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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.”
At the first-ever Players Weekend in August 2017, Major League Baseball players wore jerseys with their nicknames on the back. One player — Cleveland Indians shortstop, Francisco Lindor — picked the perfect moniker to express his cheerful, fun-loving nature: “Mr. Smile.” And Lindor gave fans plenty to smile about when he belted a 2-run homer into the stands while wearing his new jersey!
Lindor has explained that he believes smiling is an important part of connecting with fans and teammates alike: “I’ve never been a fan of the guy that makes a great play and then acts like he’s done it 10,000 times — smile, man! We’ve got to enjoy the game.”
We think Lindor is right: Smiling is a great way to generate good will. And it feels great too… as long as you have a smile that’s healthy, and that looks as good as you want it to. But what if you don’t? Here are some things we can do at the dental office to help you enjoy smiling again:
Routine Professional Cleanings & Exams. This is a great place to start on the road toward a healthy, beautiful smile. Even if you are conscientious about brushing and flossing at home, you won’t be able to remove all of the disease-causing dental plaque that can hide beneath the gum line, especially if it has hardened into tartar, but we can do it easily in the office. Then, after a thorough dental exam, we can identify any problems that may be affecting your ability to smile freely, such as tooth decay, gum disease, or cosmetic dental issues.
Cosmetic Dental Treatments. If your oral health is good but your smile is not as bright as you’d like it to be, we can discuss a number of cosmetic dental treatments that can help. These range from conservative procedures such as professional teeth whitening and bonding to more dramatic procedures like porcelain veneers or crowns.
Tooth Replacement. Many people hide their smiles because they are embarrassed by a gap from a missing tooth. That’s a shame, because there are several excellent tooth-replacement options in a variety of price ranges. These include partial and full dentures, bridgework, and dental implants. So don’t let a missing tooth stop you from being Mr. (or Ms.) Smile!
If you’d like more information about oral health or cosmetic dentistry, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Impact of a Smile Makeover.”
People with diabetes have special concerns when it comes to dental care. In fact, 1 in every 5 cases of total tooth loss is linked to this widespread health condition. November is National Diabetes month, so it’s a good opportunity for us to answer some frequently asked questions about oral health and diabetes.
Q. Can I get a dental implant to replace a missing tooth even if I have diabetes?
A number of studies have shown that people with diabetes can be good candidates for dental implants, but there are some concerns regarding dental implant treatment, which involves minor surgery. Wounds tend to heal more slowly in people with diabetes, who are also more infection-prone than those without diabetes. In diabetic individuals with poor glucose control, research has also shown that it takes longer for the bone to heal after implant placement. We will take these (and other) factors into account when planning your implant treatment. However, in many situations even poorly controlled diabetes does not necessarily preclude dental implant treatment.
Q. I’ve heard people with diabetes have a higher risk for gum disease. Is that true?
Yes. Research shows that people with diabetes are more susceptible to periodontal (gum) disease, especially when their diabetes is poorly controlled. The reverse is also true: untreated periodontal disease can worsen blood sugar levels. So it’s important to manage both of these inflammatory conditions. If you notice the early signs of gum disease, such as inflamed or bleeding gums, please bring this to our attention. Early gum disease (gingivitis) is much easier to treat than more advanced forms—which can eventually lead to tooth loss.
Q. If I have diabetes, how can I protect my oral health?
Keep doing your best to control your blood sugar levels with exercise and a healthy diet—and stick to an effective daily oral hygiene routine, which includes both brushing and flossing and coming in for regular dental checkups and cleanings. Make sure to let us know what medications you are taking and update us on any changes. If you notice any mouth sores, swelling or inflammation, bring this to our attention as soon as possible.
Tooth wear, especially on biting surfaces, is a normal part of aging — we all lose some of our tooth enamel as we grow older. Even primary (“baby”) teeth may show some wear before they’re lost. But there’s also excessive, premature tooth wear caused by disease or abnormal biting habits. This type of wear is cause for concern and action before it leads to tooth loss.
Normal tooth wear occurs because of what teeth naturally do — bite and chew. When teeth come together as we eat they generate a modest amount of force: between 13 and 23 pounds. Our teeth also make brief contacts hundreds to thousands times a day. Again, this produces force, though not to the extent we see with biting and chewing: somewhere between 0.75 and 7.5 pounds. These glancing contacts are actually good for dental health because they provide needed stimulation to the teeth and jaws that help the body maintain healthy bone and tooth attachments.
But parafunctional (outside the normal function) habits like teeth grinding or foreign object chewing can greatly increase the generated force, up to 230 pounds. These may result in noticeable symptoms like fractures or loose teeth, but not always — the damage may not be noticeable until much later in the form of excessive tooth wear.
These parafunctional habits aren’t the only cause for excessive tooth wear; tooth decay can weaken the tooth structure, making it more susceptible to wear. And, some restorative materials used for fillings may also affect the rate of wear.
Because excessive tooth wear may or may not present with immediate symptoms, it’s important to maintain regular dental checkups to monitor the condition of your teeth. Our training and experience helps us identify signs of excessive tooth wear and, depending on the extent of damage, work with you on a treatment plan. You should also keep us informed about oral habits, especially teeth grinding, thumb sucking or foreign object chewing (toys, nails, pencils, etc.).
Your teeth will wear as you grow older. By keeping a close eye on your teeth, we’ll help you keep that wear at a normal rate.
If you would like more information on preventing excessive tooth wear, 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 “When Children Grind Their Teeth.”
Whether you are an existing patient or searching for a dentist in the Port Orchard, WA area, we're excited you are here. With the dental industry advancing, we recognize the importance of keeping our patients and visitors up to date with all of the new and exciting things taking place in our practice.
As we move forward with our blog, we hope to promote dental awareness as a vital part of your healthy lifestyle. Here you will find a variety of articles and topics including dental news, advancements in dental technology and treatment, practical dental health advice and updates from Dr. Schoepflin and his staff.
We hope you find our blog to be helpful, engaging and informational to ensure your best dental health.
As always, feel free to contact us with any dental questions or concerns.