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Tooth Decay on the Root Surface

July 19, 2015 in Dentistry,Periodontal Treatment,White Fillings by mccarl_dental

Tooth decay on the root surface of teeth is also called root decay or root caries. It is an important dental problem that needs immediate treatment.

Root caries on lateral incisor, canine and first bicuspid

Root caries on lateral incisor, canine and first bicuspid

While many people are fortunate enough to have cavity resistant tooth enamel, few people have cavity resistant root surface. When gums recede below the enamel line of the tooth or pull away from the tooth, root surface is exposed. The root surface does not have a hard protective enamel covering like the crown of the tooth. This unprotected surface is very vulnerable to decay. Root caries do not occur unless the root of the tooth is exposed or there is loss of attachment of the gum to the tooth. An exposed root surface frequently becomes sensitive to hot, cold and sweet foods and drinks.

Causes of Gum Recession and Root Caries
Poor oral hygiene – not brushing teeth and flossing teeth daily
Brushing teeth too vigorously or using a hard bristle tooth brush
Age – as people age, their gums typically recede exposing root surfaces
Periodontal disease known as gum disease
Genetics – periodontal disease runs in families
Diabetes
Crooked teeth – misaligned teeth are more difficult to clean thoroughly and can make you more prone to gum disease
Smoking cigarettes or cigars, dipping, using chewing tobacco or any kind of tobacco use
Medication that causes dry mouth
Radiation treatment for head and neck cancer
Trauma to gums or teeth

Treatments for Receding Gums and Root Decay
The appropriate treatment of receding gums depends on the reason for recession and the extent and severity of the decay.

Use a soft bristle or electric toothbrush. Our dental hygienists teach dental patients how to brush teeth to clean tooth surfaces and gums thoroughly and prevent further gum recession. This will not repair existing damage but will hopefully prevent additional gum recession.

Excellent oral hygiene at home and routine cleaning by a dental hygienist and dental examinations.

If the gum recession is caused by periodontal disease, the patient will need periodontal treatment by a dental hygienist that usually starts with scaling and root planning. Plaque and tartar are removed from the surfaces of the root and teeth. Periodontal treatment can help gum tissues heal and reattach to the tooth surface.

If gum recession is advanced, a gum graft where the gum tissue has receded may be indicated. Grafts may help protect the root surface from sensitivity and decay.

Tooth colored fillings can repair this root caries before it becomes too advanced

Tooth colored fillings can repair this root caries before it becomes too advanced

Root caries on a lower molar

Root caries on a lower molar

If tooth decay or root caries are present, the patient will need to have the decay removed and replaced with a filling or crown. At McCarl Dental Group, we have not used amalgam fillings for more than 25 years. We use tooth colored composite filling material to fill a cavity after removing tooth decay.  Dental fillings should not be visible when you smile or talk.

Why Do We Measure Periodontal Pocket Depths?

September 22, 2011 in Dentistry,Periodontal Treatment by McCarl Dental Group

An important measure of periodontal (gum) health is the depth of the pocket around each tooth. The top of gum tissue does not attach directly to teeth. There is a space of pocket between the gum and the tooth before it attaches. This space or pocket deepens in the presence of gum disease. To monitor and evaluate gum health, the pocket depth must be measured, recorded, and monitored over time.

Many diseases are not obvious without testing. High blood pressure, high cholesterol, and high blood sugar levels must be measured in order to be evaluated. Similarly, periodontal disease needs to be measured by pocket depth around each tooth.

The pocket depths are compared to see if gum health is improving, maintaining, or getting worse. Gum disease is sometimes called “the sneak thief of teeth.” You may not know you have it until it is too late. People may assume their gums are fine because “they don’t hurt,” but if the pockets haven’t been measured, you can’t be for sure. The dentists and hygienists at McCarl Dental Group work to monitor these levels closely for each patient in our Greenbelt and Millersville, MD dental offices.

In a healthy mouth, a pocket can be anywhere from 1-3 millimeters deep. To measure a pocket we use a periodontal probe. The probe allows us to measure in millimeters from the top of the pocket to the bottom of the pocket. The bottom of the pocket is the area where the tissue is connected through ligaments to the root.
This measurement is taken very gently and causes no damage to the delicate gum tissue.

When a tooth has periodontal disease, this tissue becomes detached past 3mm deep. Under 3mm deep a pocket is considered healthy, while 4mm or deeper it is considered unhealthy. When connective tissue loss occurs, it is also a sign that there is bone loss. By our hygienists and dentists measuring the periodontal pockets regularly, we can monitor bone and tissue attachment levels. These measurements should be taken once or twice a year, or more often in patients with active or previous periodontal disease.

The recordings taken during periodontal probing are recorded onto a chart. There are 6 measurements taken for each tooth, 3 on the facial side and 3 on the tongue side. By monitoring the recordings against each other, the dentists and hygienists at our dental offices in Millersville and Greenbelt, MD are able to make sure no areas become progressively worse, or note improvement where treatment has occurred.

When several deep pockets are evident we will recommend scaling and root planing, or “deep cleaning.” The deep cleaning is more involved in that the focus is to remove the tartar from all pocket areas, since that is the bacteria’s “hiding place.”  Not even diligent brushing and flossing can remove the tartar from a deep pocket. If left alone, these infections can cause more bone loss and tissue detachment, resulting in tooth loss.

The Dentists at McCarl Dental Group in Millersville, MD and Greenbelt, MD, we believe in early intervention and prevention. By recording periodontal measurements at regular recall appointments, it can help us to detect small problems before they turn into large ones. We will work together with our patients to help them understand where these periodontal pockets are, and what we can do to help them heal. If you’re looking for a dentist in the Greenbelt or Millersville, MD area, please feel free to call and schedule an appointment. Greenbelt dental office –  301-474-4144; Millersville, Maryland dental office 410-987-8800. We’re available 6 days a week.   To learn more about periodontal charting and other dental topics, please visit the McCarl Dental website at www.mccarldental.com.

8601 Veterans Hwy, Suite 101, Millersville, MD 21108 USA
Dr. Clayton McCarl, Jr. Millersville, MD cosmetic, restorative, & preventive dentistry. infoshipleys@mccarldental.com
28 Ridge Road, Greenbelt, MD 20770 USA
Dr. Clayton McCarl, Jr. Greenbelt, MD cosmetic, restorative, & preventive dentistry. (301) 474-4144 infogreenbelt@mccarldental.com