By Robert Rousseau DMD
January 17, 2019
Category: Oral Health
Tags: tooth decay  
HowaNewApproachtoTreatingDecayCouldBenefitYou

Dental caries (tooth decay) is a leading cause of tooth loss. But with prompt diagnosis and care we can often stop it before it causes too much damage.

The traditional treatment approach is simple: remove all diseased tooth structure and then restore the tooth with a filling. But this otherwise effective treatment has one drawback: you may lose significant healthy structure to accommodate a suitable filling or to make vulnerable areas easier to clean from bacterial plaque.

That's why a new treatment approach called minimally invasive dentistry (MID) is becoming more common. The goal of MID is to remove as little of a tooth's natural enamel and dentin as possible. This leaves the treated tooth stronger and healthier, and could reduce long-term dental costs too.

Here's how MID could change your future dental care.

Better risk assessment. MID includes a treatment protocol called caries management by risk assessment (CAMBRA). With CAMBRA, we evaluate your individual tooth decay risk, including oral bacteria levels, the quality of saliva flow to neutralize mouth acid, and sugar consumption. We then use our findings to customize a treatment plan that targets your areas of highest risk.

New detection methods. The real key to fighting tooth decay is to find it before it can destroy tooth structure with the help of new diagnostic technology. Besides advances in x-ray imaging that provide better views with less radiation exposure, we're also using powerful dental microscopes, lasers and infrared photography to show us more about your teeth than we can see with the naked eye.

"Less is More" treatments. In contrast to the dental drill, many dentists are now using air abrasion rather than a dental drill to remove decayed tooth material. Air abrasion emits tiny material particles within a pressurized air stream that leaves more healthy tooth structure intact than with drilling. We're also using new filling materials like composite resin that not only resemble natural tooth color, but require less structural removal than other types of fillings.

Using MID, we can treat tooth decay while preserving more of your natural teeth. This promises better long-term outcomes for future dental health.

If you would like more information on new treatments for 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 “Minimally Invasive Dentistry: When Less Care is More.”

By Robert Rousseau DMD
January 07, 2019
Category: Dental Procedures
Tags: dental implants  
DentalImplantsBetterthanEverthankstoOngoingTechAdvances

While many people still consider dental implants the "new kids on the block" in dental restoration, they're now in their fourth decade of use. And since their inception implant technology has continued to improve and revolutionize how we replace missing teeth.

Implants are a different "species" compared to other restoration methods. To be precise, an implant is a tooth root replacement—usually a titanium metal post imbedded directly into the jaw bone. Titanium is not only a biocompatible metal, but bone cells naturally grow on its surface to create a strong and durable hold. It's this secure hold that's most responsible for implants' high long-term success rate.

But we should also credit some of this success to the steady stream of advances over the years in implant construction and supporting technologies. For one thing, we're now more accurate and precise with implant placement thanks to advances in computer tomography (CT) and cone beam CT (CBCT) scanning.

These digital processes merge a series of images taken by a special camera to form a three-dimensional model of the jaw. We can manipulate this model on a computer monitor to view it from different vantage points. It can help us locate and avoid anatomical structures like nerves and sinuses when determining where to place a future implant. CT and CBCT are especially useful when there's a concern about adequate available bone, a necessity for stable implants.

Technology has also improved how we create surgical guides, often used during implant surgery to obtain the most accurate results. Surgical guides are custom-made devices that fit over the teeth with the drilling locations for the implants marked on them. Recent advances in 3-D printing have made these guides even more accurate so that they fit more securely in the mouth. This greater stability increases their accuracy during the drilling sequence during surgery.

These and other advances are helping ensure every implant is a success story. The end result is both a functional restoration and a beautiful smile.

If you would like more information on dental implants, 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 “How Technology Aids Dental Implant Therapy.”

By Robert Rousseau DMD
December 28, 2018
Category: Dental Procedures
Tags: dental implants  
YourTeenagermayneedtoWaitonanImplantforaMissingTooth

Waiting is part of life for a teenager: waiting to get a driver’s license, to graduate high school or to leave home and stretch their wings. A teenager with lost teeth may also need to wait until they’re older to obtain dental implants.

The reason arises from the differences in how implants and natural teeth attach to the jaw. Although natural teeth may seem rigidly set in the bone, they’re actually held in place by an elastic tissue between them and the bone known as the periodontal ligament. Tiny filaments that attach to the teeth on one side and the bone on the other hold the teeth in place, but also allow the teeth to move gradually in response to mouth changes.

A titanium implant post doesn’t have this relationship with the periodontal ligament — it’s attached directly to the jaw bone. Over time the bone, which has a special affinity with titanium, grows and adheres to it to form a durable bond without an attachment to the periodontal ligament. Because of this the implant can’t move like a natural tooth.

This is extremely important for implant placement because the jaws in particular won’t fully develop in most people until their late teens or early twenties: the upper jaw in particular will tend to grow out and down. Natural teeth accommodate to these changes, but the implant can’t — it will appear to retreat into the jaw. The gum tissues surrounding the implant also won’t conform to the continuing growth and may appear receded.

The best approach is to choose a temporary replacement option until the jaws and other facial bone structures have finished growing. One example is a bonded bridge in which we use a bonding agent to attach a bridge of artificial teeth to teeth on either side of a missing tooth — bonding won’t permanently alter them as with a traditional bridge. Once the jaws have finished growing, we can remove the bonded bridge and install the more permanent implant.

Ask any teenager: waiting can be hard. But with dental implants, waiting until the right time will help ensure the attractive result is a permanent one.

If you would like more information on dental restorations and teenagers, 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 “Teenagers & Dental Implants.”

SteelyDanFoundersDeathHighlightsImportanceofEarlyCancerDetection

Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.

As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.

Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.

Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.

Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome. If you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”

By Robert Rousseau DMD
December 08, 2018
Category: Oral Health
Tags: oral health  
TheTop3OralProblemsinAmerica-andWhatYouShouldDoAboutThem

The Health Policy Institute, part of the American Dental Association, recently conducted a survey of around 15,000 people across the U.S., asking them about problems with their teeth and gums. Three issues in particular stood out, each affecting about one-third of those surveyed.

Here are those top 3 dental problems that plague Americans and what to do about them.

Tooth Pain. As with other parts of the body, tooth or mouth pain is a sign of something wrong — in some instances ignoring it could lead to tooth loss. Because there are a number of possible pain sources like tooth decay or periodontal (gum) disease, anyone with tooth pain should see a dentist for an examination to pinpoint the actual cause. That will determine what kind of treatment will remedy the problem and stop the pain.

Difficulty with Chewing. For 31% in the ADA survey, chewing food was a difficult and often painful task. The consequences go well beyond the mouth: with less chewing efficiency a person may be unable to eat certain foods that supply his or her body with essential nutrients. Like tooth pain, there are a number of possible causes: cracked or deeply decayed teeth, enamel erosion or recessed gums that have exposed sensitive tooth layers, or poorly fitted dentures. Finding and then treating the cause of the difficulty could help restore chewing ability.

Dry Mouth. The most prevalent dental issue in the survey was chronic dry mouth. It's more than simply being thirsty: chronic dry mouth usually stems from inadequate saliva flow. It's often caused by some systemic diseases or as a side effect to a prescription drug. Saliva helps neutralize decay-causing acid and supplies antibodies to fight infection. Without sufficient flow a person is more susceptible to diseases like tooth decay and periodontal (gum) disease. Changing medications or using products to increase saliva could help prevent these dental problems.

So, have you experienced symptoms for any these common oral health problems? If you have, be sure you see your dentist as soon as possible for diagnosis and treatment.

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





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