5 Stages of Tooth Decay

Did you know there are five distinct stages of tooth decay? And that in the first stage of decay, you can actually take steps to reverse the progression of decay?  Understanding how a cavity progresses can help you prevent each successive stage from occurring.

Stage One: White Spots

In stage one, the tooth begins to show signs of strain from the attack of sugars and acids, and white spots will begin to materialize just below the surface of the enamel. These white spots are can be easy to miss because they’re likely to occur on your molars. The dental exam Dr. Morrison performs at each check-up is designed to catch these early cavities. In this first stage of decay, whether you’re a child or an adult, the application of fluoride via fluoride treatments, your toothpaste and your local water supply can stop a cavity from penetrating through the enamel and reaching its second stage. Even the saliva in your mouth and the foods you eat help to re-mineralize a tooth in jeopardy.  At this stage, the cavity can be repaired without the need for a filling.

Stage Two: Enamel Decay

Stage two marks the beginning of the end for the surface enamel that is being attacked. Initially, the tooth erodes from the underside outward, so the outer enamel will still be intact for the first half of this second stage. Once the cavity breaks through the surface of the enamel, there is no turning back, and you or your child will need to have the cavity corrected with a filling.

Stage Three: Dentin Decay

If a cavity were to progress beyond stage two without you knowing, you’d probably become aware of it because it would start to cause some pain. At this level, the cavity begins to eat away at the second level of tooth material that lies beneath the enamel: the dentin. A filling can still be used to stop the onslaught of bacteria assaulting the tooth in order to prevent the cavity from reaching the tooth’s most critical component: the pulp. However, this filling will most likely be larger, more involved - and consequently more expensive - than taking care of the cavity at stage two.

Stage Four: Involvement of The Pulp

Once the cavity reaches the pulp, it’s going to hurt. A lot. So if you’ve unfortunately missed all the signs to this point, a screaming child or moaning teenager will certainly let you know there is a big problem. Stage four is serious, and a root canal is the only option of treatment at this stage, save for a complete extraction.

Stage Five: Tooth Abscess 

In the fifth and final stage of a cavity, the infection has reached the tip of the root and begun to infect the surrounding tissues and possibly the bone structure. Swelling would be commonplace and pain severe. In children (as well as adults) an abscess can actually be fatal if not dealt with immediately. A root canal or extraction would be the order of the day should decay reach this stage.

Cavities don’t happen overnight. They tend to form faster for young children, sometimes in just a few months, because their teeth have weaker enamel than for adults. It can take up to a year for the cavity to form in adults. Just remember, in the early stages, regular visits can stall and even reverse their progression, so coming in for regular cleaning and exams is a great idea. I've seen early treatment reverse cavities in many, many patients. And, if we told you that you have a cavity at a recent visit, please don't delay treatment, even if it doesn't hurt. If left untreated your cavity will only get worse. Possibly much worse.

Give us a call today to schedule your routine dental exam and cleaning so we can assure you that your teeth, or your kids' teeth, are healthy and cavity-free. You can reach our friendly staff at 919. 755. 3450, or go online to schedule your dental visit.

Don't Brush Where You Flush

We all know a simple toothbrush, used effectively, is central to your oral health. But before you put it in your mouth, consider this: the average toothbrush can contain 10 million bacteria or more—including E. coli and Staph, according to a study at the University of Manchester in England. Yuck.

Where do these bacteria come from? First of all, your mouth. About 100 to 200 species may live in your mouth at any given time. People who practice good oral hygiene may have 1,000 to 100,000 bacteria living on each tooth surface, while less clean mouths can have between 100 million and 1 billion bacteria on each tooth.

Your toothbrush is also a bacteria magnet. If you store your toothbrush on or next to the bathroom sink, it gets contaminated from splashing when you wash your hands — and whatever you are washing off your hands may be splashed onto the brush, as well.

