My Blog
By Aaron S. Berger, DMD
October 21, 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.”

RussellWilsonsFunnyVideoAsideRemovingWisdomTeethisNoLaughingMatter

There are plenty of hilarious videos of groggy patients coming out of wisdom teeth surgery to keep you occupied for hours. While many of these have turned everyday people into viral video stars, every now and then it really is someone famous. Recently, that someone was Seattle Seahawks quarterback Russell Wilson.

The NFL star underwent oral surgery to remove all four of his third molars (aka wisdom teeth). His wife, performer and supermodel, Ciara, caught him on video as he was wheeled to recovery and later uploaded the clip to Instagram. As post-wisdom teeth videos go, Wilson didn't say anything too embarrassing other than, "My lips hurt."

Funny videos aside, though, removing wisdom teeth is a serious matter. Typically, the third molars are the last permanent teeth to erupt, and commonly arrive late onto a jaw already crowded with other teeth. This increases their chances of erupting out of alignment or not erupting at all, remaining completely or partially submerged within the gums.

This latter condition, impaction, can put pressure on the roots of adjacent teeth, can cause abnormal tooth movement resulting in a poor bite, or can increase the risk of dental disease. For that reason, it has been a common practice to remove wisdom teeth preemptively, even if they aren't showing any obvious signs of disease.

In recent years, though, dentists have become increasingly nuanced in making that decision. Many will now leave wisdom teeth be if they have erupted fully and are in proper alignment, and they don't appear to be diseased or causing problems for other teeth.

The best way to make the right decision is to closely monitor the development of wisdom teeth throughout childhood and adolescence. If signs of any problems begin to emerge, it may become prudent to remove them, usually between the ages of 16 and 25. Because of their location and root system, wisdom teeth are usually removed by an oral surgeon through one of the most common surgeries performed each year.

This underscores the need for children to see a dentist regularly, beginning no later than their first birthday. It's also a good idea for a child to undergo an orthodontic evaluation around age 6. Both of these types of exams can prove helpful in deciding on what to do about the wisdom teeth, depending on the individual case.

After careful monitoring throughout childhood and adolescence, the best decision might be to remove them.  If so, take it from Russell Wilson: It's worth becoming the star of a funny video to protect both current and future dental health.

If you would like more information about wisdom teeth removal, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth.”

By Aaron S. Berger, DMD
October 01, 2021
Category: Dental Procedures
Tags: crowns   bridgework  
AreImplantsaNo-GoforYouConsiderTheseOtherRestorationOptions

Our primary aim as dentists is to preserve teeth. There are times, however, when preserving a tooth is no longer worth the effort and we must recommend removing it. Fortunately, extracted teeth can be replaced with a functional and attractive restoration.

Today's top tooth-replacement option is the dental implant. Composed of a titanium metal post imbedded into the jawbone, a single dental implant can replace an individual tooth or a series of implants can support other restorations for multiple teeth. Besides being incredibly life-like, dental implants are highly durable and can last for decades.

But dental implants aren't an optimal choice for everyone. Their cost often matches their status as the premier tooth replacement method. And because they require a minimum amount of bone for proper implantation, they're not always feasible for patients with extensive bone loss.

But even if dental implants aren't right for you, and you want a fixed restoration rather than dentures, you still have options. What's more, they've been around for decades!

One is a bonded crown, which works particularly well for a tooth excessively damaged by decay, excessive wear or fractures. After removing all of the damaged portions and shaping the remaining tooth, we cement a life-like crown, custom created for that particular tooth, over the remaining structure.

Besides improving appearance, a crown also protects the tooth and restores its function. One thing to remember, though, is although the crown itself is impervious to disease, the remainder of the natural tooth isn't. It's important then to brush and floss around crowned teeth like any other tooth and see a dentist regularly for cleanings.

Dental bridges are a fixed solution for extracted teeth. It's composed of prosthetic teeth to replace those missing bonded together with supporting crowns on both ends. These crowned teeth are known as abutments, and, depending on how many teeth are being replaced, we may need to increase the number of abutments to support the bridge.

Although durable, crowns or bridges typically don't match the longevity of an implant. And, implants don't require the permanent alteration of support teeth as is necessary with a bridge. But when the choice of implants isn't on the table, these traditional restorations can be an effective dental solution.

