Over the last century effectively treating a decayed tooth has often required removing any decayed structure with drilling and then filling the remaining cavity. While this approach does save teeth that might otherwise be lost, it can also result in a fair amount of healthy structure removed in the process.
But continuing advances in dentistry are now making possible a new approach to tooth decay treatment that preserves as much of the healthy portions of tooth as possible. This new way is often referred to as minimally invasive dentistry (MID).
The primary goal of MID treatment is to intercept and treat decay as early as possible to minimize tooth damage. It begins with helping patients identify their own individual risk factors for decay such as the presence of disease-causing bacteria, the adequacy of their saliva flow, or their lifestyle and dietary habits. We then recommend changes or preventive measures to reduce those risks.
The next step in MID is using various diagnostic technologies to find decay as early as possible. X-rays continue to play a major role, but dentists are also using dental microscopy to magnify the earliest forms of decay. Many also utilize laser fluorescence, infrared photography and optical scanning to further “see” decay difficult to detect with the naked eye.
In regard to treatments, MID adopts the adage “less is more.” If caught early enough, we can encourage the re-mineralization of enamel that acid has eroded with CPP-ACP, a substance acquired from milk, or strengthen teeth with topical fluoride applications. Instead of the dental drill, many dentists now turn to air abrasion for decay removal, equipment that emits a fine stream of abrasive particles that harms less healthy structure than a drill.
And if lasers continue to develop at their current pace, we’ll be able to use this technology to perform much more precise decay treatment than possible with manual instruments. As a result, we’ll be able to treat decayed teeth with less invasive means to preserve as much healthy structure as possible.
As these and other developments continue, MID promises a bright future for preventing and treating tooth decay. As a result, there’ll be less tooth structure loss and more attractive and healthy smiles.
If you would like more information on the latest techniques for treating 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.”
If you've lost a tooth, you have a number of options for replacing it. Perhaps the best choice in terms of lifelikeness and durability is a dental implant.
All implants have the same basic architecture: a titanium metal post imbedded in the jawbone to replace the root; and an abutment, a metal collar that links the post with a lifelike porcelain crown. But implants can vary in how the crown attaches to the abutment and post — either cemented to the abutment or screwed through the abutment to the post.
Either method will permanently secure the crown to the implant. But there are advantages and disadvantages for each.
A screw-retained crown may better facilitate any future repair that might be needed. For a skilled dentist it's a simple matter of removing the screw and then the crown from the abutment. There's less risk of damage to the implant during repairs or crown replacement. Many dentists also prefer screws for crowns placed at the same time they're installing the implant post (a procedure called immediate loading).
The screw access hole, however, could pose a cosmetic problem. Although we can cover it over with tooth-colored filling, it may still be noticeable and unattractive especially for a tooth visible when you smile (in the smile zone). There's also the possibility the porcelain around the access hole could chip.
By contrast, cemented crowns have a smooth, unbroken surface and are aesthetically ideal for smile zone teeth. But the cement could interact poorly with gum and bone tissue in some patients, causing inflammation and possible bone loss.
And unlike screw-retained crowns, cemented crowns are difficult to remove for implant repair. We may have to drill through the crown to access the screw between the abutment and the post, and then repair it cosmetically if we use the same crown. Again, the final result may not be quite as visually appealing.
In the end, it will depend on the implant's location, how your body reacts to the cement or your dentist's preference. In either case, though, you'll have a tooth replacement that's functional, life-like and able to endure for many years to come.
If you would like more information on dental implants, 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 “How Crowns Attach to Implants.”
When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.
"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."
Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!
“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”
Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.
Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.
Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.
Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.
If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”
A root canal can save an infected tooth from being extracted. Root canal treatment can strengthen an infected tooth and restore normal functioning in that tooth. Undergoing root canal treatment when needed can prevent additional oral health problems from developing down the road. There are many signs a root canal might be needed, such as a severe toothache. A dentist can examine your infected tooth and determine if it can be saved through root canal treatment. At Progressive Dental Group, Dr. David Salah is your dentist in Novi, MI, for root canals.
What is a Root Canal?
A root canal is a treatment method for restoring and strengthening an infected tooth that would otherwise need to be extracted. When the soft, pulp in the center of a tooth becomes infected, that infection can spread down through the root and form an abscess below the tooth. Once the infection has spread outside the tooth, it can subsequently spread to other areas of the mouth and lead to additional oral health problems.
The procedure for a root canal is similar to filling a cavity. The dentist clears away all infected pulp from inside the tooth and root. The tooth is then thoroughly cleaned inside. Finally, the tooth is filled and sealed, and protected with a dental crown. Your dentist in Novi, MI, can examine an infected tooth and determine if it can be restored with root canal treatment. Some signs you may need a root canal include:
- Sharp pain when biting into food
- A severe or persistent toothache
- Sensitivity to cold or hot items
- Constant mouth pain and pressure
Benefits of a Root Canal
Root canal treatment offers multiple benefits beyond saving infected teeth from extraction. Root canals restore infected teeth and strengthen them so they can resume normal biting and chewing functions. Root canal treatment also alleviates the pain, sensitivity, and discomfort associated with infected pulp.
Some of the signs you might need a root canal include a severe toothache, constant mouth pain, and sharp pain when biting or chewing food. To find out if you need a root canal, schedule an appointment with Dr. Salah, your dentist in Novi, MI, by calling Progressive Dental Group at (248) 349-7560.
You know the basics for a healthy mouth: daily oral hygiene and regular dental checkups. But there are other elements unique to you that also factor into your oral care: the mouth and facial structure you inherited from your parents (like a poor bite) and your past history with dental disease. Both of these help define your individual risk factors for potential dental problems.
That’s why you need a treatment strategy personalized to you to achieve the best health possible for your teeth and gums. We create this plan by using a detailed and thorough 4-step process.
Step 1: Identify your unique risk factors. To find your risk factors for dental disease, we carefully assess your history and other areas of oral function and health: the soundness of your supporting bone and gum structures; your teeth’s structural integrity and any effects from decay, enamel erosion or trauma; functional issues like a poor bite, a jaw joint disorder or a grinding habit; and problems with appearance like disproportional gums.
Step 2: Prioritize risk factors and form the treatment plan. Once we’ve identified your individual risk factors, we assess how each could impact you and whether any require immediate treatment. Any current dental disease should be treated immediately to minimize and prevent further damage. Depending on severity, other issues like bite problems or unattractive teeth may be scheduled for later treatment.
Step 3: Execute the treatment plan. With our priorities in place, we then proceed with treating your teeth and gums, the most pressing needs first. Throughout this step, our goal is to bring your oral health to the highest level possible for you.
Step 4: Monitoring and maintaining health. Once we’ve achieved an optimum level of health, we must remain vigilant about keeping it. So we monitor for any emerging problems and perform preventive treatments like clinical cleanings to help maintain that healthy state. This also means regularly repeating our 4-step process to identify and update any new, emerging risks and incorporate them into our treatment strategy.
While this process may seem overly methodical, it can actually result in more efficient and cost-effective treatment. It’s the best way to ensure good health for your teeth and gums throughout your lifetime.
If you would like more information on creating a long-term dental care plan, 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 “Successful Dental Treatment: Getting the Best Possible Results.”
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