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| Dental disease will affect all of us at some point in our lives. I have listed below many common dental problems that my patients have brought to my dental practice. I know you will find this advice useful. |
The American Dental Association studies indicate that 50% of the population in the United States don’t see a dentist on a regular basis. Fear is one of the most common reasons we hear for this lack of care. Patients often tell us of bad experiences going to the dentist as a child. Many patients don’t realize how much dentistry has changed. First of all, the anesthetics are much improved, they act more quickly, last longer, and do a much better job of eliminating all feeling in the tooth. We use a topical anesthetic to numb the area before the shot, and with smaller and thinner needles, the shots are virtually painless. Drill techniques have also improved greatly. While it is still necessary to sometimes use the "drill", they are so much improved that the drilling time is greatly reduced. Many patients use tape or CD players with headphones to further relax during a dental procedure. If a patient says " I hate dentists ", let him or her know how much dentistry has changed, and is no longer a need for fear. |
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| Fluoride has been a great benefit to patients of all ages in helping
prevent dental decay. Regular brushing and flossing lowers the chance
of developing "cavities". However, the most decay-prone
areas of the teeth are the grooves and depressions on the chewing
surfaces of the back teeth which require further preventive care.
To prevent decay, a plastic-like coating called a sealant should be painted on the chewing surfaces of all the back teeth. Studies have shown that sealants can reduce tooth decay by as much as 90% to 100%. The American Dental Association recommends sealants be placed as soon as the first adult teeth come in at age 6 or 7. Sealants should continue to be used as each adult back tooth comes into the mouth. All back teeth that need to be sealed are present by age 13. Sealant application is simple, fast and painless. |
| The American Dental Association says that over 75% of all adults
have or will have some form of gum disease. With statistics like this,
it is important that all health providers are aware of the signs and
can make the proper recommendations to the patient.
Gum disease, or more commonly called "periodontal disease", is a bacterial infection in the gums and supporting structures of the teeth. It can be divided into several categories. The first stage is called "gingivitis" and is characterized by gum tissue that is red, puffy, and bleeds easily when touched with a toothbrush, floss or dental instrument. The second, third, and fourth stages are initial, moderate, and advanced "periodontal disease", respectively. These stages are different from gingivitis because the infection has destroyed the bone supporting the teeth, causing eventual tooth loss. Additional signs of advanced gum disease are swelling of the gums, pus oozing around the teeth, bad breath, receding gums and looseness of the teeth. The treatment is more involved at these stages, usually consisting of a special cleaning with anesthetic and sometimes gum surgery. |
| A recent survey of dental patients showed that infection control
was #1 on their list of concerns about dental care. Some patients
have even stopped going to the dentist because of their fears.
Fortunately, trips to the dentist have never been safer. The case in Florida where the patient was apparently infected with the AIDS virus by her dentist is the only such case out of tens of millions of dental treatments performed since the introduction of the virus. The Center for Disease Control still does not know the method of infection. Even one case is too many. The dental profession has responded by adopting "universal precautions". These involve sterilizing all instruments in dry-heat ovens or steam autoclaves to kill any bacteria or viruses. Disposable items are used whenever possible. The chance of contracting an infection in the dental chair is extremely remote, but the chance of losing one’s teeth because of lack of proper dental care is extremely likely. We should not let our patients’ unfounded fears lead them into real problems. |
| For over 100 years, dentistry has restored teeth primarily with
a material made of mercury and silver. It has done it’s job
well, although we have had to live with it’s weaknesses. Those
weaknesses consist of cracking teeth due to the expansion of the material,
and restorations turning black as the silver material corrodes.
Now in 1997, we have many ways to provide tooth-colored restorations. We can use adhesives to bond tooth parts that look and act like teeth. We can provide a bright, healthy and strong smile with these exciting new techniques in adhesive dentistry. |
| Many seniors today have retained their own teeth, avoiding the trauma
of removable dentures. Many are on medications creating dryness of
the mouth as a side effect. Without the natural benefit of saliva
to decrease bacterial action, we see an increase of cavities on the
root surfaces of these patients.
Anyone on a medication causing a dry mouth effect should be encouraged to see their dentist for regular dental cleanings and topical fluoride rinses. |
| Many mothers have experienced gum disease, dental pain and/or tooth
extraction during or shortly after pregnancy. This is often seen as
being a "normal" side effect of being pregnant. Dental disease,
which is an infection of the teeth and/or gums, is not "normal"
for any patient.
There are three basic things that happen during pregnancy which make the patient more susceptible to dental disease. First, hormonal changes may make the gums more susceptible to gum disease. Second, pregnant women tend to eat smaller, more frequent meals, exposing their teeth and gums to sugar and acids more often. Third, the cravings for "junk foods" and inadequate oral hygiene pose an increased threat to the teeth and gums. Pregnant women should be advised to schedule a dental evaluation and receive preventive dental care. Personalized oral hygiene instruction should also be given to fight disease and promote overall good health for the mother and her baby. |
| "Well, you know Doc, it’s only a back tooth. No one will
see it so I’ll just get rid of it. It’s not going to make
a difference".
The plain truth is that it will make a difference. The loss of just a single tooth can set a course that can destroy the entire mouth. "Well, if that’s true, tell me more. I sure don’t want to lose the front ones that I smile with". Teeth will drift and tip into a space that is created by missing teeth. Just like two gears of a car that are not properly aligned, pretty soon you’ve got a whole lot of problems. "Well I don’t like that. What can I do?" If it sounds like I’ve heard this conversation a few times, you’re right. If I’m going to keep a patient happy, I need to provide options at this point. One of the options would be an implant. This is the replacement of a tooth with a false root that is surgically placed. It is often followed by the careful construction of a crown which replaces the missing tooth, to prevent teeth from shifting and thereby avoiding further tooth loss. |
| While bad breath might be a symptom of some other disorder, it most
likely stems from dental decay and periodontitis (gum disease).
Periodontitis is a disease affecting gums and bone that support the teeth, and it results from inadequate tooth brushing and flossing. In this disease, the irritated gums pull away from the teeth and form pockets between the teeth and the gums. These pockets fill with bacteria and pus and give off a foul odor. Patients with bad breath should be referred for a complete dental evaluation. If gum disease and/or dental decay is diagnosed, it can be treated readily. The patient will no longer have an infection in his or her mouth, and he or she will no longer have the embarrassment of bad breath. |
