By James E. Mikula D.D.S., P.C.
September 14, 2019
Category: Oral Health
Tags: oral health   tooth decay  
ToothHealThyselfMaySoonBeaReality

Although dental care has made incredible advances over the last century, the underlying approach to treating tooth decay has changed little. Today’s dentists treat a decayed tooth in much the same way as their counterparts from the early 20th Century: remove all decayed structure, prepare the tooth and fill the cavity.

Dentists still use that approach not only because of its effectiveness, but also because no other alternative has emerged to match it. But that may change in the not-too-distant future according to recent research.

A research team at Kings College, London has found that a drug called Tideglusib, used for treating Alzheimer’s disease, appears to also stimulate teeth to regrow some of its structure. The drug seemed to cause stem cells to produce dentin, one of the tooth’s main structural layers.

During experimentation, the researchers drilled holes in mouse teeth. They then placed within the holes tiny sponges soaked with Tideglusib. They found that within a matter of weeks the holes had filled with dentin produced by the teeth themselves.

Dentin regeneration isn’t a new phenomenon, but other occurrences of regrowth have only produced it in tiny amounts. The Kings College research, though, gives rise to the hope that stem cell stimulation could produce dentin on a much larger scale. If that proves out, our teeth may be able to create restorations by “filling themselves” that are much more durable and with possibly fewer complications.

As with any medical breakthrough, the practical application for this new discovery may be several years away. But because the medication responsible for dentin regeneration in these experiments with mouse teeth is already available and in use, the process toward an application with dental patients could be relatively short.

If so, a new biological approach to treating tooth decay may one day replace the time-tested filling method we currently use. One day, you won’t need a filling from a dentist—your teeth may do it for you.

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

By James E. Mikula D.D.S., P.C.
September 04, 2019
Category: Dental Procedures
Tags: dental cleaning  
YouNeedaDentisttoRemoveTartarFromYourTeeth

One of the key parts to an effective oral disease prevention plan is practicing daily oral hygiene to remove dental plaque. Both brushing and flossing are necessary for cleaning your teeth of this thin biofilm of bacteria and food particles most responsible for tooth decay and periodontal (gum) disease.

But as important as they are, these two essential hygiene tasks aren’t the end-all-be-all for lowering your disease risk. For the best protection, you should also visit your dentist at least twice a year for thorough dental cleanings. That’s because plaque you might have missed can turn into something much more difficult to remove: calculus.

Also known as tartar, calculus is hardened deposits of plaque. The term comes from the Latin word meaning “small stone,” an apt description of its texture on tooth surfaces. Although not the same as the branch of mathematics that bears the same name, both derive from the same Latin word: Merchants and traders centuries ago used small stones to “calculate” their various transactions.

Over time soft and pliable dental plaque hardens into calculus, in part due to a reaction with saliva. Because of the difficulty of accessing all tooth surfaces, calculus can form even if you have an effective daily hygiene practice.

Once formed, calculus can adhere to teeth so tenaciously, it’s impossible to remove it with brushing and flossing. But dentists and hygienists can remove calculus safely with special tools called scalers.

And it should be removed or it will continue to foster bacterial growth. This in turn increases the chances for infections that attack the teeth, gums or underlying bone. Keeping it under control will therefore diminish your risk for developing dental disease.

Although there are other factors like heredity that can affect your disease risk, keeping your mouth clean is the number one thing you can do to protect your teeth and gums. A daily hygiene practice and regular dental visits will help ensure plaque and its calcified form calculus won’t be a problem.

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

By James E. Mikula D.D.S., P.C.
August 25, 2019
Category: Dental Procedures
DontBreakItLikeBeckham

During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.

Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.

For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.

When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.

But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.

Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.

So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…

If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”

By James E. Mikula D.D.S., P.C.
August 15, 2019
Category: Oral Health
Tags: tooth decay   gum disease  
DontLetSummerHeatIncreaseYourRiskofDentalDisease

In many parts of the country, summer is often a synonym for "blast furnace" and can be downright hot and miserable. If you find yourself in such a climate, it's imperative that you drink plenty of water to beat both the heat and heat-related injuries. Your teeth and gums are another reason to keep hydrated during those hot summer months.