Even more disturbing is what happens when you flush with the toilet lid open. Charles Gerba, Ph.D., Professor, Microbiology & Environmental Sciences, University of Arizona College of Public Health, points out that bacteria and viruses falling from spray generated when you flush the toilet “remain airborne long enough to settle on surfaces throughout the bathroom.”  An English study found that diarrhea-causing bacteria from a lidless flush flew as high as 10 inches above the toilet.  Another study demonstrated that three different types of toilets, when flushed with the cover open "aerosolized" their bio-contents. The fecal matter was found on everything within a 5- to 6-foot radius.

Needless to say, if your toothbrush is sitting on the bathroom counter, it will probably be within that range.

Still need convincing? Another study compared the bacteria on toothbrushes from two groups: people who had bathrooms with attached toilets, and those with bathrooms without attached toilets. The toothbrushes were analyzed at one month and then again at three months. In each group, the toothbrushes contained an array of microorganisms commonly found in the mouth, such as streptococcus mutans, candida, pseudomonas, and lactobacilli microorganisms. However, samples from bathrooms with an attached toilet also included E. coli, a bacteria associated with gastrointestinal disease.

Tips on Keeping Your Toothbrush Clean

Now that you are sufficiently revolted, are you ready to start treating your brush a little better? Here’s what to do to keep your toothbrush as bacteria-free as possible.

Replace your toothbrush 

The ADA recommends replacing your toothbrush every three to four months, or more often if bristles become frayed, if you are sick, or if you have a weakened immune system. For an electric toothbrush, replace the head as frequently as you would a regular disposable brush.

Toothbrush storage

Keep your toothbrush in a medicine cabinet. Don’t store it in an airtight container, which encourages bacteria growth. Instead, allow your brush to dry out between cleanings. And If you store toothbrushes together, make sure the heads don’t touch.

Don’t share toothbrushes 

No matter how conscientious you are about cleaning, you will never remove all bacteria. Give family members different colored brushes - especially your children - to prevent them from getting mixed up. If you want to be really safe, have different tubes of toothpaste for family members. 

Clean your bristles

Occasionally soak toothbrush in hydrogen peroxide or mouthwashes with antibacterial agents, especially if you’ve dropped it on the floor, and rinse your toothbrush in tap water thoroughly after brushing.

Get rid of the toothbrush holder

A study by the National Sanitation Foundation (NSF) found that toothbrush holders are the third-most "germy" household items (behind dish sponges and kitchen sinks). If you really want to use one, remember to clean your toothbrush holder regularly.  

Close the lid when you flush

Always flush your toilet with the lid down 

Do you have any comments? Questions? Feel free to leave them below. Do you know someone who may benefit from this information? We encourage you to share this article. Is it time for you to schedule a cleaning or dental exam?  Give our friendly staff a call at 919.755.3450 or go online to schedule an appointment.  We look forward to seeing you! Thank you. 

Chew Gum - Save Money?

According to a new study published in the American Journal of Dentistry, if current consumers of sugar-free chewing gum increase their consumption by just one piece per day, $4.1 billion could be saved worldwide on dental expenditures from treating tooth decay each year, according to the Institute of Empirical Health Economics (IEHE). These savings would include $2.07 billion in the United States, $1.1 billion in Europe, and $149 million in China.

Chewing Gum Increases Saliva Flow

Chewing increases salivary flow, which helps remove leftover food debris while neutralizing and washing away the acids that are produced when food is broken down by the bacteria in plaque on teeth. This acid can break down tooth enamel, creating conditions for decay. Also, the increased saliva provides more calcium and phosphate to help strengthen the enamel.

ADA Recommendations for Chewing Gum

The American Dental Association, (ADA), recommends chewing sugarless gum for 20 minutes after meals, since it's been proven to reduce plaque, promote tooth enamel, reduce cavities, and reduce gingivitis. Just make sure your gum is sugarless, as sugar-containing gums can actually add to acid build-up. Look for gums with xylitol too, which can reduce decay-causing bacteria. Finally, be mindful of sorbitol, which can cause GI discomfort if ingested in extremely large doses.

