Man in dental chair getting cleaning | Dentist Gretna LA

Stopping Decay

April 20, 2020
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Posted By: Nola Dentures and General Dentistry
Man in dental chair getting cleaning | Dentist Gretna LA

As I’m a dentist, it is common for me to see patients who have a lot of cavities. Some of my patients come to me having not seen a dentist for years and have cavities on almost every tooth. Other patients are ones who routinely see me for cleanings, but at every check-up, a new cavity pops up. These people are at high risk for infection, and I have developed protocols in my office to help stop or at least slow the rate of cavities. The three parts of what I recommend are quickly removing and treating the infected teeth, take-home, prescription-grade oral hygiene products, and seeing me or my hygienist for more frequent recare appointments.

How to Treat Cavities

Obviously, when someone has cavities they need to be fixed lest they get bigger.  However, depending on a person’s history with cavities, some may need to be treated immediately whereas others can be monitored. If I have a patient who has never had a cavity before in her life and I see a questionable spot on an x-ray, I am ok monitoring that every six months at her cleaning appointment. On the other hand, if she has had cavities in the near past, I am more aggressive recommending treatment on these teeth as they are more likely to progress into larger lesions.  If a person comes with many cavities, I am most likely to recommend only fillings and no crowns initially. The reason is that crowns can easily get a cavity on them again and are very difficult to treat when this happens. Also, I tend to shy away from restoring teeth where the nerve is infected and needs a root canal, and I recommend implants in patients who continuously suffer from cavities. The reason is that implants will not get cavities on them and will likely last longer in this patient’s mouth.  For treating the cavities, I like to do them all in at most four visits. Doing them this quickly makes sure that the cavities have less chance to spread.

Cavity Prevention

After the cavities are treated, I will give my patients oral hygiene products to help prevent new cavities from happening. First, I like everyone brushing with a high fluoride toothpaste.  This will help prevent new cavities as fluoride is anti-microbial and also strengthen the teeth as well. Next, I recommend a better mouth wash called Peridex.  Peridex is a diluted form of chlorohexidine which is the same medication used by orthopedic surgeons to clean an area prior to surgery. It is also anti-microbial and is to be used for the first seven days of each month.  Using more frequently will cause the teeth to stain but will not cause any other issues. The last thing that I recommend is at-home whitening trays.  Whitening once per week also helps keep the bacterial levels to a minimum so that the risk of new cavities is lower.

Cavity Treatments for High-Risk Patients

The final part for minimizing new cavities is for my patients at high risk for cavities to come once every three months for cleanings and get x-rays every six months to check around the teeth.  By doing these more frequent cleanings and x-rays, we can catch cavities when they are small and little damage has been done. Also at these visits, I will place a medication called silver diamine fluoride or SDF around the back teeth. SDF has been used in Japan for a few decades and has recently been approved in the USA.  SDF reacts with any cavity and kills the bugs. The only issue with the SDF is that it turns any cavities black and that blackness will not go away on its own.  The only way to fix this blackness is to remove the affected tooth structure and do a filling. For this reason, I limit SDF to posterior areas that are not in the smile line and guarantee that if an anterior area is affected, I’ll fix the area with a filling. I offer SDF for all my patients who routinely get cavities as well as those with many expensive crowns and bridges in the back of their mouth. I still recommend SDF for my patients with crowns in the back of their mouth simply because it is cheaper to apply the SDF and try to prevent a cavity than it is to replace any of the crowns. The most impressive part of SDF is that I have applied to it to areas where I detected no cavities and in mouths where I would not expect any cavities, but it had a reaction and a small cavity was prevented.

Contact Our Gretna LA Dental Clinic

By using modern techniques, I am able to help my patients prevent further break down in their mouths due to cavities. While fixing the cavities is important, by changing home care as well as finding ways to maintain health, patients who have suffered through frequent cavities might have a bit of reprieve in visiting the dentist. If you chronically get cavities or have a lot of bad teeth in your mouth and want to find ways to stop the decay from happening, call us at 504-392-5104 and we will help you out.
 

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