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Posts for: December, 2015

TreatingaBabyToothwithInnerDecaycanbeComplicated-butStillNecessary

Even though a child’s primary (“baby”) teeth eventually give way, it’s still important to treat them if they become decayed. Primary teeth serve as guides for the emerging permanent teeth — if they’re lost prematurely, the permanent tooth may come in misaligned.

If the decay, however, affects the tooth’s inner pulp, it poses complications. A similarly decayed adult tooth would be treated with a root canal in which all the pulp tissue, including nerve fibers and blood vessels, are removed before filling and sealing. Primary teeth, however, are more dependent on these nerves and blood vessels, and conventional filling materials can impede the tooth’s natural loss process. It’s better to use more conservative treatments with primary teeth depending on the degree of decay and how much of the pulp may be affected.

If the decay is near or just at the pulp, it’s possible to use an indirect pulp treatment to remove as much of the softer decay as possible while leaving harder remnants in place: this will help keep the pulp from exposure. This is then followed with an antibacterial agent and a filling to seal the tooth.

If the pulp is partially exposed but doesn’t appear infected, a technique called direct pulp capping could be used to cover or “cap” the exposed pulp with filling material, which creates a protective barrier against decay. If decay in a portion of the pulp is present, a pulpotomy can be performed to remove the infected pulp portion. It’s important with a pulpotomy to minimize the spread of further infection by appropriately dressing the wound and sealing the tooth during and after the procedure.

A pulpectomy to completely remove pulp tissue may be necessary if in the worst case scenario the pulp is completely infected. While this closely resembles a traditional root canal treatment, we must use sealant material that can be absorbed by the body. Using other sealants could inhibit the natural process when the primary tooth’s roots begin to dissolve (resorb) to allow it to eventually give way.

These all may seem like extraordinary efforts to save a tooth with such a short lifespan. But by giving primary teeth a second chance, their permanent successors will have a better chance of future good health.

If you would like more information on treating decay in primary teeth, 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 “Root Canal Treatment for Children’s Teeth.”


By Jeffrey J. Kraig, DDS, SC
December 14, 2015
Category: Oral Health
ActorDavidRamseySaysDontForgettoFloss

Can you have healthy teeth and still have gum disease? Absolutely! And if you don’t believe us, just ask actor David Ramsey. The cast member of TV hits such as Dexter and Arrow said in a recent interview that up to the present day, he has never had a single cavity. Yet at a routine dental visit during his college years, Ramsey’s dentist pointed out how easily his gums bled during the exam. This was an early sign of periodontal (gum) disease, the dentist told him.

“I learned that just because you don’t have cavities, doesn’t mean you don’t have periodontal disease,” Ramsey said.

Apparently, Ramsey had always been very conscientious about brushing his teeth but he never flossed them.

“This isn’t just some strange phenomenon that exists just in my house — a lot of people who brush don’t really floss,” he noted.

Unfortunately, that’s true — and we’d certainly like to change it. So why is flossing so important?

Oral diseases such as tooth decay and periodontal disease often start when dental plaque, a bacteria-laden film that collects on teeth, is allowed to build up. These sticky deposits can harden into a substance called tartar or calculus, which is irritating to the gums and must be removed during a professional teeth cleaning.

Brushing teeth is one way to remove soft plaque, but it is not effective at reaching bacteria or food debris between teeth. That’s where flossing comes in. Floss can fit into spaces that your toothbrush never reaches. In fact, if you don’t floss, you’re leaving about a third to half of your tooth surfaces unclean — and, as David Ramsey found out, that’s a path to periodontal disease.

Since then, however, Ramsey has become a meticulous flosser, and he proudly notes that the long-ago dental appointment “was the last we heard of any type of gum disease.”

Let that be the same for you! Just remember to brush and floss, eat a good diet low in sugar, and come in to the dental office for regular professional cleanings.

If you would like more information on flossing or periodontal disease, please contact us today to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”


By Jeffrey J. Kraig, DDS, SC
December 06, 2015
Category: Oral Health
Tags: oral health   gum disease  
ManagingGumDiseaseCouldBenefitOtherConditionsYouMayHave

Nearly half of all Americans have some form of periodontal (gum) disease. Without proper daily hygiene and treatment, this aggressive disease can ultimately cause tooth loss. It also appears the effects of gum disease reach beyond the mouth, as researchers have found relationships between it and other systemic diseases.

Inflammation, the body’s response to infection, is at the center of these relationships. In the case of gum disease, periodontal tissues become inflamed as the body attempts to isolate and fight the infection. If the inflammation becomes chronic, however, it will begin to damage gum tissues.

Inflammation is also a major feature of diabetes, a condition in which the pancreas doesn’t produce enough insulin. Without enough of this hormone that transforms sugar into usable energy for the body, the sugar accumulates in the blood stream; as a result, the patient becomes more susceptible to an exaggerated inflammatory response when the body encounters an infection. This is especially true for periodontal infections: the resulting inflammation can be greater and harder to control in diabetic patients. What’s more, uncontrolled gum disease may worsen their blood sugar levels.

Although not as prominent as with diabetes, cardiovascular disease also seems to share a connection with gum disease. This collection of chronic conditions like high blood pressure or restricted blood vessel flow raises the risk of heart attack or stroke. Like gum disease, inflammation is a major component in the progression of cardiovascular disease — in fact, both diseases leave similar chemical “markers” in the blood that indicate their early development.

Ongoing research has also produced some promising treatment findings for both gum disease and inflammatory diseases, which also include osteoporosis, respiratory disease and rheumatoid arthritis. We’re now finding in many cases that treating one side of the disease connection can have positive effects on the other side. For example, diabetics who receive professional treatment for gum disease may see better blood sugar control.

With this in mind, the best approach is to practice effective, daily oral hygiene to reduce the risk of gum disease, coupled with regular office cleanings and checkups. Not only will this help you maintain optimum oral health, it may also contribute to better management of other conditions you may have.

If you would like more information on the relationship between periodontal (gum) disease and other diseases, 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 “Good Oral Health Leads to Better Health Overall.”