Dentists without drills: Minimally invasive dentistry is on the rise

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By: Katharine Gammon, USC News

😷 Are you afraid to go to the dentist or do you have phobia on dental drills? Well, not anymore!

Microdentistry is now part of the University of Southern California dental curriculum, and its focus on stopping cavities early and without drills can make a big difference for patients with dental anxiety. Learn more! The Oral Surgery DC Team

Ariella Glodowski could see on her X-rays that she had small caries lesions forming — even though they weren’t large, painful or even visible to the naked eye. The early detection gave the then-third-year dental student an opportunity to experience firsthand a minimally invasive dental procedure called resin infiltration, where early caries lesions are infused with resin rather than drilled and filled.

In December, she had the procedure, which she noted was nearly pain-free. “It was like a normal procedure except there was no drilling involved,” she said. “It was relaxing, to some extent, because there were no sharp objects involved, just some pressure.”

She was also relieved to know that she wasn’t losing any tooth structure to the drill. Often, when dentists complete traditional dental restorations they can end up removing healthy tooth tissue, which can result in more damage over time.

Minimally invasive dentistry: Leaving the drill behind

Resin infiltration is part of a growing trend in microdentistry, also known as minimally invasive dentistry, said Jin-Ho Phark, an associate professor of clinical dentistry at the Herman Ostrow School of Dentistry of USC and the dentist who performed Glodowski’s procedure.

“Patients tend to associate dentists with drilling, and they don’t like that,” he said. Plus, every time dentists complete a restoration, they have to drill away a little more of each tooth. Over time and multiple procedures, there is less and less healthy tooth structure to work with. “So,” he said, “we have been trying for a while to reduce the amount of drilling while still taking care of the disease.”

Caries and tooth decay can take a long time to develop. There might be many years before a patient feels any pain or physical evidence of a cavity due to caries, Phark explained. The trick to minimally invasive dentistry is to catch the decay before it becomes a big problem and stop it in the early stages.

“In the past, the standard was to wait until the lesion was big enough to be worthy to be drilled into,” Phark said. “With the new technique, we can stop the cavity early on and prevent it from breaking down and needing a filling at a later time.”

A dentist can use a special liquid resin to infuse into the lesions, which are porous. “We fill those pores with this resin,” Phark said. “It acts, in a way, like a sealant, and it’s a very preventive measure.”

Dentists have been using sealants to cover the grooves on chewing surfaces, and now they are using them to close up lesions developing between teeth. They apply the resin onto the tooth’s surface, and a network of pores within the enamel force the resin deep into the tooth. “After that, we harden the resin with blue light,” he said.

New in minimally invasive dentistry: silver diamine fluoride

In situations where the caries lesion has already progressed further and turned into a visible cavity, another minimally invasive dentistry technique gaining in popularity is the use of silver diamine fluoride. Though used internationally for years to stop caries progression, it has only recently been approved by the U.S. Food and Drug Administration for use in tooth sensitivity.

In its off-label usage, the antimicrobial, remineralizing compound is painted onto a tooth’s surface where cavitated lesions are visible, effectively halting any further caries cavitation. The method has been widely used in children or patients who might have a fear of the drill, Phark said. One negative side effect is that the compound can leave teeth blackened at the application site, which is why it has been widely adopted for children’s primary teeth, where it is only a temporary problem.

First in the nation? USC

USC is the first school to teach minimally invasive dental techniques on a large scale, already starting on the pre-clinical level. So far, these techniques have been offered only to patients in special clinics or advanced programs, such as advanced operative and adhesive dentistry. However, last fall Phark started teaching them to the first-year class in a new module called Cariology and Microdentistry. Once this class enters the clinic, they will be performing this kind of treatment on a regular basis.

Glodowski is excited to experience it firsthand and also to offer more drill-free options to her patients in the future as the technique becomes widely available. “Patients are going to be really happy that this is a possibility that works for them, especially if they have phobias about drilling,” she said. “It offers a more conservative approach, which is what we’re trying to strive for.”

Phark said resin infiltration, resin sealants, and silver diamine fluoride shouldn’t be expected to replace good oral hygiene and other healthy habits. Dental teams should start a larger conversation around health, which might even include having a nutritionist as part of the practice. “We are trying to be more and more preventive in the case of tooth decay and fight the causes of this disease, rather than patching up the consequences by drilling and filling,” he said.

