leaving more healthy structure intact better than using a traditional dental drill.
Restoring teeth after treatment has also improved. While dental metal amalgam is still used for some fillings, the main choice is now composite resin. These new tooth-colored dental materials require less tooth preparation (and thus less material loss) and bond well to the remaining structure, resulting in a stronger tooth.
Following a MID protocol leads to less intervention and less time in the dentist’s chair. It also means preserving more of a natural tooth, an important aim in promoting long-lasting dental health.
Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.
“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into caviÂties. How did this happen?
Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.
While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.Â Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.
This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”
Here are some other basics of infant dental care that every parent should know:
Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.
“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”
If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctormagazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”
What you eat (and how often you eat it) is a major factor in the ongoing battle to prevent tooth decay. High levels of sugar or similar carbohydrates in your diet could encourage the growth of bacteria that cause tooth decay. Constantly sipping on acidic beverages like sodas or sports drinks can lead to enamel erosion.
You may be well aware of the kinds of foods that contribute to tooth decay. But did you know some foods can actually protect us from this damaging disease? Here are 4 kinds of foods believed to inhibit tooth decay.
Cheese. This food formed from milk is rich in calcium and has a stimulating effect on saliva. By eating a little cheese after a sugary snack, the increase in saliva can help neutralize the acid produced by the bacteria feeding on the sugar; the added calcium will also strengthen tooth enamel.
Fibrous plant foods. Beans, peanuts and leafy vegetables are rich in fiber and many require vigorous chewing. This in turn stimulates saliva flow, which as previously noted helps to neutralize high levels of acid.
Black and green teas. Beverages brewed from these plants are rich in polyphenols and flavonoids, providing an antioxidant effect on cells. Black tea also contains fluoride, which helps strengthen tooth enamel.
Chocolate. There’s some evidence that cocoa (from which chocolate is derived) may have some properties that inhibit tooth decay. But there is a catch — this evidence is based on unrefined cocoa, without the addition of any sugar. The high levels of sugar in processed chocolate negate this effect. Sorry chocolate lovers!
Of course, any of these and similar foods (like cow’s milk) should be considered complements to a comprehensive prevention approach that includes daily oral hygiene, limits on sugar and acidic food consumption and regular dental cleanings and checkups.
If you would like more information on preventing tooth decay, 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 “Nutrition & Oral Health.”
Did you know that tooth decay (dental caries) is the second most frequently occurring disease — surpassed only by the common cold? It can start as soon as toddlers sprout their first teeth and by middle age, more than 90% of adults are affected by the problem! Fortunately, you can significantly lower your risk for decay. The key is to nurture health-promoting (protective) factors in your mouth while discouraging those that are disease causing (pathologic).
The top two traditional steps can’t be stressed enough:
Good Oral Hygiene. Diligent brushing and flossing, along with routine professional cleanings, help limit a buildup of bacterial plaque (biofilm). This whitish film is attractive to decay-producing bacteria (among the many types of bacteria — including beneficial ones — that normally live in the mouth). These microbes like to snack on sugars and carbohydrates (perhaps part of that bagel you had for breakfast or the midafternoon candy bar), and in the process they produce acid. A healthy oral environment has a neutral pH — a perfect balance between acids and bases. But in a more acidic environment, minerals in the protective enamel of your teeth start to dissolve, exposing the dentin and root surfaces underneath that are even more vulnerable.
Sensible Diet. Keep decay-producing bacteria in check by limiting your intake of sugars and carbohydrates; the bacteria need these nutrients to grow and reproduce. Choose products containing natural sugars, such as those in fruits and vegetables, over those containing added sugars, such as sodas and candy. Be aware that Xylitol, an “alcohol sugar” used in some chewing gums and dental products, can actually help reduce pathogenic bacteria. And don’t forget that frequent consumption of acidic foods and beverages, such as sipping coffee during the day, can create an acidic environment in your mouth that can contribute to decay by eroding tooth enamel and weakening its defenses.
You also may have individual risk factors as well that our office can help you identify and address. For example, the shape of everyone’s teeth varies and some of us have more valleys, tiny grooves and pits than others. These likely places for bacteria to congregate can be the most difficult to reach with a toothbrush, but invisible sealants can be applied to prevent bacteria from reaching those areas.
If you would like more information about tooth decay and prevention, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Tooth Decay” and “Tooth Decay — How To Assess Your Risk.”