Stimulating Stem Cells With Dental Fillings

You have probably seen headlines across the internet discussing new a newly invented dental filling that stimulates stem cells within the teeth. Researchers at The University of Nottingham and Harvard University came together and created this material that is proposed to change the face of dentistry. While this discovery has huge implications for dental care, many articles oversell its proposed abilities. 

In discussing how this material is supposed to work, it is important to understand the anatomic structure of teeth. Every tooth has three general layers: enamel, dentin and pulp tissue. The enamel is mostly mineral and happens to be the hardest structure in the human body. It is also the layer most resistant to tooth decay. Beneath the enamel lies the softer and porous inner dentin. The pulp tissue is the innermost layer that contains nerves, blood supply and stem cells. These new fillings rely on changing the pulp's response to trauma and inflammation. 

Unfortunately, dental pulp tissue is not very resilient. Trauma, extreme temperatures, deep fillings and bacteria can all cause the pulp to become inflamed and/or die, necessitating a root canal. However, if the attack is moving slowly enough, the pulp may shrink itself by laying down new dentin and "move away" from the irritating source. The new filling material hopes to capitalize on this mechanism when placing deep fillings near the pulp tissue. Instead of causing the nerve to die, the substance hopes to induce the tooth to lay down more dentin, creating a safe and natural barrier between the tooth and filling. 

It is important to understand that (by design) this material is not an end-all solution to cavities and root canals. For starters, it would have little benefit over traditional fillings when used in shallow cavities far from the pulp. It would also not be of use in teeth that need root canals due to fracture, trauma or decay that extends entirely to the pulp. Many times, teeth need root canals not due to deep fillings that aggravate the pulp tissues, but rather because the bacteria have travelled through the enamel and dentin and have infected the inner tooth. Once the pulp comes in contact with outside microbes, it will almost certainly need a complete root canal treatment. 

Still, this new material has wonderful applications in the modern dental office. Many fillings that were previously given with a questionable prognosis can now be provided with increased likelihood of success. Likewise, this invention paves the road for future regenerative dental technologies. Who knows what the future holds in store! For more information on these new fillings and how they work, feel free to give our office a call or email us at staff@thousandoaksfamilydentistry.com

The Benefits of Sugar Free Gum

Are you a frequent gum-chewer? Men's Health Magazine recently published an article discussing how chewing sugar free gum can save you thousands of dollars in dental expenses. Find out why adding gum to your daily routine can help fight cavity causing bacteria!

Every time we eat or drink anything made with sugars or carbohydrates, our mouths turn acidic for a thirty minute period. This is caused by bacteria in our mouths processing sugars into their associated acids. Over time, the acid buildup weakens dental enamel and begins to form cavities in our teeth. These cavities tend to develop in areas that trap food, as bacteria have more fuel to turn into acid. This is one of the reasons why decay in common in between teeth and in the pits/grooves of posterior teeth. 

The Men's Health article correctly identifies that sugar free gum lacks the necessary ingredients to fuel bacterial acid production. In addition to this, gum helps loosen food that gets packed into our teeth after meals. Finally, chewing gum stimulates saliva flow which is a crucial factor in preventing tooth decay. Our saliva has incredible natural remineralizing properties and can have a tremendous effect on the progression of cavities.  

One topic the article does not address is the type of sweetener to look for in sugar free gum. Most brands use typical sugar substitutes like sorbitol and aspartame. However, chewing gum made with xylitol will add even more protective factors into your daily routine. Xylitol is a natural sugar alcohol that inhibits ability of bacteria to grow and stick to our teeth. While xylitol gum can be purchased at many stores, health food markets typically carry the best variety. You can also order it online from companies like Dr. John's Candies (our office's favorite!).

It is currently believed that Xylitol's maximum dental benefit comes from using it three to five times a day. However, it is not a substitute for flossing or brushing with a fluoride toothpaste. If you would like to know more about the protective factors of xylitol gum, how it is best used and what it does for our teeth, please give our office a call!