The new cardiology curriculum is also paired with the implementation of new caries detection methods that use near-infrared, laser fluorescence and even the use of dental microscopes. This will help to detect and monitor such caries lesions more reliably.

The “death spiral of a tooth”

Part of what students learn is how to look at a patient’s history and ask questions to determine their risk of developing cavities. They also are trained to assess if patients have enough saliva, as saliva contains minerals that have a protective function for teeth.

There are very few downsides to the resin infiltration, though Phark said that some people don’t like the rubber dam that dentists have to place over the tooth to make sure there is no saliva and blood getting into the preparation. In addition, after the resin is placed, dentists can’t see it on an X-ray; they can still see the dark spot of the lesion, and they have to compare the size of the lesion to make sure the resin seal is working.

Still, the technique is far better than composite fillings, which last an average of five-to-seven years. “A young patient, a teenager, is going to live another 80 years,” Phark said. “You would replace that multiple times? And every time it gets bigger.”

He calls it the death spiral of a tooth: starting with a small filling, then a bigger filling and eventually a partial crown or a crown. “We are trying to stop this cycle that the tooth is going down from the beginning,” he said. “It’s especially important for adolescents.”

“This is a really exciting innovation,” said Glodowski, whose X-rays show the lesion isn’t growing under the resin. “I hope it will become more widely used in the future.”

Source: https://news.usc.edu/157157/minimally-invasive-dentistry-no-drilling/

Genetic make-up has little impact on dental health, a new study finds

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By: University of Melbourne, Medical Xpress

📃 A new study has found genetic makeup does not predispose people to tooth decay, however, the research did find that children with overweight mothers are more likely to have cavities.

🤰 A research conducted by Murdoch Children’s Research Institute found a link between the mother’s health and lifestyle during pregnancy and the child’s future dental health, with obesity in pregnancy a definite marker for increased risk of child tooth decay. Learn more about this surprising news via Medical Xpress – Medical and Health News! The Oral Surgery DC Team

The paper, published in the latest edition of Pediatrics, estimates that one in three Australian children have tooth decay by the time they start school.

Lead researcher Dr. Mihiri Silva, from the Murdoch Children’s Research Institute, said the study looked at the teeth of 173 sets of twins (identical and non-identical) from pregnancy through to six years of age.

“How genetics impacts on dental health has not often been studied,” Dr. Silva said. “This is the first twin study that looks at both genetics and early life risk factors, such as illness and lifestyle.

“We found that identical twins, with identical genomes, have varying degrees of decay. This means that environmental factors, like a lack of fluoride in water, seem to be the prime cause of cavities not genetic makeup.”

However, Dr. Silva said the research did find a link between the mother’s health and lifestyle during pregnancy and the child’s future dental health, with obesity in pregnancy a definite marker for increased risk of child tooth decay.

“The relationship between maternal obesity and child tooth decay is complex,” Dr. Silva said. “Perhaps the mother’s weight has a biological influence on the developing fetus or perhaps the risk of decay rises because of increased sugar consumption in that household.”

One in three of the twins studied (32.2 per cent) had dental decay, and almost one in four (24.1 per cent) had advanced decay.

Dr. Silva said it was important that people don’t think of tooth decay as genetic.

“If people think the health of their teeth is down to their genetic make-up, they may not be prepared to make important lifestyle changes,” she said.

“Our findings also reinforce how important it is for pediatricians and other health professionals to educate children to start preventive measures early in life, prior to the onset of damage to dental tissues.”

Dr. Silva said tooth decay was a serious health problem, because there was a clear link between child cavities and developing diabetes and cardiovascular disease later in life.

“Tooth decay is also the leading cause of preventable hospital stays for Australian children,” Dr. Silva said.

According to 2011 Victorian Department of Health statistics, more than 26 000 Australians under the age of 15 are admitted to hospital to treat tooth decay every year.

Dr. Katrina Scurrah, from Twins Research Australia and the School of Population and Global Health at the University of Melbourne, said the study illustrated the advantages of studying twins to find out about health conditions and the importance of considering the effects of early life risk factors as well as genes.

But she said it’s important to try to replicate these findings in other studies that follow children through to adulthood and to explore other risk factors for dental decay.

This latest study in Pediatrics collected data about the twins at 24 and 36-weeks’ gestational age, at birth, 18 months and six years of age. This included a dental examination at age six.