If you would like more information on crown or bridge restorations, 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 “Crowns & Bridgework.”

By Aaron S. Berger, DMD
September 21, 2021
Category: Oral Health
Tags: oral hygiene  
DentalHygieneandCareCriticalDuringCancerTreatment

After months or even years of radiation or chemotherapy, the words "cancer-free" is music to your ears. Your joy and relief, though, may be tempered by the toll these treatments can take on the rest of your body—including your mouth.

Both of these treatments can destroy healthy tissue along with targeted cancer cells. If the focus has been on the head and neck regions, they could damage the salivary glands to the point that they won't produce adequate saliva flow.

A lack of saliva can have a detrimental effect on your oral health. Saliva buffers and helps lower oral acid levels that soften and erode enamel and increase the likelihood of tooth decay. Saliva also supplies antibodies that fight disease-causing bacteria. Otherwise, bacteria—and the risk for disease—can rapidly grow.

If these or other scenarios occur, you may experience dental damage, even tooth loss. Fortunately, we can restore an injured smile in various ways, including dentures, bridges or dental implants. But we should also attempt to limit the potential damage by taking steps to prevent dental disease during cancer treatment.

The most important of these is to brush and floss daily. Everyone should practice these hygiene tasks to remove disease-causing dental plaque, regardless of their health status. But because some natural disease-fighting mechanisms in the mouth may be disrupted during either radiation or chemotherapy, it's even more important if you're a cancer patient.

It's equally important to maintain as much as possible regular dental visits during cancer treatment. Dental cleanings provided during these visits remove any residual plaque and tartar (hardened plaque), which further lowers your disease risk.

Your dentist can better monitor your overall dental condition during frequent visits and provide as much treatment as you can tolerate. They can also enhance your protection against disease by prescribing antibacterial mouthrinses, fluoride applications or products to boost saliva production.

Some teeth and gum problems may be unavoidable; in that case, you may need post-treatment dental care to restore your oral health as needed. But caring as much for your dental health as you're able during cancer treatment could help you realize a better outcome.

If you would like more information on dental care during cancer treatment, please contact us or schedule an appointment for a consultation.

By Aaron S. Berger, DMD
September 11, 2021
Category: Oral Health
Tags: teeth grinding  
KeepaWatchfulEyeonYourChildsTeethGrindingHabit

More than one parent has wakened in the middle of the night to an unnerving sound emanating from their child's bedroom. Although it might seem like something from the latest horror flick is romping around in there, all that racket has a down-to-earth cause: teeth grinding.

Teeth grinding is the involuntary habit of gnashing the teeth together when not engaged in normal functions like eating or speaking. It can occur at any time, but frequently with children while they sleep. Adults may also grind their teeth, but it's more prevalent among children.

While stress seems to be the main reason for adult teeth grinding, many health providers believe the habit in children is most often caused by an overreactive response of the neuromuscular system for chewing, which may be immature. Other conditions like asthma, sleep apnea or drug use may also play a role.

Fortunately, there doesn't appear to be any lasting harm from young children grinding their teeth, although they may encounter problems like headaches, earaches or jaw pain in the short term. Most, though, will outgrow the habit and be no worse for wear.

But if it persists beyond childhood, problems can escalate. Adults run the risk of serious cumulative issues like chronic jaw pain, accelerated tooth wear or tooth fracturing. It's similar to finger sucking, a nearly universal habit among young children that poses no real harm unless it persists later in life.

And as with finger sucking, parents should follow a similar strategy of carefully monitoring their child's teeth grinding. If the habit continues into later childhood or adolescence, or noticeable problems like those mentioned previously begin to appear, it may be time to intervene.

Such intervention may initially include diagnosis and treatment for underlying problems like upper airway obstruction, asthma or stress. For short term protection against dental damage, your dentist can also fashion a custom mouthguard for your child to wear while they sleep. Made of pliable plastic, the guard prevents the teeth from making solid contact with each other during a grinding episode.

Outside of some lost sleep, there's little cause for alarm if your child grinds their teeth. But if it seems to go on longer than it should, you can take action to protect their long-term dental health.

If you would like more information on teeth grinding, 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.”





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