While some people associate the need for root canal treatment with an injury or trauma to a tooth (which is a valid cause), it can also most commonly be caused by tooth decay that is left untreated. This is the reason why we have put together this brief guide to explain the three common stages of tooth decay that lead up to the need for a root canal.

Stage 1: During this stage, decay begins to form in the tiny grooves on the biting surface of a tooth or where the teeth contact each other. The result is loss of the surface enamel of the tooth.

Stage 2: Left untreated, the disease progresses through the enamel and into the dentin, which forms the body of the tooth. Once in the dentin, it progresses more rapidly until it reaches the pulp — the living tissue within the root canals of the tooth. The decay infects the pulp tissues, which contain the nerves of the teeth, causing pain. The end result of inflammation and infection of the pulp is that it dies.

Stage 3: As the nerve dies an infection results, which causes pain and swelling. For some people who do not regularly visit our office, this may be the first physical sign that they have a problem. But all is not lost, a successful root canal treatment, whereby the infected pulpal tissue is removed and the root canals are cleaned and sealed will not only relieve the pain, but save your tooth. So the good news is that once a tooth has had the appropriate endodontic treatment (“endo” – inside; “dont” – tooth) followed by a proper restoration, the tooth can last as long as your other teeth. The key is to take proper care of your teeth, have routine cleanings, and visit our office as soon as you feel you have a problem with a tooth.

If you are having pain or symptoms from a tooth or teeth, check it out with us — you may or may not need a root canal treatment. Contact our office to schedule an appointment and find out. Don't wait until it's too late. And to learn more about the signs, symptoms, and treatments for a root canal, read the article “I'd Rather Have A Root Canal....”

A number of factors can lead to dental caries (tooth decay). To find out if you are at high risk, ask yourself these questions.

Is plaque visible in my mouth?
Dental plaque is a whitish film of bacteria that collects on your teeth. If it is clearly visible, it means that there is a lot of it. Among the bacteria in the plaque are those that produce tooth decay, particularly in an acidic environment. (A normal mouth is neutral, measured on the pH scale, midway between the extreme acidic and basic ends of the scale.)

Do I have a dry mouth?
Saliva protects your teeth against decay by neutralizing an acidic environment and adding minerals back to the outer surface of enamel of your teeth, so reduced saliva is a high risk for caries. Many medications can cause dry mouth as a side effect.

Do I eat a lot of snacks, particularly unhealthy ones?
Frequently eating sugars, refined carbohydrates, and acidic foods promotes the growth of decay-producing bacteria. The more frequently you eat, the longer your teeth are bathed in sugars and acids. Acidic foods not only promote bacterial growth, they also directly cause erosion of the tooth's hard surface by softening and dissolving the minerals in the enamel.

Do I wear retainers, orthodontic appliances, bite guards or night guards?
These appliances are recommended for various conditions, but they tend to restrict the flow of saliva over your teeth, cutting down on the benefits of saliva mentioned above.

Do my teeth have deep pits and fissures?
The shape of your teeth is determined by your heredity. If your teeth grew in with deep grooves (fissures) and pits in them, you are at higher risk for bacterial growth and resulting decay.

Do I have conditions that expose my teeth to acids?
If you have bulimia (a psychological condition in which individuals induce vomiting), or GERD (Gastro-Esophageal Reflux Disease), your teeth may be frequently exposed to stomach acids that can cause severe erosion to your teeth.

Do I already have cavities?
Visible cavities can range from those only visible with laser technology or x-ray examination to those a dentist can see with a naked eye. If you already have small cavities, you are at high risk for developing more.

Do I have white spots on my teeth?
White spots are often the first sign of decay in a tooth's enamel. At this point, the condition is often reversible with fluorides.

Have I had a cavity within the last three years?
Recent cavities point to a high risk of more cavities in the future, unless conditions in your mouth have significantly changed.

If you have any of these indications of high risk, contact us today and ask us for suggestions for changing the conditions in your mouth. You can also learn more by reading the Dear Doctor magazine article “Tooth Decay.”

Dental decay is an infectious and very common disease, but it's also very preventable. Today's dentistry has many tools at its disposal to accurately determine your risk for tooth decay, lower it, turn it around, and completely prevent it. What's more, we can even reverse early decay. You might never have to see or hear the drill again.

Striking the right balance between factors that promote oral health and those that cause disease is of the utmost importance. And knowing whether or not you have indicators of disease or risk for tooth decay is a great place to start.

