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Posts for tag: tooth decay

By Raul A. Montalvo, D.D.S.
June 12, 2020
Category: Oral Health
Tags: tooth decay  
NewAdvancesCouldRevolutionizeDecayTreatment

The basics for treating tooth decay have changed little since the father of modern dentistry Dr. G.V. Black developed them in the early 20th Century. Even though technical advances have streamlined treatment, our objectives are the same: remove any decayed material, prepare the cavity and then fill it.

This approach has endured because it works—dentists practicing it have preserved billions of teeth. But it has had one principle drawback: we often lose healthy tooth structure while removing decay. Although we preserve the tooth, its overall structure may be weaker.

But thanks to recent diagnostic and treatment advances we’re now preserving more of the tooth structure during treatment than ever before. On the diagnostic front enhanced x-ray technology and new magnification techniques are helping us find decay earlier when there’s less damaged material to remove and less risk to healthy structure.

Treating cavities has likewise improved with the increased use of air abrasion, an alternative to drilling. Emitting a concentrated stream of fine abrasive particles, air abrasion is mostly limited to treating small cavities. Even so, dentists using it say they’re removing less healthy tooth structure than with drilling.

While these current advances have already had a noticeable impact on decay treatment, there’s more to come. One in particular could dwarf every other advance with its impact: a tooth repairing itself through dentin regeneration.

This futuristic idea stems from a discovery by researchers at King’s College, London experimenting with Tideglusib, a medication for treating Alzheimer’s disease. The researchers placed tiny sponges soaked with the drug into holes drilled into mouse teeth. After a few weeks the holes had filled with dentin, produced by the teeth themselves.

Dentin regeneration isn’t new, but methods to date haven’t been able to produce enough dentin to repair a typical cavity. Tideglusib has proven more promising, and it’s already being used in clinical trials. If its development continues to progress, patients’ teeth may one day repair their own cavities without a filling.

Dr. Black’s enduring concepts continue to define tooth decay treatment. But developments now and on the horizon are transforming how we treat this disease in ways the father of modern dentistry couldn’t imagine.

If you would like more information on dental treatments for tooth decay, please contact us or schedule an appointment for a consultation.

By Raul A. Montalvo, D.D.S.
May 03, 2020
Category: Oral Health
Tags: oral hygiene   tooth decay  
5QuestionstoAskYourselfAboutYourRiskforToothDecay

Among our most common diseases, tooth decay can be a big problem at any age: in the U.S., one in four children 5 and under has some form of the disease, as well as ninety percent of those 60 and older — and a quarter of those have suffered complete tooth loss.

Fortunately, we now know what needs to be done on a regular basis to prevent tooth decay. Unfortunately, many are uninformed about all they need to do to lower their risk.

Here, then, are 5 questions to ask yourself to see if you’re on the right prevention path or not.

Do I brush and floss daily? If not, you’re aiding and abetting the “enemy” — bacteria that cause tooth decay. Bacteria that make up plaque feed on any food remnants that adhere to tooth surfaces. Brushing at least once daily (twice is better) removes plaque, while flossing removes plaque between teeth that can’t be reached with a brush. Removing plaque will lower your mouth’s acid levels that cause a loss of minerals to the enamel surface.

Do I use the proper techniques for brushing and flossing? While it’s important to establish daily hygiene habits, if you’re not performing them properly you won’t realize the full benefit from your efforts. But don’t dismay — we can train you in the proper techniques for brushing and flossing your teeth.

Do I use fluoride toothpaste? This naturally-occurring chemical strengthens tooth enamel and makes it more resistant to decay. You can increase fluoride’s absorption rate into enamel by using hygiene products that contain it.

Do I constantly snack between meals? Saliva neutralizes acid remaining in the mouth after eating in about 30 to 60 minutes. If you’re constantly snacking or sipping acidic beverages, however, saliva can’t do this effectively. It’s best to limit snacking to a few, specific times and restrict acidic beverages to meal time only.

Do I visit the dentist for cleanings and checkups? While brushing and flossing reduce plaque, it can’t remove it from hard-to-reach places below the gums or harder deposits (calculus) that have developed. A professional cleaning twice a year removes the plaque and calculus left from daily hygiene. We can also gauge the health of your teeth and determine if tooth decay or gum disease may be developing.

