Posts for: May, 2020

By Randall J. Bartoe, DDS, PLC
May 21, 2020
Category: Oral Health
Tags: oral health  
FriendlyBacteriaCanHelpProtectOurMouthsFromDisease

If you know anything about dental disease, then you know bacteria ranks high on the Usual Suspects list. Tooth decay gets its start from acid produced by bacteria; periodontal (gum) disease is often triggered by bacteria that infect the gums.

But the particular strains of bacteria that can cause dental disease are a small percentage of the 10,000-plus species inhabiting your mouth. The rest, numbering in the millions, are fairly benign—and some, as recent research is now showing, play a sizeable role in protecting your teeth and gums against other malicious bacteria, fungi and viruses.

Dr. Aaron Weinberg, a dental researcher at Case Western Reserve University, has been investigating these protective bacteria for many years. His research began with a scientific conundrum: although the mouth has one of the highest densities of bacterial populations, wounds in the mouth tend to heal quickly.

The answer, he believes, originates with human beta defensins (hBDs), substances produced by cells in the lining of the mouth that are natural antibiotics against disease. He has found that certain bacteria actually help stimulate their production.

This isn't just an interesting fact about the body's defenses and immune system. During his research, Dr. Weinberg was able to identify the agent within the bacteria that triggered hBD production. This has opened up a new line of research: The possibility that harnessing this agent might help assist in our treatment of infection by boosting the body's defensive capabilities.

For example, researchers have proposed including a form of the agent in toothpaste. Over time, this might stimulate hBD production and guard the mouth against the development of dental diseases like gum disease.

These possibilities all come from our increasing knowledge and understanding of the microscopic world around us, especially in our mouths. Bacteria are much more complex than we may have realized—not all are our enemies, and some are definitely our friends. Learning more may open up new ways to keep our teeth and gums healthy.

If you would like more information on the mouth's healing abilities, please contact us or schedule an appointment for a consultation.


By Randall J. Bartoe, DDS, PLC
May 11, 2020
Category: Dental Procedures
Tags: tooth pain  
WhyandHowtoSaveaDiseasedTooth

Let's say you have a diseased tooth you think might be on its last leg. It might be possible to save it, perhaps with a significant investment of time and money. On the other hand, you could have it replaced with a life-like dental implant.

That seems like a no-brainer, especially since implants are as close as we have to natural teeth. But you might want to take a second look at salvaging your tooth—as wonderful as implants are, they can't beat the real thing.

Our teeth, gums and jaws form an intricate oral system: Each part supports the others for optimum function and health. Rescuing a troubled tooth could be the best way to preserve that function, and replacing it, even with a dental implant, a less satisfying option.

How we save it will depend on what's threatening it, like advanced tooth decay. Caused by bacterial acid that creates a cavity in enamel and underlying dentin, decay can quickly spread into the tooth's pulp and root canals, and eventually threaten the supporting bone.

We may be able to stop decay and save the tooth with a root canal treatment. During this procedure, we remove diseased tissue from the pulp and root canals through a drilled access hole, and then fill the empty spaces. We then seal the access and later crown the tooth to protect it against future infection.

A second common threat is periodontal (gum) disease. Bacteria in dental plaque infect the outer gums and, like tooth decay, the infection quickly spreads deeper into the root and bone. The disease weakens gum attachments to affected teeth, hastening their demise.

To treat gum disease, we manually remove built-up plaque and tartar (hardened plaque). This deprives the infecting bacteria of their primary food source and “starves” the infection. Depending on the disease's advancement, this might take several cleaning sessions and possible gum surgery to access deep pockets of infection around the root.

Because both of these treatment modalities can be quite in-depth, we'll need to assess the survivability of the tooth. The tooth could be too far gone and not worth the effort and expense to save it. If there is a reasonable chance, though, a rescue attempt for your troubled tooth might be the right option.

If you would like more information on whether to save or replace a tooth, 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 “Save a Tooth or Get an Implant?


WithProperCarePartialDenturesareaViableToothReplacementOption

When you hear the word “dentures” you probably think of an appliance that replaces all the teeth on a dental arch. But there is another type: a removable partial denture (RPD), which can be a viable option for replacing a few missing teeth.

An RPD rests on the bony gum ridges that once held the missing teeth and are secured with clasps or other attachments to adjacent teeth. While lightweight, RPDs are designed to last for many years — they’re made of vitallium, a light but very strong metal alloy that reduces the RPD’s thickness. Recently, metal-free partial dentures are being used that don’t have the fit or longevity of the vitallium partial dentures, but are considered more of a cosmetic solution.

RPDs are custom-made for each individual patient to accommodate the number, location and distribution of teeth missing throughout the mouth. Their design must also reflect the health and stability of the gums and remaining natural teeth to ensure they won’t move unduly during normal mouth function, and will be as lifelike and unnoticeable as possible.

RPDs have been a mainstay in dentistry for many years and represent a less expensive tooth replacement option than implants or fixed bridgework. But they do have their downsides: because of their method of attachment to the remaining natural teeth they tend to accumulate plaque, which increases the risk of both periodontal (gum) disease and tooth decay. Their fit requires that they attach to the adjacent teeth that will cause some damage and lead to their looseness over time.

If you wear an RPD, there are some things you can do to decrease these problems. First and foremost, you should clean your RPD thoroughly every day, as well as brush and floss your remaining teeth to reduce plaque buildup especially at contact points. Be sure to remove the RPD at night while you sleep. And keep up regular dental visits not only for additional plaque removal but also to allow us to inspect the RPD for problems or wear.

An RPD is a viable option for improving mouth function and restoring your smile after multiple tooth loss. With proper care and maintenance, your RPD can serve you well for many years to come.

If you would like more information on removable partial dentures, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Removable Partial Dentures.”