Posts for: September, 2018
When things get unpleasant in your mouth, it’s most often related to some underlying cause. In fact, the discomfort you’re feeling is often a call to action to have it checked and treated.
The American Dental Association recently surveyed approximately 15,000 U.S. adults about their oral problems. If you have any of the top 3 problems found in this survey, it could be a “warning bell” sounding in your mouth right now.
Here, then, are the top 3 dental problems in America, what they mean and what you should do about them.
#3: Tooth Pain. About a third of respondents (more among those younger or from lower-income households) indicated pain as a problem. As a warning sign of something wrong, tooth pain could be telling you that you have a decayed tooth, a gum abscess or something similar. The best thing to do is get a checkup as soon as possible. It’s unlikely that whatever is causing the pain will go away on its own and procrastination could make ultimate treatment more complex and difficult.
#2: Difficulty Biting. A slightly higher number of people named difficulty chewing and biting as their main oral problem. As with tooth pain, chewing difficulty causes could be many: cracked, loose or decayed teeth, ill-fitted dentures, or a jaw joint disorder (TMD). Again, if it hurts to chew or bite, see a dentist. Besides the underlying problem, chewing difficulties could also affect the quality of your nutrition.
#1: Dry Mouth. Chronic dry mouth garnered the highest response in the survey, especially among older adults. This is more serious than the occasional “cotton mouth” feeling we all experience—with chronic dry mouth the salivary glands aren’t producing enough saliva to neutralize mouth acid or fight disease, thus increasing your risk for tooth decay or periodontal (gum) disease. It’s most likely caused by medications or systemic conditions, so talk with your dentist or physician about boosting saliva flow.
The basics for treating tooth decay have changed little since the father of modern dentistry Dr. G.V. Black developed them in the early 20th Century. Even though technical advances have streamlined treatment, our objectives are the same: remove any decayed material, prepare the cavity and then fill it.
This approach has endured because it works—dentists practicing it have preserved billions of teeth. But it has had one principle drawback: we often lose healthy tooth structure while removing decay. Although we preserve the tooth, its overall structure may be weaker.
But thanks to recent diagnostic and treatment advances we’re now preserving more of the tooth structure during treatment than ever before. On the diagnostic front enhanced x-ray technology and new magnification techniques are helping us find decay earlier when there’s less damaged material to remove and less risk to healthy structure.
Treating cavities has likewise improved with the increased use of air abrasion, an alternative to drilling. Emitting a concentrated stream of fine abrasive particles, air abrasion is mostly limited to treating small cavities. Even so, dentists using it say they’re removing less healthy tooth structure than with drilling.
While these current advances have already had a noticeable impact on decay treatment, there’s more to come. One in particular could dwarf every other advance with its impact: a tooth repairing itself through dentin regeneration.
This futuristic idea stems from a discovery by researchers at King’s College, London experimenting with Tideglusib, a medication for treating Alzheimer’s disease. The researchers placed tiny sponges soaked with the drug into holes drilled into mouse teeth. After a few weeks the holes had filled with dentin, produced by the teeth themselves.
Dentin regeneration isn’t new, but methods to date haven’t been able to produce enough dentin to repair a typical cavity. Tideglusib has proven more promising, and it’s already being used in clinical trials. If its development continues to progress, patients’ teeth may one day repair their own cavities without a filling.
Dr. Black’s enduring concepts continue to define tooth decay treatment. But developments now and on the horizon are transforming how we treat this disease in ways the father of modern dentistry couldn’t imagine.
Like other living tissue, your teeth can feel. Dentin, the layer below the enamel, houses fluid-filled conduits that transmit temperature or pressure sensations to a nerve network within the tooth’s inner pulp. It’s so effective that incoming sensations must be buffered — “toned down”— to avoid a painful overload of the nerves. The enamel above the gum line and a bone-like substance called cementum below help do this.
Unfortunately, if teeth lose this protection they can become hypersensitive. This can cause a flash of sharp pain while eating or drinking something cold or hot or just biting down.
There are a number of causes for tooth sensitivity, any of which can influence how we treat it. While you’ll need a dental exam to know for sure, your hypersensitivity will more than likely stem from one of these 3 problems.
Periodontal (gum) disease. This is an infection caused by bacterial plaque, a thin film of bacteria and food particles that accumulates on the teeth due to poor oral hygiene. The inflamed gum tissues weaken and detach from the teeth, causing them to shrink back or recede. This leaves the cementum unprotected, which easily erodes and exposes the dentin to acid and bacteria — and hypersensitivity. Clinically removing the plaque helps the affected gums heal. In extreme cases, the gums may need surgical grafting to regenerate.
Overaggressive brushing. While a lack of oral hygiene can contribute to gum recession, ironically too much hygiene — brushing too hard for too long — can damage your gums and cause them to recede. Brushing really doesn’t require a lot of elbow grease — a gentle scrubbing motion over all tooth surfaces is sufficient to remove plaque. Fine-tuning your brushing will help your gums to recover and heal.
Mouth acid. Although quite strong, enamel has one formidable enemy: acid, which can erode enamel and expose the dentin. Over-indulgence in acidic foods and beverages can make your mouth more acidic; more likely, though, bacterial plaque will again be the culprit, because bacteria excrete an acidic waste product. You can reduce mouth acid with daily brushing and flossing and consuming less acidic foods and beverages.
If you’re experiencing any kind of tooth pain, see us for an examination. We’ll determine the cause and initiate the appropriate treatment to regain your oral health.
If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity: Understanding Your Options.”