Your body needs water to produce all that saliva swishing around in your mouth. When you have less water available in your system, the production of this important bodily fluid can go down—and this can increase your risk of dental disease. That's because saliva performs a number of tasks that enhance dental health. It helps rinse the mouth of excess food particles after eating that could become a prime food source for disease-causing bacteria. It also contains antibodies that serve as the first line of defense against harmful microorganisms entering through the mouth.

Perhaps saliva's most important role, though, is protecting and strengthening enamel, the teeth's outer "armor" against disease. Although the strongest substance in the body, enamel has one principal foe: oral acid. If the mouth's normally neutral pH becomes too acidic, the minerals in enamel begin to soften and dissolve. In response, saliva neutralizes acid and re-mineralizes softened enamel.

Without a healthy salivary flow protecting the mouth in these different ways, the teeth and gums are vulnerable to assault from bacteria and acid. As they gain the upper hand, the risk for tooth decay or periodontal (gum) disease can skyrocket. Keeping yourself adequately hydrated ensures your body can produce an ample flow of saliva.

By the way, summer heat isn't the only cause for reduced saliva: Certain prescription medications may also interfere with its production. Chemotherapy and radiation, if targeting cancer near the head or neck, can damage salivary glands and impact flow as well.

If you have reduced saliva from medication you're taking, talk to your doctor about switching to an alternative prescription that doesn't affect saliva production. If you're undergoing cancer treatment, be extra vigilant about your oral hygiene practice and regular dental visits. And as with summer heat, be sure you're drinking plenty of water to help offset these other effects.

Even when it's hot, summertime should be a time for fun and relaxation. Don't let the heat ruin it—for your health or your smile.

If you would like more information about the oral health benefits of saliva and how to protect it, please contact us or schedule an appointment for a consultation.

By James E. Mikula D.D.S., P.C.
August 05, 2019
Category: Dental Procedures
Tags: crown  
AStainlessSteelCrownCouldExtendtheLifeofaPrimaryMolar

One of the key elements in a child’s development is their first set of teeth. Although primary (“baby”) teeth last only a few years, they’re critically important for enabling a child to eat solid foods, speak and smile.

But they also provide one more important benefit—they hold the space in the jaw reserved for the permanent teeth developing just under the gums until they erupt. But if a child loses a primary tooth prematurely because of disease or injury, other teeth may drift into the vacant space and crowd it out for the intended permanent tooth. It may then come in misaligned or remain stuck within the gums (impaction).

To avoid this, we try to treat and preserve a diseased primary tooth if at all practical. For a primary molar, one of the large teeth in the back of the mouth, this might include capping it with a stainless steel crown.

Why a metal crown? Primary molars normally don’t fall out until around ages 10-12, so it may be years for a younger child before their permanent molars erupt. All during that time these particular teeth will encounter heavier biting forces than teeth in the front.

A steel crown is often the best solution for a molar given their longer lifespans and encountered biting forces. The crown’s metal construction can stand up to these forces while still protecting the tooth from re-infection from decay. And because molars are typically outside of the “smile zone” occupied by more visible front teeth, the crown’s metal appearance isn’t usually an aesthetic issue.

Crowning a molar usually takes one visit, a dentist typically performing the procedure with local anesthesia and possibly a mild sedative like nitrous oxide gas (“laughing gas”). After removing any decayed structure from the tooth, the dentist will then fit a pre-formed crown over the remaining structure, sized and shaped to match the original tooth as close as possible.

A stainless steel crown is a cost-effective way to added needed years to a primary molar that could otherwise be lost prematurely. Preserving it may help a child avoid bite problems and expensive future treatments.

If you would like more information on dental care for 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 “Stainless Steel Crowns for Kids: A Safe and Effective Way to Restore Primary Molars.”





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