We will scientifically calculate your risk for tooth decay by:

1. Recording and monitoring your oral and dental health: Our risk assessment/evaluation form allows us to gather information about critical dental health habits. Oral hygiene habits, use of fluoride toothpaste, tobacco smoking, frequent snacking on sugary foods and beverages, and past experience of decay are all examples of disease indicators that will help gauge your level of risk. For example, using fluoride toothpaste decreases your risk, but smoking and between-meal snacking increases it.
2. Testing for decay producing bacteria: You've probably heard of dental bacterial plaque, the biofilm that sticks to your teeth, forming in the tiny little grooves on the biting surfaces of the teeth where decay starts (and along the gum line). Today, acid-producing bacteria responsible for causing decay can be tested by simply sampling your biofilm on a swab, and placing it in a meter to accurately determine acid-producing activity. A high number indicates high risk. You can see it for yourself in less than a minute.
3. Saliva testing: A simple history will tell us whether your mouth is dry or moist most of the time. A saliva test will tell us if your saliva is acidic or neutral. A dry acidic mouth promotes decay, while a moist neutral mouth with healthy saliva promotes health. Measuring salivary “pH,” the measure of acidity, is another factor for determining your risk for decay and reversing it. Special rinses can help reduce decay-producing bacteria and reduce acidity.
4. Very early decay detection: Modern ultra-low-dosage x-ray equipment allows us to determine the very earliest signs of decay. Decay that is detectable with the naked eye (or feel with a dentist's instrument, an explorer) is already at an advanced stage. Catching the disease very early with the help of this sophisticated equipment can allow us to reverse early decay before it has even turned into cavities. It can actually be reversed with remineralizing fluids, rinses that put calcium back into the tooth surfaces reforming and hardening them.

This is a new and exciting era in the fight against tooth decay and we have all the tools to determine your decay risk and reverse it.

If you would like us to determine your risk for tooth decay, please call the office to schedule an appointment. To read more about disease indicators and risk factors for dental caries, read the Dear Doctor magazine article “Tooth Decay: How To Assess Your Risk.”

Millions of people suffer from mouth dryness, but most people just never talk about it. As your dental care providers, we don't want you to keep it a secret anymore and mouth dryness really can be a problem.

Why? Saliva is a very important fluid that moisturizes, lubricates, and aids in the first stages of chewing and digestion. A normal flow of saliva provides antibacterial benefits that even protect against cavities by buffering the effects of acids. It can also make the surfaces of your teeth more vulnerable to abrasion and erosion. Without enough saliva, you may be especially at risk for not only tooth decay, but even yeast infections.

Causes of dryness include dehydration and even morning breath, both of which are normal. Smoking, alcohol and coffee drinking also cause dryness. It is also a side effect of many medications. Although mouth dryness is not a disease in itself, it could be a symptom of salivary gland or other systemic (general body) disease.

As a first step in the treatment, we will assess your situation by taking a detailed habit, diet, medical, and drug history to properly assess the cause and establish whether this is a local condition affecting only your mouth or an indication of a generalized bodily problem.

It's always helpful to keep yourself well hydrated by simply drinking a sufficient amount of water every day and by using good daily oral hygiene to remove dental bacterial plaque. Chewing gum, especially containing Xylitol, will also help promote saliva flow and keep your mouth moist. Be careful not to suck on candy or mints, because they are likely to cause decay. There are also prescription medications that can be used to promote more saliva flow.

Contact us today to schedule an appointment or to discuss your dry mouth and what we can do to help. For more information read the article on Dry Mouth in Dear Doctor magazine.

1. Xylitol is a kind of sugar.
   True or False
2. Xylitol is made from
   1. Bark of birch trees
   2. Coconut shells
   3. Cottonseed hulls
   4. All of the above
3. Xylitol is a natural “sugar alcohol” similar to other so-called sugar alcohols such as mannitol and sorbitol.
   True or False
4. Xylitol is broken down by decay-causing bacteria to produce acid.
   True or False
5. Decay-causing bacteria are transmitted from a parent to a child through oral contact such as a simple lip-to-lip goodnight kiss.
   True or False
6. Researchers have found no difference in prevention of tooth decay in gum made from xylitol compared to gums containing sorbitol/xylitol and sucrose.
   True or False
7. Other xylitol products such as mints, candy and cookies also seem to decrease the incidence of tooth decay.
   True or False
8. Xylitol products increase salivary flow and allow saliva to neutralize acids in your mouth.
   True or False
9. The only side effect of too much xylitol ingestion is a possible mild laxative effect.
   True or False
10. The target dose of xylitol is one to two teaspoons spread throughout the day.
    True or False

1. True. Xylitol is a kind of sugar that does not contribute to tooth decay.
2. All of the above. It is also found naturally in some fruits and vegetables.
3. True. The others, mannitol and sorbitol, are used as sugarless sweeteners.
4. False. Unlike sucrose (table sugar), xylitol is NOT broken down by bacteria to produce acid. Xylitol also stops saliva from becoming acidic so your mouth becomes an unfriendly environment to acid-producing bacteria.
5. True. However, xylitol inhibits growth and attachment of the bacteria to your teeth, so it also inhibits transmission to your children.
6. False. Systematic use of xylitol chewing gum significantly reduces the relative risk of caries (tooth decay) when compared to chewing gums containing sorbitol/xylitol and sucrose. Xylitol gum also appears to halt the development of tiny cavities when compared to other types of chewing gum.
7. True. Use of these products seems to stop the progression of active decay.
8. True. Xylitol and your saliva combine to re-mineralize (harden) your teeth after an acid attack.
9. True.
10. True. This means two pieces of xylitol gum or two pieces of xylitol candy or mints should be consumed for five minutes four times a day after eating meals or snacks.

Contact us today to schedule an appointment to discuss your questions about xylitol and other methods of preventing tooth decay. You can also learn more by reading the Dear Doctor magazine article “Xylitol in Chewing Gum.”