Link to Men's Health Article: www.menshealth.com/health/habit-save-money-dentist

Dentistry and Children's Teeth

If you ever took a fall or had a cavity as a child, you're probably thankful that we get two sets of teeth. Our primary dentition can certainly seem like a second chance to recover from youthful mishaps. You may be wondering why, if adult teeth will eventually take their place, do we perform restorative dental procedures on kids teeth? Crowns, fillings and even braces may seem excessive when you could simply "extract and wait" for the adult teeth to come in. On the contrary, primary teeth serve a number of important roles in establishing a healthy adult dentitition. 

One of the most basic goals of primary teeth is to hold space for the permanent teeth. They create markers for where the adult teeth need to erupt and keep adjacent teeth from crowding into the open spaces. Once you lose a primary tooth, the teeth on either side can start to drift into its space, blocking the adult tooth from eruption. Many times, children who lose a primary tooth prematurely will receive a space maintainer- a cemented retainer that keeps two teeth from coming closer together.

Primary teeth also play an important role in the development of the jawbones. This is the guiding principle behind interceptive orthodontics, where braces and orthodontic appliances are placed on baby teeth. By ensuring these teeth are in ideal locations, an orthodontist can guide the development of the jaws and palate while lessening the need for future adjustment. 

Beyond the developmental importance of primary teeth, they are critical in psychological and social factors as well. Missing multiple anterior teeth can be embarrassing or humiliating, particularly when children are not at the appropriate age of tooth loss. Moreover, the posterior teeth are important in chewing and processing food. Without the ability to chew, we miss out on important nutrients in our diet. Molars allow us to break down food, increase surface area and ultimately facilitate healthy digestion. 

In short, the primary teeth are an incredibly important part of childhood development. With this in mind, dentists do all they can to maintain these teeth through their healthy lifespans. If you want to know more about childhood dentition, the importance of brushing and flossing or dental development, please give our office a call!

Dental Questions: What is a flipper?

With the rise of dental implants, many patients are electing to have teeth extracted rather than spending time and money on a losing battle. Since implants can take months to heal before a crown is placed, there is now a question on what to do with the missing spaces in the meantime. While you can elect to leave these areas open in the interim, this is not an option when the implant is placed in the smile zone. For these situations, you may be made a flipper- or temporary denture. 

Flippers are also known as stay plates or temporary partial dentures. They are made of a hard, pink acrylic resin that supports the prosthetic teeth. They may also have a series of metal clasps that hold the frame firmly in place. Flippers differ from permanent dentures primarily in the way they rest on the teeth and gums. Partial dentures are fitted to the mouth so that the teeth serve as the primary supporting structures. If the gums have to be utilized in holding the denture, very specific areas are used, as to not cause any lasting damage. In contrast, flippers rest entirely on the gums and soft tissues. Over time, the constant pressure on gums can cause the underlying bone to resorb or irritate the periodontal tissues. With this in mind, they are inappropriate as permanent appliances. However, they can be a great interim solution in implant placement. 

Flippers are created by a dental laboratory and take about two weeks to complete. They typically blend seamlessly with the natural tissues and aren't noticeable as "denture teeth." If you would like to know more about flippers and how they can be a part of your implant treatment, please give our office a call!

Photographs at the dentist's office

If you have had a new patient exam at Thousand Oaks Family Dentistry, part of your appointment was dedicated to taking pictures of your face, smile and teeth. Depending on where you previously received care, this may have seemed like a strange proposition. However, photography is an increasingly useful tool in the modern dental practice that allows us to better serve our patients. 

In it's most simple form, photography gives us a baseline idea of how your teeth look. While x-rays allow us to see cavities, infections and bone levels, nothing short of a traditional photograph can clue us into the cosmetic history of your teeth. If, God forbid, you were in an accident that damaged your anterior teeth, these images would help us recreate your smile most accurately. Additionally, photos help us track changes over time. Acid erosion, staining and orthodontic movement are all best recorded using traditional photography.

In addition to creating a cosmetic record, photographs can help us in billing your insurance. Many times, insurance companies will not cover certain treatments unless they were used to treat tooth decay. This becomes a problem on the chewing surfaces of teeth,  where decay is usually visible to the naked eye but poorly imaged on x-rays. By the time decay on these surfaces is visible on an x-ray, the cavity usually extends almost entirely to the tooth nerve. In contrast, photographs allow us to document decay early and reduce the number of hiccups between you and your insurance provider. 

