The American Academy of Pediatric Dentistry (AAPD) suggests that a child go to the dentist by one year or about 6 months after the first baby tooth erupts into the mouth. The first baby tooth usually erupts at around 6 months. This first visit is usually easy and quick. The child stays on the parent’s lap and the dentist just peaks around to see if any problems are developing.
A cavity, literally a hole in the tooth, is caused by the acid released by certain bacteria on the teeth that consume sugar. “Sugar causes cavities,” is a shorthand way of saying this but it is not directly the sugar that is the problem. If you removed all the harmful bacteria in the mouth, you would not get cavities! This is why daily flossing and brushing is so important.
When a cavity, literally a hole in the tooth, reaches the softer inner part of the tooth called dentin, it will always progress and get bigger. A filling removes the bacterial and dead tooth structure from the cavity and replaces the missing part of the tooth with a dental filling material. In the past, mercury-silver amalgam was most common filling material. More recently, composite material is often used because it is much more esthetic than mercury-silver fillings.
A crown is used to hole a tooth together when it is weak from decay or large fillings. A weak tooth can crumble or break apart. A crown fits over the tooth like a thimble fits over your finger. Just like a thimble on your finger, the crown protects the tooth from the forces of biting and chewing.
Fluoride is a natural element that makes the teeth harder and so more resistant to decay. Fluoride naturally occurs in the water in many areas but where the fluoride is at a low level, in many areas supplemental fluoride is added to the drinking water. Even with the use of fluoride toothpaste, mouthwash, and dentist-applied fluoride, optimal water fluoridation reduces children’s tooth decay by up to 40% and adult’s tooth decay by about 35%.
The inside of a tooth is hollow. This is the space that contains the nerve and blood vessels that are important when the tooth forms. Unfortunately, when a deep cavity reaches these nerves and blood vessels in the tooth, it causes an infection (and often pain). This infection, called an abscess, can spread out of the tooth and into the gums, bone, and other parts of the mouth. A root canal is a procedure that removes all the infection inside the tooth and tooth root. A filling, usually using a material called gutta percha, is sealed into the space previously occupied by the nerves and blood vessels. The only alternative to a root canal for an infected tooth is to extract the tooth. So, a root canal treats the infection and abscess and allows the tooth to be preserved rather than extracted.
A dental implant is a round cylinder, usually made from titanium alloy, that is placed in the jawbone and acts an “artificial tooth root.” Just as with a natural tooth root, an implant can be used to support the replacement of a single missing tooth or several missing teeth. For example, when one missing tooth is replaced, an implant is placed where the natural tooth root used to be, then a crown is placed on top of the implant. When several or all the teeth are missing, two to eight implants can be placed to secure either a removable partial or full denture. In some cases, four to eight implants can be used to hold a fixed, non-removable bridge, eliminating the need for a full denture.
Silver diamine fluoride, or “SDF,” is a clear liquid that can be placed on teeth by a dentist or hygienist to reduce tooth sensitivity or to slow or completely stop cavities. SDF has been used for 50 years in Japan and has been used in this country for about 10 years. SDF does not fill up the hole created by a cavity but it can stop the progression of the cavity so it does not get deeper. SDF is sometimes used to treat cavities in young children who would be very difficult to treat with conventional dental fillings. It can also be used in adults, especially seniors, to stop cavities without “Novocain,“ fillings, or crowns.
When the bacteria around the necks of the teeth at the gumline is there for more than 24 hours, it begins to absorb calcium from the saliva and gets very hard. The hard substance, like a barnacle on a ship, is called tartar or calculus. You cannot remove calculus with a toothbrush – it is too hard! With time, the calculus “grows” down under the gums of the root of the tooth. This creates a “pocket” below the gums. Because the calculus contains millions of bacteria, it causes a gum infection that makes the pocket deeper and destroys the bone holding the tooth. If the calculus is not removed from the pocket, eventually bone is lost and subsequently the tooth is lost. A “deep cleaning,” also called “scaling and root planing,” is the treatment performed by a dentist or hygienist to remove the calculus and infection from these pockets. Deep cleaning is the most conservative and inexpensive way to treat the infected pockets around teeth.