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Dear Valued Patients,
We will be re-opening on May 18, 2020 to resume dental procedures.

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please contact us on our emergency phone-in line at 410-472-3574.

 

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We will continue to monitor current guidelines so that we may provide the best and safest dental care to our patients.


 

 

 

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My Blog

Posts for tag: tooth decay

By John Kelmenson, D.D.S.
November 08, 2021
Category: Dental Procedures
Tags: tooth decay  
WereImprovingOurEffectivenessinTreatingToothDecay

For several decades, dentists have been saving teeth from tooth decay following a few basic guidelines: 1) Identify decay as soon as possible; 2) Thoroughly remove decayed tooth structure; and 3) Fill any cavities. With millions of diseased teeth rescued, observing these simple steps have proven a rousing success.

But as with most things, even this successful protocol isn't perfect. For one, some healthy tissue gets removed along with the diseased portions. The average percentage of "collateral damage" has dropped over the years, but it still happens—and a reduction in healthy tissue can make a tooth less structurally sound.

Another drawback, at least from the patient's perspective, is the dental drill used for removing decay and preparing cavities for filling. Many people find drilling unpleasant, whether from its vibrations in the mouth or its high-pitched whine. The drill's burr head design also contributes to greater healthy tissue loss.

But those weaknesses have lessened over the last few years, thanks to innovations on a number of fronts.

Better risk management. Tooth decay doesn't occur out of thin air—it arises out of risk factors unique to an individual patient like personal hygiene, bacterial load, saliva production or even genetics. Taking the time to identify a patient's "tooth decay risk score" can lead to customized treatments and practices that can minimize the occurrence of decay.

Earlier detection. Like other aspects of dental health, the sooner we detect decay, the less damage it causes and the more successful our treatment. X-rays remain the workhorse for detecting decay, but now with improvements like digital film and better equipment. We're also using newer technologies like laser fluorescence and infrared technology that can "see" decay that might otherwise go undetected.

Less invasive treatment. The dental drill is now being used less with the advent of air abrasion technology. Air abrasion utilizes a concentrated spray of particles to remove diseased tooth structure more precisely than drilling. That means less healthy tissue loss—and a more pleasant (and quieter!) experience for the patient.

In effect, "less is more" could describe these improvements to traditional decay treatment. They and other methods promise healthier teeth and happier patients.

If you would like more information on current 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 “Minimally Invasive Dentistry: When Less Care is More.”

By John Kelmenson, D.D.S.
October 24, 2021
Category: Uncategorized
Tags: tooth decay  
ThisTwo-PartApproachCouldSaveYourChildsTeethFromToothDecay

Your child's dental development is in overdrive between birth and early adulthood. The rapid growth of the teeth, gums and jaws occurs mostly on its own—but tooth decay could significantly derail it.

Although most cases of dental disease occur in adults, tooth decay is a major problem for children, particularly involving primary teeth. These teeth are much more important than they seem given their short lifespans: Because they help incoming permanent teeth to align properly, their premature loss due to decay can create future bite problems.

To prevent this from happening, taking steps to prevent tooth decay in young children is well worth the effort. The best strategy is a double-pronged approach. You'll first want to address certain areas that directly contribute to tooth decay. You'll then want to add measures that strengthen the teeth themselves against the disease.

In regard to the former, reducing the levels of harmful bacteria in the mouth tops the list. These bacteria produce acid as a byproduct that in turn softens and erodes enamel, the teeth's natural barrier against decay. We reduce bacteria by eliminating dental plaque, a film of built-up food particles that feeds and shelters bacteria, through daily brushing and flossing.

Certain dietary choices may also contribute to bacterial growth. Refined sugar is a prime food source for bacteria, so limiting it in the diet will help reduce tooth decay. Furthermore, a diet rich in whole, unprocessed foods and dairy provide nutrients strengthen teeth against decay.

The other prong in defeating tooth decay mainly involves protective measures provided by your dentist. Sealants applied to the chewing surfaces of a child's teeth help protect the enamel from the buildup of bacteria in these highly susceptible areas. An occasional direct application of fluoride to teeth further strengthens their enamel, and makes them less susceptible to decay.

This approach can minimize the chances of tooth decay, but it won't eliminate the risk altogether. If it does occur despite your best efforts, prompt treatment can limit the damage and preserve the teeth. Working with your dentist, you can help ensure your child's teeth are protected from this damaging disease.

