Month: September 2019

The Future in Dentistry

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There is a bright future in dentistry in the next 10 to 20 years, if not sooner. According to Dr. Lawrence Tabak, director of the National Institute of Dental and Craniofacial Research, a whole new set of tools will be available to identify individuals with the greatest risk for the variety of oral diseases and conditions that the profession now faces. Diagnostic tools such as genome association studies and the identification of relevant biomarkers found in saliva.

Saliva, is said to be the widespread of research interest because it holds the potential to impact dentistry’s future position in the overall health care arena. Although this is further into the future, identifying biomarkers will allow us to create interventions that are personalized to an individual. The fact is not everybody metabolizes medicine the same way. If we can predict early on that a particular individual will need a particular medicine, we can personalize the level of the medication to best match the individual’s makeup and their ability to metabolize it. The way caries and gum disease are being handled and treated are going to be dramatically different than it is today. Prevention is still the key but there will be focus on restoration of form and function. We will have the means on identifying people who are most susceptible and the early stages of diseases. Interventions may allow us to remineralize and reverse the disease process. We will be able to alter the bacterium present to a more healthy bacteria group in periodontal (gum) disease. As for oral cancer, early stage identification would allow us to institute therapies that would help reverse the progression so it never proceeds beyond that point.

Dentistry will have an arsenal of ways to tackle the various devastating diseases and conditions requiring restorations including diagnostic and prevention measures. With the promising stem cell research and tissue engineering and even gene therapy, dentists will be able to achieve what was impossible before.

In this regard, Dr. Gerard Kugel, associate dean for research at Tufts University School of Dental medicine, sees the real future and the real breakthroughs, coming from tissue and biomedical engineering research, including stem cell research. They are finding ways to grow bone on matrix so that they can replace bone that are lost both periodontally and post-surgically. Also included are growing primitive teeth from stem cells in the hopes that someday, replacing missing teeth by regrowing them can be possible.

Although these researches may not be implemented in practice yet for another 20 years or 30 years, its beginnings are happening now. It is all possible.

The idea of replacing any structure and tissue in the mouth damaged by pathologic disease or trauma using the regeneration techniques being studied right now is the future of dentistry.

“Today, we may be talking about what materials to use to build up a broken-down tooth,” says Dr. Kugel. “Tomorrow, you may be talking about how to regrow enamel and dentin on that broken-down tooth.”

There have also been studies being conducted in coming up with a caries vaccine. We have the science to make it possible to come up with the right vaccine that will battle the bacteria responsible for tooth cavities in the mouth. This vaccine intercepts the accumulation of bacteria thereby delaying them from colonizing in the mouth to prevent the onset of decay. This vaccine would make a monumental difference in the prevention of decay among children – particularly in populations that don’t have very good access to care.

For questions, please call 619-464-2801 for an appointment. We are located on 4700 Spring St., Suite 210, La Mesa, Ca. 91941.

Advantages and Disadvantages of Amalgam (Silver) Fillings and Composite Resin (White) Fillings

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According to the State of California Department of Consumer Affairs, dental amalgam is a self-hardening mixture of silver-tin-copper alloy powder and liquid mercury and is sometimes referred to as silver fillings because of its color. It is often used as a filling material and replacement for broken teeth.

The advantages of amalgam filling is that it is durable and long lasting, wears well, holds up well to the forces of biting, relatively inexpensive, generally completed in one visit, self-sealing, minimal-to-no shrinkage and resists leakage, resistance to further decay is high, but can be difficult to find in early stages, frequency of repair and replacement is low.

The disadvantages however are, the concerns about the safety of such a material, gray colored and not tooth colored, may darken as it corrodes, may stain teeth and even tissue (tattooing) over time, requires removal of some healthy tooth structure, in larger amalgam fillings, the remaining tooth may weaken and fracture, because metal can conduct hot and cold temperatures, there may be a temporary sensitivity to hot and cold, and contact with other metals may cause occasional, minute electrical flow (galvanism).

Composite fillings are a mixture of powdered glass and plastic resin, sometimes referred to as white, plastic, or tooth-colored fillings. It is used for fillings, inlays, veneers, partial and complete crowns, or to repair portions of broken teeth.

The advantages of composite resin fillings are that it is strong and durable, tooth colored, single visit for fillings, resists breaking, maximum amount of tooth preserved, small risk of leakage if bonded only to enamel, does not corrode, generally holds up well to the forces of biting depending on product used, resistance to further decay is moderate and easy to find, and frequency of repair or replacement is low to moderate.