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 Raul A. Montalvo, D.D.S.
April 03, 2020
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 Raul A. Montalvo, D.D.S.
December 25, 2019
Category: Oral Health
Tags: nutrition   tooth decay   sugar  
LimitSugarinYourDietforBetterOralandGeneralHealth

Even after decades emphasizing oral hygiene and supplemental fluoride to fight dental disease, we’re now seeing an increase in tooth decay, especially among children. What’s causing this alarming trend?

Many in both the dental and medical professions link this and other health problems to a rise in the amount and consumption of sugar added to food products. A number of years ago our annual average consumption of added sugar was about 4 pounds per person; today, it’s closer to 90 pounds.

The increase in sugar consumption can be traced to the 1970s when the food industry began adding more sugar to make processed foods stripped of oils and fats taste better. Today, 77% of the approximately 600,000 food items sold in the United States contain some form of sugar (under a variety of names).

This additional sugar, however, has produced an unintended consequence: sugar triggers the release of a brain chemical called dopamine that regulates our sense of reward when we engage in a desirable behavior. The excess dopamine creates a weak addiction to sugar, which then leads to overconsumption, contributing to our current obesity epidemic and the rise in health problems like heart disease or Type 2 diabetes. This is especially alarming among children: thirty years ago Type 2 diabetes was unheard of among children — today there are over 55,000 diagnosed pediatric cases.

For both you and your family’s general and dental health, you should consider ways to reduce your sugar intake: purchase and eat most of your food from the “outer edges” of your supermarket — meats, dairy, and fresh vegetables and fruits (which do contain the sugar fructose, but are mostly fiber that slows the liver’s processing of the sugar); limit processed foods with added sugar, and learn to recognize its inclusion in products by reading ingredients labels. You should also be wary of sweetened beverages such as sodas, sports drinks, teas or juices, and try to drink more water.

The recommended daily sugar consumption is less than six teaspoons a day (about two-thirds the amount in one can of soda). By restricting this consumption, you’ll improve your general health and reduce your risk for dental disease.

If you would like more information on the general and dental health effects of sugar, please contact us or schedule an appointment for a consultation.

By Raul A. Montalvo, D.D.S.
August 27, 2019
Category: Oral Health
Tags: tooth decay  
YourReoccurringSinusInfectionsMayActuallyBeCausedbyToothDecay

If you suffer frequent sinus infections, you might want to talk with your dentist about it. It could be your chronic sinus problems stem from a deeply decayed or infected tooth.

Sinuses are hollow, air-filled spaces in the front of the skull associated with nasal passages. The largest, the maxillary sinuses, are located just behind the cheekbones and above and to the rear of the upper jaw on either side of the face. These sinuses can become painfully congested when infected.

One possible cause for an infection in the maxillary sinus can occur in certain people whose upper back teeth (the molars and premolars) have roots that are close to or even protrude into the sinus. This is normally a minor anatomical feature, unless such a tooth becomes infected.

An infection in teeth with advancing decay or whose nerve tissue has died will eventually reach the root tip through tiny passageways called root canals. If the roots are close to or penetrating the maxillary sinus, the infection could move into the sinus. This is known as Maxillary Sinusitis of Endodontic Origin (MSEO).

A case of MSEO could potentially go on for years with occasional flare-ups of sinus congestion or post-nasal drip. Because of the nature of the infection within the sinus, the affected tooth itself may not show the normal signs of infection like sensitivity or pain. Doctors may attempt to treat the sinus infection with antibiotics, but because the actual source of the infection is within the tooth, this therapy is often ineffective.

If your doctor or dentist suspects MSEO, they may refer you to an endodontist, a specialist in root canals and interior tooth problems. With their advanced diagnostic capabilities, endodontists may have a better chance of accurately diagnosing and locating the source of a tooth-related infection.

As with any non-vital tooth, the likely treatment will be root canal therapy in which the infected tissue within the tooth is removed and the empty spaces filled to prevent future infection. For MSEO, the treatment not only preserves the tooth but may also relieve the infection within the sinus.

If you would like more information on the possible dental causes to sinus problems, please contact us or schedule an appointment for a consultation.



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