Posts for tag: tooth decay

By Baker Family Dentistry
August 11, 2019
Category: Oral Health
Tags: tooth decay  
IfYoureOlderbeontheLookoutforRootCavities

Tooth decay is a destructive oral disease, which along with periodontal (gum) disease is most responsible for tooth loss. And as you age, your disease risk goes up.

One form of decay older people often experience is root cavities. Unlike those occurring in the visible crown, root cavities often occur below the gum line and are especially destructive to tooth structure.

That's because, unlike the crown protected by ultra-hard enamel, the roots are covered by a thin, mineralized material called cementum. Although cementum offers some protection, it can't compare with the decay-resistant capacity of enamel.

The roots also depend on gum coverage for protection. But unfortunately, the gums can shrink back or recede, usually due to gum disease or over-aggressive brushing, and expose some of the root surface. With only the cementum to protect them, the roots can become highly susceptible to decay. If a cavity forms here, it can rapidly advance into the tooth's interior, the pulp, weakening the tooth and increasing its risk of loss.

To stop the decay, we must treat root cavities much like we do with crown cavities: by removing any decayed structure and then filling the cavity. But root cavities are often more difficult to access depending on how far below the gum line they extend. We may need to perform minor gum surgery to expose the cavity to treat it.

But as with any form of tooth decay, the best strategy is to prevent root cavities in the first place. Your first line of defense is a daily hygiene habit of brushing and flossing to remove dental plaque, the main cause for tooth decay. You should also visit your dentist at least twice a year (or more, if recommended) for more thorough cleanings and checkups. Your dentist can also recommend or prescribe preventive rinses, or apply fluoride to at-risk tooth surfaces to strengthen them.

You should also be on the lookout for any signs of gum disease. If you see swollen, reddened or bleeding gums, see your dentist as soon as possible. Stopping possible gum recession will further reduce your risk of root cavities.

If you would like more information on the prevention and treatment of 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 “Root Cavities: Tooth Decay Near the Gum Line Affects Many Older Adults.”

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.”



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Baker Family Dentistry

305 S Oakland Ave Carbondale, IL 62901