In total, photography is not a replacement for standard x-rays. However, they are a safe, quick and reliable supplement that helps us better serve our patients. If you have any more questions about dental photography, our exams or any other service offered at Thousand Oaks Family Dentistry, please give us a call. We are always here to serve any and all of your dental needs!

Hidden Sugars

While we typically think of tooth decay as a childhood disease, it can affect anyone at any age. In fact, while cavities are slowly declining in young children, 92% of adults over the age of 20 have some form of decay. This is largely attributed to "hidden sugars" in our daily diets. 

Nearly everyone tries to eat healthy and stay away from sweets and sugary drinks. However, it is important to understand that sugars can "hide" in the foods we eat every day. These hidden sugars are particularly detrimental when used as snacks or consumed over a long period of time. Duration, not quantity, is the most important factor in the decay process. A prime example of hidden sugars would be cheese crackers like Goldfish or Cheez-its. While they may have a low sugar content by recipe, our saliva can break down the carbohydrates into smaller glucose and fructose molecules. Combine this with the the crackers' sticky nature and you have a perfect storm for tooth decay!

Other sugars we consume aren't quite as discreet, but still manage to sneak in without us noticing. This is particularly true in an office environment where coworkers are constantly bringing in donuts, birthday cakes and sweet treats. While we may not plan or think of these foods as part of our diet, they still can have a serious effect on our teeth. 

Asking someone to give up their favorite snacks "cold turkey" is usually impossible. Instead, we suggest keeping the duration and number of snacking sessions to a minimum. For example, instead of eating a box of raisins over the course of an afternoon, try to consume all of them in an even fifteen minute period. Also, make sure to follow any snack or meal with a rinse of water and some xylitol gum. This combination is a quick and easy way to minimize bacterial activity after an influx of sugar.

If you would like to know more about tooth decay, what causes it and how we can stop the process, please call our office. The most important component of dental care is prevention, and we want to keep our patients equipped with the latest research in hygiene and oral health. 

Recent changes to our Root Canal Policies

Our office recently changed our protocols on finishing root canal procedures done by endodontic specialists. These changes reflect the safest and most effective dental practices known today. As with all procedures carried out at Thousand Oaks Family Dentistry, we put your treatment, comfort and convenience first!

When a root canal is finished, you are essentially left with a tooth sans nerve tissue and a small opening at the top. This opening is a necessary part of the root canal procedure that allows the endodontist to reach the nerve tissue and roots. Unfortunately, it is also a major deterrent to the long term structural integrity of the tooth. In order to restore strength to the tooth, the opening needs to be sealed with a special filling material called a core and finished off with a dental crown. This core material chemically bonds to the enamel and protects against fractures and cracks. Many times, a device called a post will be added to the core to provide more rigidity when necessary. Posts extend partially down one root and create an additional structural anchor for the core to adhere to. 

Historically, the endodontists we work with would complete the root canal procedure and place a temporary filling into the opening (a "temporary core). This material does not actually bond to dental enamel and only serves to keep bacteria and food out of the inner tooth. It is very easy to remove, allowing for the quick re-access of a tooth if the first root canal was unsuccessful. Patients then had to return to our office, have the temporary filling removed and have a permanent restoration placed. Not only did this create a new opportunity for bacteria to invade the tooth, it caused our patients to spend days to weeks functioning with a severely weakened tooth. 

Currently, our endodontic specialists are placing permanent posts and cores at the time of root canal completion. This ensures the tooth is continuously sealed and structurally reinforced prior to crown placement. While immediately placing a permanent core can make re-accessing the tooth more difficult, the positives largely outweigh any negatives. Very few teeth end up needing immediate re-access, and the continued structural support of the tooth is a far more important factor in long term root canal success. 

If you would like to know more about root canals, posts, cores or any other dental procedures, please call our office. We are always happy and excited to walk you through any part of your dental treatment!

Endodontists we work with

At Thousand Oaks Family Dentistry, we take our patient's individual needs very seriously. With this in mind, we have cultivated a network of highly skilled dental specialists to address any and every concern. For our patient who require root canals and other endodontic services, we are proud to work with Conejo-Simi Endodontics and Southern California Endodontic Group.