If you would like more information on best dental care practices for children, 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 “Dentistry & Oral Health for Children.”

By John Kelmenson, D.D.S.
June 05, 2021
Category: Oral Health
Tags: tooth decay   salvia  
KeepYourSalivaFlowing-YourOralHealthDependsonit

We often don't realize how important something is until it's gone. Like saliva: you're usually not aware that it's cleaning the mouth, neutralizing mouth acid or helping with digestion. But that could change if your saliva flow drops below normal: your health may soon suffer with your mouth taking the brunt.

In particular, reduced saliva flow increases your risk for tooth decay and periodontal (gum) disease. Both diseases are linked to oral bacteria. While many of the myriad strains in the mouth are beneficial, a few bacteria can infect and inflame gum tissues. Bacteria also produce acid, which can soften and erode enamel and make the teeth more susceptible to decay.

Saliva inhibits bacteria in a number of ways. It first clears the mouth of leftover food so not as much stays behind to form bacterial plaque, a thin film of food particles that builds up on teeth. You still need to brush and floss daily to remove plaque, but it's less effective without saliva's cleansing action. Saliva also contains antibodies that destroy disease-causing bacteria and other organisms, which keeps their populations in the mouth low.

One of saliva's most important functions, though, is buffering acid. The mouth's ideal pH level is neutral, but many foods we eat can cause it to become more acidic. Even a slight acidic rise after eating can soften the minerals in enamel. But saliva goes to work immediately and usually restores normal pH within a half hour to an hour. It also aids in re-mineralizing the enamel.

For these reasons, it's important for you to find out the cause of chronic dry mouth and treat it. If it's a side effect of your medication, talk to your doctor about an alternative, or drink more water before and after you take your dose. Certain products can also stimulate saliva flow, like chewing gum with xylitol, an alcohol-based sweetener that has dental health-protecting properties too.

Although you often don't notice this unsung bodily fluid swishing in your mouth, it's important that you take care of it. Keeping your saliva flowing will help ensure better oral health.

If you would like more information on the importance of saliva to health, 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 “Saliva: How it is used to Diagnose Disease.”

By John Kelmenson, D.D.S.
November 22, 2020
Category: Oral Health
Tags: tooth decay  
RootDecayinYourLaterYearsCouldEndangerYourTeeth

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.

If you would like more information on preventing and treating tooth decay, please contact us or schedule an appointment for a consultation.

By John Kelmenson, D.D.S.
May 01, 2020
Category: Oral Health
Tags: tooth decay   sugar  
TooMuchSugarCanWreckMoreThanYourTeeth

You've heard it. Your parents heard it—maybe even your grandparents too. Dentists have been alerting people for more than half a century that high sugar consumption contributes to tooth decay.

That message hasn't changed because the facts behind it are the same in the 2020s as they were in the 1950s: The bacteria that cause tooth decay feast on sugar and other leftover carbohydrates in the mouth. This causes them to multiply and increase their production of acid, which softens and erodes tooth enamel.

What has changed though, especially over the last couple of decades, is a growing understanding of how sugar consumption may affect the rest of the body. Just like the evidence of sugar's relationship to tooth decay, current scientific studies are now showing there are strong links between sugar and diseases like diabetes, heart disease and liver disease.

What's startling about what researchers are finding is that cases of these diseases are growing, Especially in younger people. This is a parallel trend to our skyrocketing increases in per capita sugar consumption: the average American now eats the equivalent of 19.5 teaspoons of added sugar every day. Health experts generally agree we should consume no more than 6 teaspoons a day, and children 4.

This is vastly more than we consumed a generation ago. One reason is because processed food manufacturers have increased sugar in their products, hiding under technical, unfamiliar names in ingredient lists. But it's still sugar, and an estimated 74% of processed foods contain some form of it.

But the real surge in sugar has come from our increasing consumption of sodas, as well as energy and sports beverages. These beverages are high in sugar—you can meet your daily allowance with just one 12-oz can of soda. These beverages are now the leading source of sugar in our diets, and, according to experts, a highly dangerous way to consume it.

In effect, dentists of old were on to something: too much sugar is bad for your teeth. It now turns out that it may be bad for your overall health too. Strictly limiting it in your family's diet could help lower your risk of tooth decay and dangerous diseases like diabetes.

If you would like more information on sugar and your health, please contact us or schedule an appointment for a consultation.