Scott R. Cayouette, DMD, FAGD
B. Thomas Kays, DDS

Dentist - Charleston

1040 Savannah Hwy, Charleston, SC 29407

(843) 556-8030
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Posts for tag: tooth decay

By Charleston Restorative & Cosmetic Dentistry, LLC
January 20, 2019
Category: Oral Health
Tags: tooth decay  
TheTaleoftheToothworm

Ever wonder just exactly what causes cavities? Once upon a time, “Toothworms” — miniscule, yet relentless pests — were thought to be responsible for this widespread malady. This belief persisted from ancient times through the 17th Century; William Shakespeare even made reference to the baneful beasts in his play Much Ado about Nothing. (“What, sigh for a toothache? [It] is but a humor or a worm.”) Today, however, we know why no one ever observed an honest-to-goodness toothworm: it’s because they’re much too tiny to see with the naked eye.

Actually, it isn’t worms, but much smaller organisms that cause tooth decay. These harmful plaque bacteria (along with many helpful microorganisms) live in the mouth, and build up on surfaces of the teeth when they aren’t cleaned properly. They feed on sugar in the diet, and release substances that erode tooth enamel, which causes small holes called cavities. Cavities, in turn, are what’s responsible for most toothaches.

While we may scoff at old legends, one fact remains: Even today, according to the National Institutes of Health, tooth decay is the number one chronic disease of both children and adults; and it’s almost entirely preventable. We can’t blame it on toothworms — but what can we do about it?

Glad you asked! The best way to avoid decay is through prevention. That means brushing your teeth twice a day with a fluoride toothpaste, and flossing them every day. It also means eating a balanced diet and avoiding acidic and sugary foods — like soda, some juices, and sweet, sticky snacks. If you do consume these types of foods, limit them to mealtimes; that gives your saliva enough time in between to neutralize the acids naturally. And, of course, make an appointment see us twice a year for a complete check-up and professional cleaning.

If you do begin to notice the symptoms of tooth decay (toothache, for example) it’s important to come in to the dental office right away, so we can treat the problem before it gets worse. Prompt action can often help save a tooth that might otherwise be lost. Besides filling the cavity, we may be also able to recommend ways to help prevent the disease from affecting other teeth. And if you need a more extensive procedure to relieve the problem — such as a root canal — we can make sure you get the appropriate treatment.

We’ve come a long way since the “toothworm” days — but we can still do a lot more to make tooth decay a thing of the past.

If you would like more information about tooth decay and cavity prevention, please contact us or schedule an appointment. You can learn more in the Dear Doctor magazine article “Tooth Decay — The World’s Oldest & Most Widespread Disease” and “Tooth Decay — How To Assess Your Risk.”

By Charleston Restorative & Cosmetic Dentistry, LLC
November 01, 2018
Category: Oral Health
Tags: oral hygiene   tooth decay  
BeyondBrushingandFlossingConsiderOtherRiskFactorsforToothDecay

Tooth decay is a primary cause of tooth damage and loss, with annual treatment costs in the billions of dollars. It arises mainly from oral bacteria, which proliferates in the absence of effective oral hygiene. There are, however, other risk factors besides poor hygiene that could make you more susceptible to this disease.

Many people, for example, have genetically inherited deeper grooves (fissures) and depressions (pits) than the average tooth anatomy. These may be harder to reach with a toothbrush and can become havens for bacterial plaque. Others may have health conditions that indirectly affect the mouth: bulimia or anorexia, psychological conditions that involve self-induced vomiting, or GERD, gastro-esophageal reflux disease, in which stomach acid could regurgitate into the mouth. These conditions could result in a highly acidic mouth environment.

Some medical and — ironically — dental treatments could also increase your tooth decay risk. Some medications can reduce saliva flow, which inhibits acid neutralization and re-mineralization of enamel. Retainers, braces, bite guards or other dental appliances may also reduce the saliva wash over teeth, and can make brushing and flossing more difficult.

There are also risk factors that result from our lifestyle choices. Eating a lot of foods rich in sugars and other carbohydrates, for example, or acidic beverages like soda, energy or sports drinks contributes to the rise of bacteria in our mouths.

There are ways to reduce the effects of these risk factors. In addition to a daily habit of effective brushing and flossing, you should also include semi-annual cleanings and checkups at our office a part of your routine. If you have genetic, medical or dental issues that are out of your control, we can discuss solutions, such as alternatives to medications or different techniques for cleaning around dental appliances. For lifestyle-related factors, you should consider removing the habit or modifying it: for example, snacking at specific times or drinking acidic beverages only at mealtime.

While tooth decay is a serious, destructive disease, it is highly preventable. Addressing all your risk factors, not just hygiene, will reduce your chances of having it.

If you would like more information on tooth decay prevention, 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 “Tooth Decay: How to Assess Your Risk.”

By Charleston Restorative & Cosmetic Dentistry, LLC
October 22, 2018
Category: Dental Procedures
Tags: tooth decay   gum disease  
StopRootCavitieswithPreventionandPromptTreatment

Tooth decay is a highly destructive dental disease, responsible along with periodontal (gum) disease for most adult tooth loss. And we become even more susceptible to it as we get older.

