First, it is important to realize what causes cavities. Cavities are caused by acid that is excreted by bacteria in your mouth. The plaque and tartar that collect on your teeth are actually colonies of bacteria. This bacteria feeds on sugars and carbohydrates. The waste by-product of these cavity producing bacteria is acid that demineralizes the tooth surface which can lead to a full blown cavity or hole in the tooth.
When teeth are decayed, it is necessary to repair the tooth with either a filling or crown (cap), depending on the amount of damage.
The long term challenge is preventing the teeth from getting cavities again. It is common to find new cavities around existing fillings and crowns. The picture below shows the progression of tooth decay. The teeth on the left are healthy and the further you look to the right the more damage has occurred.
The traditional methods for preventing tooth decay have focused on removing the bacteria from the teeth and hardening the outer tooth enamel with fluoride. These methods include brushing, flossing, and professional teeth cleanings. It is important to note that these methods still apply and are very important.
The challenge is that these bacteria attach to the teeth again shortly after they are removed and continue to produce the decay-causing acid.
Here is an analogy that I hope will make sense: Imagine you have termites destroying your home. If you killed only the termites that you could see, and then went ahead and repaired the damage, you would still have the problem of having termites. Other termites are still lurking in areas that you cannot see. The logical solution would be gettig rid of all the termites first, and then repairing the damage.
Treating teeth is very similar. If we just repair the damage without getting rid of the harmful bacteria we have not truly solved the decay problem. So what can be done?
At our office we use CAMBRA (Caries Management by Risk Assessment ) as a way of preventing cavities and treating early cavities before they need surgical removal and restorations like fillings or crowns. We use a series of steps to evaluate the current dental disease and determine risk factors that can lead to future cavities.
When evaluating your mouth, we do a full dental exam and use a very easy and painless test to determine the level of acid producing bacteria on your teeth. A special cotton swab is rubbed along the teeth and then put into a testing meter. In less than a minute we get the results that tell us the level of harmful bacteria that are present.
If you are determined to be high risk for dental decay, we use a system developed by a company called Carifree to treat the bacterial infection. The products are designed to kill the harmful bacteria and create an environment in your mouth where only healthy bacteria can live. In three months we test the bacteria again to make sure the treatment was successful. Once the bacteria levels are determined to be healthy, a maintenance mouth rinse is then used to keep the bacterial levels within the healthy range.
So what does this mean to you as a patient? It is well known that preventing disease is much less expensive that treating disease. By adding this service we are confident we can keep your teeth healthy for a lifetime. It is now clear that you cannot brush or floss this disease away, and that different techniques and protocols are needed.
Keep Smiling,
Dr. Clint Euse
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