Questionnaires about the mother’s weight, illnesses, medication use, vitamin D levels, stress, alcohol intake, and smoking were collected during pregnancy.

Source: https://medicalxpress.com/news/2019-04-genetic-make-up-impact-dental-health.html

Charcoal Kinds of Toothpaste ‘Don’t Whiten Teeth’

By: BBC News

⚠️ Charcoal-based toothpaste, which claims to whiten teeth, is a “marketing gimmick” which could increase the risk of tooth decay and staining, says a review in the British Dental Journal.

The charcoal products, which are increasingly popular, often contain no fluoride to help protect the teeth. And there is no scientific evidence to back up the claims they make, the authors say. Also, excessive brushing with them can do more harm than good. Instead, they advise people to go to their dentist for advice on bleaching, or whitening, their teeth. The Oral Surgery DC Team

And they say it is better to stick to using a regular fluoride-based toothpaste.

Charcoal was first used for oral hygiene purposes in ancient Greece, as a way of removing stains from teeth and disguising unpleasant odours from diseased gums.

Celebrity effect

Dr Joseph Greenwall-Cohen, co-author of the study from the University of Manchester Dental School, said “more and more shops are selling charcoal-based toothpastes and powders”, including Superdrug, Boots and Tesco, after celebrities had started talking about using them.

But he said the claims they made had been found to be unproven by a 2017 US review of 50 products.

Some said they were “anti-bacterial” or “anti-fungal”, that they helped with “tooth whitening” and would “reduce tooth decay”.

The review said people were brushing regularly with the charcoal-based products in the hope that they would offer “a low cost, quick-fix, tooth-whitening option”.

But too much brushing could lead to tooth wear and more sensitive teeth and, with few of the products containing fluoride or making the ingredient inactive, any protection from tooth decay was limited, it said.

‘Don’t believe the hype’

“When used too often in people with fillings, it can get into them and become difficult to get out,” Dr Greenwall-Cohen said.

“Charcoal particles can also get caught up in the gums and irritate them.”

He said charcoal toothpastes and powders were more abrasive than regular toothpastes, potentially posing a risk to the enamel and gums.

The charcoal contained in today’s toothpastes is usually a fine powder form of treated charcoal, the review says.

Charcoal can be made from materials including nutshells, coconut husks, bamboo and peat, and possibly wood and coal.

Prof Damien Walmsley, from the British Dental Association, said: “Charcoal-based kinds of toothpaste offer no silver bullets for anyone seeking a perfect smile, and come with real risks attached.

“So don’t believe the hype. Anyone concerned about staining or discolored teeth that can’t be shifted by a change in diet, or improvements to their oral hygiene, should see their dentist.”

Source: https://www.bbc.com/news/health-48216116

Oral cancer: What you can do to help end this disease

By: American Dental Association, ASDA

🦷 The American Cancer Society estimates there will be 53,000 new cases of oral and oropharyngeal cancer in 2019, and the American Dental Association is working to provide members with resources that can help them do their part to fight and end this disease.

While April marks Oral Cancer Awareness Month, every day presents an opportunity to make a difference. Discover the ways you can do to end this disease via the American Student Dental Association. The Oral Surgery DC Team

The association published its clinical practice guideline on evaluation for oral cancer in 2017. It offers guidance for dentists on how to check for lesions, how to identify potentially malignant disorders and how to proceed in relevant clinical scenarios. The guideline points out that even though a variety of adjunct tools are marketed to dentists to enhance pick up of lesions, because there isn’t evidence demonstrating that they improve screening, they aren’t recommended. And for situations where a lesion is observed, the guideline provides clinical pathways for follow up.

In addition to the guideline, the ADA has produced a chairside guide to walk you through the guideline’s recommendations, along with an instructional video that shows how to perform each step of a conventional visual and tactile exam on a patient. You also can watch a brief video on the ADA’s YouTube page that highlights how to check patients for oral cancer.

Given the current increase in HPV-associated oropharyngeal cancer, the most effective thing dentists can do to prevent oropharyngeal cancer is to encourage appropriately aged individuals to receive the HPV vaccine. Learn more about the ADA’s HPV vaccine policy at ADA.org, and check out this video from an ADA dentist who has a personal connection to the disease she hopes to one day defeat.

Source: https://www.asdablog.com/oral-cancer-what-you-can-do-to-help-end-this-disease/

Do You Know The Importance Of Family Dental Care?