“In addition to the well-established clinical benefits, for the first time, this study models the reduction in the relative risk of tooth decay and subsequent cost savings for dental care as a result of increased consumption of sugar-free gum as part of a complete oral hygiene routine,” said Michael Dodds, BDS, PhD, lead oral health scientist with Wrigley, which funded the study and produces a range of sugar-free gum brands.

While sugarless gum should not replace brushing and flossing with a fluoride toothpaste twice a day, flossing once a day, and a dental cleaning and exam every six months, the ADA reports, it can be an effective adjunct to oral care.  

Did you find this article interesting?  Please leave a comment and also let us know about any other dental topics you may be interested in. 

The study, “A Global Approach to Assess the Economic Benefits of Increased Consumption of Sugar-Free Chewing Gum,” was published by the American Journal of Dentistry.

The Importance of a Smile

Just smile. Really. Try it. A simple smile can be the most powerful tool at our disposal… and we all have one. Most of all, a smile can make all the difference in the world. One smile has the power to release stress, calm you down, make you attractive, make someone else happy and believe it or not, smiling can actually cause your own happiness.

So, in honor of National Smile Month, I would like to share my top five reasons for encouraging you to smile today.

Smiling Releases Stress

Smiling reduces stress that your body and mind feel, almost similar to getting good sleep, How does this happen? Smiling decreases the stress-induced hormones that negatively affect your physical and mental health. Scientists have also demonstrated that holding a smile on one's face during periods of stress may help the heart. This lends support to the old adage "grin and bear it", suggesting it may also make us feel better.

Smiling Makes You More Attractive

“A smile is the prettiest thing you can wear” – Unknown. This is true! Scientists have shown that happy, smiling faces influence the emotional well-being of the observer, which in turn makes us more attractive. A smile may also signal better health (and indeed, positive emotions have been found to improve cardiovascular function) and the perception of good health has been associated with attractiveness in a number of studies.

Smiling Can Improve Your Social Network

Ever wondered why people forget who you are, even when you think you’ve made the right sort of impression? Or why you can remember a certain business contact’s face more readily than others? Well, according to new research the reason for this is simple. Researchers say it has to do with your smile. A smiling face is much more memorable than a neutral or fearful one. So if you really want to make a great impression, put on a happy face.

Smiling Can Influence Your Happiness

Many of us smile because we’re happy and it conveys the emotion of joy to others. But this is not always the case. Sometimes we can be happy because we smile.

For a long time, scientists have linked emotions with smiling.  It’s called ‘facial feedback hypothesis’. Our brains react to what our body is doing and it can affect our emotions. If we put on a smile, whether we’re genuinely happy or not, our brains will interpret it as happiness and our mood will change accordingly. This means just the simple act smiling can lead you to feel actual happiness or joy — and being happier helps you keep the smile going in a genuine way. Your fake smile is now a real one!

Smiling Can Make Others Happy

Smiling helps to generate more positive emotions in the people around you. That’s why we often feel happier around children – they smile more. On average, children smile 400 times a day while average "happy" adult smiles 40-50 times a day. It’s important to remember that smiling, even we we are not necessarily happy, will make it more likely that  the people around us will smile, and that can improve our mood as well.

There's just one trick to making smiling work for you: You need to do it right. A true, genuine smile is called a Duchenne smile. It uses all the muscles in the face, including the "laugh lines" around your eyes. Engaging all these muscles is important, even in a fake smile.

If you're smiling on purpose to help your mood or the mood of other people, or to make a great impression, you want to smile until your cheeks lift and you feel your laugh lines crinkle. You can see how it feels by holding a pencil horizontally between your teeth as you smile.

So there we go. A smile might seem like a simple act that we often take for granted. But it can really can make you feel better, and make others respond more positively to you. We can use a smile to show our positive feelings or mask our more negative ones. A smile really is one of our greatest gifts!

Do you want to improve your smile?  Give us a call at 919.755.3450.  We offer complimentary cosmetic dentistry consultations.  Thank you.

Travelling Abroad? Tips For Emergency Dental Care

What do you do if you wake up with a toothache while hiking in Patagonia? Or your child knocks out a tooth during a family vacation in Mexico? 

