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There’s one sure thing about tooth decay: you can’t ignore it. In fact, the best outcomes result from finding it early and treating it before it enters the pulp in the center of the tooth, often a filling or similar treatment.
If it does advance to the pulp, you may need a root canal treatment to save the tooth. This is a moderately invasive procedure where we access the pulp and root canals, tiny passageways leading to the root and supporting bone. We then remove all the diseased tissue and fill the empty pulp chamber and root canals with a special filling. Later we’ll crown the tooth for added protection against future infection or fracture of the tooth.
But there’s also another less-invasive method than a root canal called pulp capping. It’s only appropriate to use, however, if the pulp has become exposed or almost exposed by decay, but hasn’t yet shown signs of disease.
Pulp capping can be either direct or indirect. We use direct pulp capping if the healthy pulp has been exposed by the disease process. We first isolate the tooth from the rest of the mouth to prevent contamination and then proceed to remove all of the tooth’s decayed dentin structure. We then apply a biocompatible material directly over the pulp to protect it from further decay and to facilitate healing. We then restore the tooth, usually with a filling, to its proper function and life-like appearance.
When the pulp is threatened by decay but not yet exposed, we may then use the indirect method. In this approach we first remove most of the decayed dentin, but leave a small amount next to the pulp to keep it covered. We then treat this remaining dentin with a material to help it heal and re-mineralize, followed by a temporary filling of the tooth. A few months later we’ll remove this filling and inspect the treated dentin. If it has regenerated sufficiently, we remove any remaining decay and permanently restore the tooth.
As we said, pulp capping is only used with patients with deep decay whose pulp tissue is healthy. But when we can use it we can avoid some of the permanent alterations that often come with a root canal treatment and still save the tooth.
If you would like more information on treatments for 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 “Pulp Capping: A Procedure that May Save a Decayed Tooth.”
Study Looks Into Oral HPV Infections In US Men, Women.
The New York Times (10/16, Bakalar, Subscription Publication) “Well” blog reports that research published in the Annals of Internal Medicine indicated “11 million men and 3.2 million women in the” US have “oral HPV infections.” Among these individuals, “7 million men and 1.4 million women” have “strains that can cause cancers of the throat, tongue and other areas of the head and neck.” TIME (10/16, Sifferlin) reports that the investigators “note that the number of men with HPV-related cancer of the oropharynx – the tongue, tonsils and back of the throat – has rapidly increased and has already surpassed the incidence of cervical cancer among women.” Reuters(10/16, Rapaport) reports that the research suggested “men were at the highest risk of developing oral HPV when they had oral sex with other men or also had genital HPV infections.”
CNN (10/16, Scutti) reports the study also found “HPV infections overall and high-risk HPV oral infections in particular were ‘significantly associated’ with cigarette and marijuana use.” While “an HPV vaccine is available for both men and women and can protect against infection...many men are over the eligibility age of 26, and younger men have low vaccination rates.”
NBC News (10/17, Fox) features information from Dr. Erich Sturgis, professor of head and neck surgery at the MD Anderson Cancer Center at the University of Texas, who highlighted how the center and the American Dental Association are collaborating to prevent oropharyngeal cancers.
Today at ADA 2017 – America’s Dental Meeting, the ADA and the University of Texas MD Anderson Cancer Center are hosting a joint symposium to address the relationship between HPV infection and oropharyngeal cancer.
The ADA has released an updated oral cancer clinical practice guideline, and Dr. Mark Lingen, chair of the guideline’s expert panel, will present the guideline’s recommendations during a talk, ADA Clinical Practice Guidelines on the Evaluation of Oral Cancer (6809), on the ADA Science Institute Stage at ADA 2017 – America’s Dental Meeting on Friday, Oct. 20.
In addition, the Oral Health Topics on ADA.org and MouthHealthy.org provide information on oral and oropharyngeal cancer for dental professionals and for patients. MouthHealthy.org also provides information for patients on HPV and oral cancer.
Click here to for more information
When it comes to teeth whitening, you may see many different methods featured online and in magazines—from oil pulling to charcoal, and even turmeric. It's no surprise that DIY whitening is top of mind, either. When the American Academy of Cosmetic Dentistry asked people what they’d most like to improve their smile, the most common response was whiter teeth.
Healthy smiles come in many shades, though it's tempting to think ingredients in our own kitchens could hold the key to a brighter smile. Still, just because a method is natural doesn’t mean it’s healthy. In fact, DIY whitening can do more harm than good to your teeth. Here’s how:
The approach maintains you can make your teeth whiter and brighter using household staples that are naturally acidic (like lemons, oranges, apple cider vinegar), contain digestive enzymes (such as pineapple or mango) and something that is abrasive (like baking soda).
When eaten as usual, fruit is a great choice. However, fruit and vinegar contain acid, and you put your pearly whites at risk when you prolong their contact with your teeth or use them to scrub your teeth because acid can wear away your enamel. Enamel is the thin outer coating of your teeth that protects you from tooth sensitivity and cavities.
These methods claim that scrubbing your teeth with ingredients like activated charcoal or a baking soda-hydrogen peroxide paste will bring a shine back to your smile.
There is no evidence that shows dental products with charcoal are safe or effective for your teeth, according to the September 2017 issue of the Journal of the American Dental Association.
Also, using materials that are too abrasive on your teeth can actually make them look more yellow. Enamel is what you’re looking to whiten, but if you’re using a scrub that is too rough, you can actually wear it away. When that happens, the next layer of your tooth can become exposed – a softer, yellow tissue called dentin.
Instead, choose a whitening toothpaste with the ADA Seal of Acceptance. The Seal lets you know the toothpaste you choose is safe, effective and won’t damage your teeth.
SPICES AND OILS
Swishing oils like coconut oil in your mouth (oil pulling) or using spices like turmeric can help whiten your teeth.
There is no reliable scientific evidence to show oil pulling or turmeric whitens teeth. Save the oil and spices for healthy meals instead.
STILL INTERESTED IN WHITENING?
The best natural ways to keep your teeth white are everyday healthy habits, including:
- Brushing your teeth twice a day for two minutes
- Use a whitening toothpaste with the ADA Seal of Acceptance
- Cleaning between your teeth once a day
- Limiting foods that stain your teeth, like coffee, tea and red wine
- Not smoking or using tobacco
- Regular visits to your dentist for checkups and cleanings
If you want to try a specific whitening product or service, just talk to your dentist before you begin. There are at-home bleaching options that have earned the ADA Seal of Acceptance, which means they’ve been tested to be safe and effective for your teeth. Get a list of all ADA-Accepted at-home bleaching products.
Whitening may not work on all teeth, and if you are a candidate, some methods—whether at-home or in the dental office—may be better for your teeth than others.