By: Longevity

Most of us are well-versed with the fact that dental care is important. But why exactly it is so important, is something which a majority of us are unaware of. Oral health is related to the overall health in more ways than we can imagine.

Longevity explains the importance of dental care for every member of your family, right from toddlers to seniors. Let’s take a look! The Oral Surgery DC Team

Toddlers

  • The first baby teeth generally appear between the time periods of 6 to 10 months. In some toddlers, these can appear as early as at 3 months, while in some they can arrive as late as at 12 months. By the time the child turns 3, all the primary teeth have erupted.
  • This phase of the eruption of teeth may result in a tender and irritable gums. Try soothing the gums by rubbing them with a clean finger or frozen teething ring.
  • Some toddlers may develop a habit of thumb sucking, which is normal. However, this habit can cause problems in the development of jaw and mouth and even teeth positioning. Sucking on pacifiers for extended periods of time can also disrupt jaw development and may result in protruded teeth. One of the best solutions to help your child get rid of thumb sucking is adapting positive reinforcement.
  • This is also an important phase to get your child started on brushing. A pea-sized amount of a toothpaste containing fluoride should be used. Make sure that your child doesn’t swallow it.

Use a toothbrush with soft bristles and gentle stroke s to brush the inside surfaces first where most of the plaque most.

Children

  • Primary teeth are important for chewing and learning to talk. They also play a vital role in determining proper alignment and spacing of the permanent teeth.
  • The enamel on the teeth of children, though fully formed, is still porous and inadequately mineralized. The jaw is growing significantly to make space for more teeth.
  • At this stage, the diet of your child is very important apart from a proper oral care routine. The quantity of sugar and the frequency of its consumption should be monitored strictly. Limit the amount of sweets between meals and prevent snacking throughout the day. Ensure that your child gets wholesome and a healthy diet and opts for healthy options instead of sugary, chewy and hard foods, which can damage the teeth and gums.
  • Supervise the brushing times of your child. Brushing twice a day regularly is very important for maintaining healthy teeth and gums.

Tweens And Teenagers

  • Children between the ages of 10 and 12 or tweens are still losing their primary teeth. The last baby tooth is generally lost by the age of 12 and around this time the second permanent molars appear. Since the permanent teeth are so new, they are more prone to decay.
  • Teenagers, during the age bracket of 16 and 20 get their permanent third molars or the wisdom teeth. These can either grow in earlier, later or never at all. In many cases, the pediatric dentist may recommend the removal of the wisdom teeth since they are difficult to clean or are causing problems.
  • Teenagers often face a lot of peer pressure. This can cause them to might make choices which are harmful to their oral as well as overall health. These include oral piercings, smoking, eating disorders, chewing tobacco, etc.
  • Most kids during this stage of their lives need braces because of misaligned teeth. It’s best to find a dentist who is trained in kids’ oral care and seek professional help for your child’s healthy teeth.
  • Parents should help both tween and teenagers make healthy lifestyle choices including oral habits since their new permanent teeth are more prone to decay and damage.

Adults

  • Adults are more likely to neglect their oral health due to a plethora of reasons. They are at an increased risk of getting gum diseases such as gingivitis or even tooth loss in severe cases
  • Oral health problems can lead to overall health problems such as diabetes, heart diseases, inflammation, etc.
  • Regular brushing and flossing, quitting smoking, limiting coffee and tea intake, eating a healthy diet and drinking sufficient amount of water can help adults maintain a healthy mouth.

Seniors

  • A majority of them don’t have natural teeth. The remaining teeth need to be preserved as they are more prone to oral health issues, such as gum diseases.
  • Certain medical conditions such as arthritis in fingers and hands can make brushing difficult.
  • Use an electric toothbrush. Rinse afterward with an antiseptic mouthwash. Clean the dentures daily.
  • Oral issues at this age can result in overall health complications related to digestion, heart and other vital organs.

A family dentist offers many advantages such as familiarity, convenience, and reliability. They know your family’s dental history thoroughly, which allows for early detection and prevention of any underlying oral or related overall health issues. So if you still haven’t consulted one, find a dentist near you.

Never miss out on dental checkups. Professional dental care can help ensure healthy smiles in your family.

Source: https://www.longevitylive.com/health-living/family-health/know-importance-family-dental-care/