One form of decay that’s especially prominent among senior adults is a root cavity. Similar to a cavity in the crown (visible tooth), this form instead occurs at or below the gum line in the roots. They happen mainly because the roots have become exposed due to gum recession, a common consequence of periodontal (gum) disease and/or brushing too hard.

Exposed roots are extremely vulnerable to disease because they don’t have the benefit of protective enamel like the tooth crown, covered instead with a thin and less protective mineral-like material called cementum. Normally, that’s not a problem because the gums that would normally cover them offer the bulk of the protection. But with the gums receded, the roots must depend on the less-effective cementum for protection against disease.

Although we treat root cavities in a similar way to those in the crown by removing decayed structure and then filling them, there’s often an added difficulty in accessing them below the gum line. Because of its location we may need to surgically enter through the gums to reach the cavity. This can increase the effort and expense to treat them.

It’s best then to prevent them if at all possible. This means practicing daily brushing and flossing to remove bacterial plaque, the thin, built-up biofilm on teeth most responsible for both tooth decay and gum disease. You should also visit your dentist at least twice a year for professional cleanings and advanced prevention methods like topical fluoride to strengthen any at-risk teeth.

You should also seek immediate treatment at the first sign of gum disease to help prevent gum recession. Even if it has occurred, treating the overall disease could help renew gum attachment. We may also need to support tissue regeneration with grafting surgery.

Root cavities are a serious matter that could lead to tooth loss. But by practicing prevention and getting prompt treatment for any dental disease, you can stop them from destroying your smile.

If you would like more information on diagnosing and treating root cavities, 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.”

By Charleston Restorative & Cosmetic Dentistry, LLC
June 24, 2018
Category: Dental Procedures
Tags: tooth decay   crowns  
ACrownCouldbetheAnswertoPreservingYourDamagedTooth

We’ve been treating one of your decay-prone teeth for some time with one filling after another. Each incident required a little more removal of decayed tooth material until now there isn’t enough structure to support another filling.

We could remove the tooth and replace it with a bridge or a dental implant, both viable restoration options. But keeping the tooth if possible would be more beneficial in the long-run for your gums, bone and remaining teeth. If it still has a healthy and stable root, it’s possible to permanently cover or “cap” the tooth with a life-like crown.

Crowns have been used for decades: the first were mainly composed of metal like gold or silver and later dental porcelain, a ceramic material that could be molded, shaped and oven-fired to resemble a real tooth. The earliest porcelains, though, were brittle, so a hybrid with a metal interior for strength and a fused exterior porcelain layer for appearance came into prominence.

Today, advances in materials have led to all-porcelain crowns strong enough to withstand biting forces. While the metal-porcelain hybrid still account for about 40% of crowns installed annually, the all-porcelain types are steadily growing in popularity.

Regardless of the type, though, the process for fitting any crown is relatively the same. The first step is to reshape the affected tooth so that the future crown will fit over it, followed by an impression mold of the tooth a dental technician will use to form a custom crown. Once the new crown has been prepared, we then permanently bond it to the tooth.

With a crown, you’ll be able to enjoy normal function and have a tooth that looks as healthy and normal as its neighbors. Be aware, though, that your underlying tooth is still subject to decay — so diligent, daily hygiene and regular dental visits are a must. With proper care your newly crowned tooth can continue to serve you and your smile for many years to come.

If you would like more information on dental restoration options, 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 Charleston Restorative & Cosmetic Dentistry, LLC
November 23, 2017
Category: Oral Health
Tags: tooth decay  
ToothDecaycanbeLessofaProblemwithMinimallyInvasiveDentistry

“Less is more” is a truism for much of life. It’s also an important feature of an emerging approach to treating tooth decay known as minimally invasive dentistry (MID).

MID updates another revolution in dental care that occurred in the early 1900s. Treating decay took a quantum leap thanks to techniques developed by Dr. G. V. Black, considered the father of modern dentistry. Dr. Black’s approach (known as “extension for prevention”) involved not only removing decayed tooth structure, but also adjacent areas deemed vulnerable to decay, which made them easier to clean. On the downside, though, it also created larger than normal fillings.

As the practice prevailed through much of the Twentieth Century another weakness became apparent—the approach could not guarantee a treated tooth would not experience decay again. This became the real impetus toward MID—to find more comprehensive ways to treat decay with as little impact on the tooth structure as possible.

These efforts received a real boost from emerging technology. This was especially true in diagnostics with the rise of new devices like intraoral cameras and techniques like laser fluorescence that can enable dentists to detect decay much earlier. It’s now possible to catch the disease at an earlier stage before substantial damage to the tooth occurs.

MID has also led to new treatments that preserve more of the tooth structure. Traditional drilling is increasingly giving way to air abrasion, the use of a fine particle stream of aluminum oxide, glass beads or baking soda directed precisely at decayed structure and minimizing damage to healthy structure. We’re also using new filling materials like composite resin for restorations after treatment that are strong yet still life-like and attractive.

We also can’t forget the role of the twin daily hygiene practices brushing and flossing to remove bacterial plaque, the main source of dental disease. And regular dental cleanings and checkups round out the MID approach, helping to ensure that decay doesn’t get too far. The end result of this revolutionary approach: your teeth can experience less impact from treatment and remain healthier and more attractive in the long-run.

If you would like more information on minimally invasive dental care, 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.”