Dental Care

Erosion

Erosion is an epidemic that is affecting adults and youths alike. Many estimate that this problem has the potential to be a larger problem than dental decay. Erosion is caused by a number of things. The chronic consumption of sodas, energy drinks, and teas leads to the destruction of tooth structure at an alarming rate. Erosion is also caused by the regurgitation of stomach acids in instances of GERD and bulimia.

Erosion is particularly harmful because as it destroys the hardest thing in our body, enamel. After the enamel is gone a softer layer of tooth called the dentin is exposed. The wear of the dentin occurs at an exponentially faster rate than the enamel. Erosion is made worse by brushing after consumption because the tooth is softened by the acidity. Erosion often leads to a loss of the vertical dimension of the face, giving the appearance of premature aging. Chipping and shortening is also common with erosion in the presence of dysfunction (grinding or constricted bite). Sensitivity is also common. It is our goal to first and foremost determine the cause of erosion, be it medical (stomach acid) or chemical (see link below).

Often the appropriate referrals are necessary to eliminate the etiology. Secondarily, we place the patient on the appropriate therapy that has been proven effective by research to stop any further erosion and strengthen the remaining tooth. Lastly, we treat the erosive lesion when necessary to decrease the level of risk moving forward.

See below for more articles on Dental Care Newport Beach.

See the following link to determine the acidity of your favorite drinks
www.agd.org/support/articles/?artid=923

For more information on erosion please click on the link below
http://www.ada.org/1989.aspx

Decay

Dental decay is a transmissible disease that is caused by two bacteria in the oral environment, Streptococcus Mutans (SM) and Lactobacillis (LB). These bacteria utilize refined sugar and produce acid as a byproduct that destroys enamel and dentin, leading to decay. This process does not elicit pain until it gets very deep or has infected the nerve in the tooth.

Goal: Reduce the damaging bacterial numbers and modify the diet to reduce the food that is being metabolized by the damaging bacteria.

Carious risk reduction protocols indicated for individuals with moderate to severe risk.

Low risk: zero carious lesions in the last 3 years
Moderate risk: 1-2 Carious lesions in the last 3 years or at least one risk factor
Severe risk: 3 or more carious lesions in the last 3 years

1) Removing irreversible existing dental decay.

2) Sealants or preventative resin restorations, eliminating pits and fissures, the most susceptible areas in ones mouth (accounts for 90% of decay).

3) Fluoride varnish application 3 times in the first week (5% NaF) remineralizing early decay. Proven with evidence based research to be the most effective means of reducing new cavities in individuals with a history of dental decay (Executive Summary of Evidence-Based Clinical Recommendation, The ADA Council of Scientific Affairs, May 2006) Level of Evidence is 1a (highest possible)

4) Treatment rinse

Restorerinses https://www.amerisciencesrx.com
are one of the only basic mouth rinses on the market. Cavities and erosion are caused by an acidic environment the mouth. All other rinses on the market are acidic (Listerine, Scope, ect). It makes sense to use a rinse that decreases acidity.

5) Adjunctive therapy

• Xylitol gums or mints are effective after meals and throughout the day to buffer the acidic environment by stimulating salivary flow (J. of Evidence Based Dent Pract 2007;7:120-2) Level of Evidence 2b
• Xerostomatic(low salivary flow) management Biotene rinses or Restore Rinses
• Prevident 5000+ fluoride toothpaste prescription high fluoride content toothpaste

6) Follow-up care

• Recare exams every 6 months
• 3, 4 or 6 month fluoride varnish
• Fluoride rinse at home Restore
• Oral Hygiene Instruction and reinforcement

For more information on Dental Decay Please click on the link below
http://www.ada.org/2752.aspx?currentTab=2

Gum Disease Dental Hygiene

Gum disease is the number one cause of tooth loss. Gum health can often be overlooked resulting in inflammation, bone loss, tooth mobility, and eventual tooth loss. An individual is inherently at risk for gum disease or is not.

Risk factors include

• Heredity
• Ethnicity
• Smoking
• Diabetes
  
  
• Gum disease is not your fault! We will never make you feel like it is your fault. We want to team up against this disease by treating it effectively with proven, evidence based research.
• Gum disease and bone destruction occur in a rapid episodic manner starting and stopping many times throughout your lifetime.
• The same inflammatory medians that cause inflamed gums cause buildup of arterial plaque.
• If you are susceptible to gum disease and your gums bleed the disease is active.
• If you are susceptible to gum disease and your gums do not bleed the disease is arrested.
• Our goal is to stop the bleeding!!!!!

We stop the bleeding by teaching patients the appropriate way to clean and care for their teeth and gums. We also adjust the recall frequency for periodontal maintenance based on our findings.
Each individual is placed into one of four categories based on signs and symptoms:

Gingivitis inflammation of the gums

AAP type 1 Pockets less than 4mm
AAP type 2 Inflammation with pocket depth 4-6mm with 2 mm bone loss
AAP type 3 – Pockets of 5-8 mm with 2-4 mm of horizontal bone loss
AAP type 4 – pockets of more than 6 mm with 4mm< bone loss

Treatment

AAP type 1 6 month-recall for prophylaxis
AAP type 2 Initial scaling and root planning with periodontal maintenance 3-4 months
AAP type 3 Initial scaling and root planning with periodontal maintenance 3-4 months, a possible referral to a periodontist, adjunctive therapy
AAP type 4 Initial scaling and root planning with periodontal maintenance 3 months a possible referral to a periodontist, adjunctive therapy

For more information on gum disease please click on the link below
http://www.ada.org/2660.aspx?currentTab=2