The disadvantages are moderate occurrence of tooth sensitivity, sensitive to dentist’s method of application, costs more than dental amalgam, material shrinks when hardened and could lead to further decay and/or temperature sensitivity, requires more than one visit for inlays, veneers, and crowns, may wear faster than dental enamel and may leak over time when bonded beneath the layer of enamel.

Patient health and the safety of dental treatments are the primary goals of California’s dental professionals and the Dental Board of California. Components in dental fillings may have side effects or cause allergic reactions, just like other materials we may come in contact with in our daily lives. The risks of such reactions are very low for all types of filling materials. Such reactions can be caused by specific components of the filling materials such as mercury, nickel, chromium, and/or beryllium alloys. Usually, an allergy will reveal itself as a skin rash and is easily reversed when the individual is not in contact with the material.

There are no documented cases of allergic reactions to composite resin, glass ionomer, resin ionomer, or porcelain. However, there have been rare allergic responses reported with dental amalgam, porcelain fused to metal, gold alloys, and nickel or cobalt-chrome alloys.

If you suffer from allergies, discuss these potential problems with your dentist before a filling material is chosen.

By law, your dentist must provide a fact sheet to every new patient and all patients of record once before beginning any dental filling procedure.

As the patient or parent/guardian, you are strongly encouraged to discuss with your dentist the facts presented concerning the filling materials being considered for your particular treatment.

For questions, please call 619-464-2801 for an appointment. We are located on 4700 Spring St., Suite 210, La Mesa, Ca. 91941.

Orofacial Trauma Today and How To Prevent It

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In this day and age when sports is so popular and has been fast becoming people’s favorite past time activity, whether one participates in it or just being a spectator, cheerer, directly or indirectly, celebrating sweet victory or experiencing the agony of defeat, we often witness accidents resulting in injury to the face. Some sports are more risky than others in that it is safe to assume that all contact sports can be very dangerous. Health clubs and gymnasium attendance is on the rise due to more children and adult participation in events where the probability of trauma is apparent. People in general are not aware of how many of these sports can cause real damage to one’s face when inflicted accidentally or intentionally. The mouth is the focus here because this is where the teeth are located. Imagine having your teeth getting knocked off! Teeth you have been taking very good care of? Teeth you have spent a fortune on and have spent countless time trying to keep them clean and cavity free. The smile that defines you as the unique individual that you are and taking pride of its ownership. Perhaps it is the smile that belongs to your sweet child that it wouldn’t be the same without those teeth beaming at you? You get the picture.

So how do we protect this smile without giving up all these physically demanding sports and activities? Well, general dentists are now being asked about their opinions on prevention of athletic injuries. Since the inception of the Academy for Sports Dentistry in the United States (responsible for providing insight on trauma treatment and prevention), a more viable and responsible solution for orofacial trauma prevention has been introduced. In the past, our patients would feel comfortable going to local sporting goods store to get their dentistry in the form of a mouthguard. This is no longer the case as the population becomes more educated on injury prevention and the availability of proven methods of prevention. The use and acceptance of preventive mouthguards is gaining on the general dentist’s list of priorities today. However, there is still a significant number of dentists who do not provide this service. An important issue to consider on identifying and managing is parental perceptions of mouthguards. How do they overcome objections of cost, custom made versus store bought, vacuum versus pressure and availability? Patient education is essential to the success of trauma prevention. The dental hygienist may play a critical role in this education during routine periodontal treatment.

There are basically three types of athletic mouthguards presently available, all significantly different in fit, comfort and acceptance. Type I is the stock mouthguard available at sporting goods stores – which are the least desirable and acceptable. There is no attempt at fit. It is simply a remove from package and place in mouth kind of thing. Type II refers to the common Boil and Bite Mouthguard. These are also mostly store bought types of mouthguard with a little attempt at fitting by heating up (via boiling) the material and then try to mold it into the mouth. The uneven distribution of material and instability does not lend itself to proper fit and protection. The Type III mouthguard is of course, the custom made mouthguard. It is reported that many occurrences of injuries comes from wearing the Type I and Type II variety of mouthguards. A mouthguard will not be as protective if it does not fit properly. When it comes to mouthguards, the better the fit, the better the protection, acceptance and compliance. The internal adaptation of the Type III appliance makes all the difference. The role of the dentist is to determine the thickness of the mouthguard needed for the type of sport it will be used for, age of the athlete and history of trauma. The custom made mouthguard’s precise fit tends to be less bulky and more retentive in the mouth which increases the compliance of wearing it by the athlete as compared to the bulkiness and lack of retention of the store bought kind.

For questions, please call 619-464-2801 for an appointment. We are located on 4700 Spring St., Suite 210, La Mesa, Ca. 91941.