I am loving the Cerec more and more. Look at this broken down tooth.
Amalgam metal fillings last really well but over time they slump and deform from chewing. Eventually the tooth develops stress fractures and often people wait too long before they decide to replace the filling. The tooth may break unfavourably and split through the middle meaning it can’t be treated and needs removal, or the nerve could be affected and a root canal treatment is required.
Fortunately the tooth pictured at the start didn’t have any extensive fractures in the underlying tooth structure and a hard ceramic crown could be scanned, milled, and cemented on the tooth in one visit on the same day. It makes for such a great day at the office to provide these high quality restorations!
Teeth and gums are damaged by bacteria. The bacteria feed of the sugars in our food and excrete acid as a waste product! The acid dissolves the protective calcium enamel shell on the teeth making it chalky and porous. Then more bacteria can grow in the porosities where they can’t be cleaned away, and so the lesion progresses into the tooth. Often people have no idea until they have pain and by then it is way too late – often leading to need for the tooth to have root canal treatment or extraction.
Where do the bacteria live on my teeth? Where it is hardest to clean! Think about your bathroom. If you have a dark moist room the shower will get mouldy even if you clean the shower often. The worst areas will be in the grooves and edges where it is hardest to clean. These areas often need a knife to scrape the biofilm off followed by heavy scrubbing and bleach. A light airy bathroom with a dry environment is not friendly to the bacteria and mould, and if the bathroom has no tiles, it just needs a simple wipe over.
Think about your teeth. The smooth biting surfaces are cleaned simply by chewing. The bacteria live in the deeper grooves, and especially in between the teeth. You can see in the photos above the decay is the black infected dentine inside the tooth coming from in between the teeth. there are also some stains and a spot in the biting surface from a small pit that held bacteria. The other areas are unaffected by decay.
What about diet and sugars. Sugar feeds the bacteria and allows them to become sticky and harder to clean off the tooth – like the dark moist bathroom favours mould, the unflossed high sugar mouth favours bacteria for decay.
You’ll also see that the decay is hardly visible without drilling into the tooth. that is why you dentist wants to take X-rays every couple of years. Otherwise, we sometimes can’t see decay until it is too big! Remember that most tooth coloured fillings last maybe 6-12 years in studies. Good hygiene, well placed fillings and healthy mouths may have much longer lasting fillings. I have patients with 20-year-old resin fillings and ones that fail every few years. Every time a filling is replaced, a little bit more tooth is sacrificed, therefore trying to get decay early is crucial if you want to keep your teeth into your 80s and beyond. A dental Xray these days is very low radiation equivalent to about that received during an hour’s flight in a plane. If the decay gets to cause a toothache, then the dentist needs multiple X-rays to do a root canal treatment or an X-ray to safely remove your tooth without damage to the jaw and vital structures.
What to do?
Eat well, brush 2/day, floss each night, find a good dentist you trust, get a check and cleaning every 6 months, and have an Xray every couple of years. That’s what I do! Below are my teeth when I was 42 – the result of following my advice. The crown on the bottom is the end result of needing a filling when I was 15, which needed replacement, and then the tooth cracked. Prevention is way better than cure.
Happy 2023 – for further info go to nundahdental.com.au or better yet – come in and say hello!
Here are some final pictures showing how decay is seen on a dental X-ray – the dark bit in the middle is the nerve, and the dark bit coming from the flossing contacts is decay.
Posted by myteethnvd 
Nundah Village Dental 