You may be referred to an endodontis' office to diagnose and treat certain types of tooth pain or resolve an infection. Specialists like Conejo-Simi Endo and So-Cal Endo have technology like microscopes and cone-beam CT scanners that can better visualize cracks, abscesses and root fractures on teeth. If the tooth in question is savable, an endodontist can then perform a root canal to remove infection or stop tooth pain. Their technical expertise shines in treating posterior teeth, where root anatomy can become complicated and difficult to visualize. Nevertheless, our specialists have years of experience and will always strive for the best treatments possible!

We typically refer to out to endodontists following an exam and X-rays. However, certain types of pain will clue us in to your need for a specialist even before looking in the mouth. Our office is positive that you will have a great experience at Conejo-Simi Endodontics or Southern California Endodontic Group. If you would like to know more about the specialists we refer to or why we use them, please give us a call!

Dental Questions: Why do teeth need root canals?

When most patients think of endodontics (root canal procedures), they usually assume it is being provided to treat an infection.  While the most common reason for a tooth to need a root canal is infection, there are a whole host of procedures and conditions that benefit from endodontic therapy. Take a look at this list of typical reasons that teeth need root canals!

Infection- Indeed, the most common reason most patients need root canals is from bacteria growing around the roots of the teeth. In the classic model of tooth infection, tooth decay spreads to the dental pulp, causing the tissue to become necrotic. This dying tissue becomes a food source for the bacteria, allowing them to flourish. A root canal treats these infections by removing the remaining tooth pulp, sterilizing the interior of the tooth and cutting off the bacterial food supply. 

Fractured Teeth- Fractured teeth are often impossible to see and difficult to diagnose. Many times it takes the imaging technology found at an endodontist's office to reveal the location and extent of the crack. Most fractured teeth are impossible to restore and require extraction. However, some smaller cracks can be rectified through a combination of a root canal and crown. 

Post Placement- If the top of a tooth is broken off at or near the gum line, placing a crown on the remaining structure is impossible. In certain occasions, a root canal procedure can be performed along with a post placement to save the tooth. A dental post is a metal or composite rod that extends from the root of the tooth to above the gum line, creating a new substructure for a crown to be fashioned. 

Trauma- Many times, dental trauma will cause the internal tooth pulp to recede or become necrotic. A clear sign of this is a tooth becoming darker or red-toned following injury. In order to preserve the tooth and minimize risk of infection, a root canal is often performed. After the root canal is finished, internal bleaching can be used to lighten the tooth back to a natural tone. 

We hope you found this article helpful! If you have any more questions about root canals, dental trauma or dental crowns, please give our office a call!

New treatments for burning mouth syndrome

Have you ever heard of Burning Mouth Syndrome? About bout five of every 100,000 people report this painful condition yearly, with women more likely to be affected than men in a ratio of 33 to 1. In about half of all cases, there is no known cause or source. Fortunately, new research suggests that the drug clonazepam may provide relief for this elusive condition. 

Burning mouth syndrome is a usually reported by patients as a feeling of burning or pain over the tongue, gums or palate. The sensation is often difficult to pinpoint and usual pain medications like aspirin or ibuprofen don't help. Many individuals will report suffering for extended periods of time- from weeks to months. In these instances, burning mouth syndrome is a form of chronic or "internalized" pain. This type of pain has little to do with actual injury to the mouth and more to do with how the brain interprets sensation.

Clonazepam is traditionally prescribed as a sedative and is often used to treat chronic pain conditions like back pain, fibromyalgia and arthritic knee pain. Only now has it's efficacy in treating burning mouth syndrome been recorded in scientific research. On average, patients taking clonazepam reported noticeable improvements in their burning mouth syndrome when compared to placebo groups. 

As with any oral condition, a thorough examination with a dentist is required to diagnose and burning mouth syndrome. Facial pain has many sources- from tight jaw muscles to tooth infections- and we want to be absolutely sure we are treating the true cause! If you would like to know more about burning mouth syndrome or other facial pain conditions, please contact our office.