Finding good emergency dental care abroad can be challenging. Dentists in the United States have been educated in accredited schools, taken national and state boards prior to receiving a license to practice, and are held to high standards of care which include infection control guidelines for disease prevention. You can't always count on that when travelling abroad.

Here are some ways to avoid potential problems, or ensure the best possible outcome, should an emergency occur while you are on vacation.

Schedule a checkup before your trip

Mention any dental concerns you have so Dr. Morrison can diagnose potential issues and complete treatment before you leave.

Complete any treatment

Finish treatment on any outstanding dental work before you leave. Schedule the root canal you have been putting off or address that cracked tooth you have been “living with" well ahead of time so that adjustments, if needed, can be made prior to your trip.

Insurance information

Take your dental and medical insurance policy numbers. Make a contact entry on your phone or write it on a piece of paper and tuck it someplace safe. You will appreciate having this information handy if you do encounter a dental emergency on vacation.

Maintain good oral hygiene

Maintain a great oral hygiene routine before you travel to keep your mouth in a healthy, non-emergency state.

Take a mouth guard

Are you going to be participating in any sports or adventurous activities while away? Consider having an athletic mouth guard made to provide extra protection for your mouth and jaw. Also, vacations are not always relaxing - so if you tend to clench your jaw or grind your teeth when under stress, consider a night guard.

Travel insurance policy with dental coverage 

Consider a travel insurance policy that includes dental coverage. If you have a travel insurance or assistance policy, the company’s 24-hour hotline can refer you to qualified dental care when you’re away from home, as well as provide translation help, if needed.

Taking precautionary measures like these can help avoid some dental emergencies on vacation, but they can’t prevent them all. If you do have a dental emergency, the important thing is to act fast to preserve the tooth and alleviate discomfort. Read Dr. Morrison's blog on what to do if you experience a dental emergency for an overview of common dental emergencies and what to do right away.

Finding good dental care when travelling

Once you've handled the immediate concern, you'll need to find a qualified dentist who can help you. Here are some resources to check:

The American Dental Society of Europe

These dentists are members of the society who live and work in Europe but studied in the U.S. or Canada.

International Association Medical Assistance to Travellers (IAMAT)

IAMAT is a network of doctors and medical institutions around the world that can help you find an English speaking doctor. You will need to be a member, but it could be worth it to get you in touch with a dentist or medical professional that can help you when you are traveling abroad. To learn more go to www.iamat.org.

Board Certified Asia Dental Association

While many sites for finding a dentist abroad are targeting those that would participate in dental tourism, they can also be handy for finding a dentist in the part of the world in which you find yourself.

Other Suggestions

Your hotel concierge or trip guide may be able to recommend a quality dentist in the area; the American Consulate or Embassy; Americans, or American military personnel living in the area.

What to remember at your dental appointment abroad

Finally, here are some things to think about as you are going into your appointment:

Licensing requirements and safety regulations

Some countries will have exceptional dental care and safety regulations they follow like the U.S. does, however, there are many places you can travel to that won’t have this. Make sure you know who you are seeing and what they are going to be doing to you. Verify that the dentist has a license and can practice as a dentist. You’ll want to be sure that the dental care you get is of the highest standards and that they use the proper tools as well as standard safety measures such as new gloves for each patient and sterilizers for instruments.

Verify the cost

Avoid surprises by verifying the cost, in writing, before you start treatment. Also, make sure your quote is in US currency.

Language barrier

Language can be a barrier to treatment. If you do not understand what the dentist or dental staff are saying to you, and the dentist and employees do not understand what you are saying to them, this is not the place for you to have dental care performed.

Dental emergencies on vacation happen all the time. Be sure to prepare before your trip, act fast if you have a problem, and use the resources available to you to find a qualified dental professional that can treat you to facilitate the best possible outcome—for your tooth and your vacation.

Was this article helpful? Leave a comment and also forward it to someone you know who may be travelling abroad. Have a great trip!