Restorative Dentistry

There are many reasons why adult teeth may need restorative treatment. The most common reason is decay, followed by fractured teeth, and old restorations needing replacement.

Tooth decay causes change as people grow older. Two out of three cavities in people over fifty are cases of decay around fillings. Many older adults grew up without fluoride, and are likely to have many fillings. Cavities that reoccur form next to existing restorations such as fillings, crowns, bridges, etc. As restorations get old, the filling material can shrink or wear away, causing the possibility of a small space forming between the tooth and the restoration. This provides a prime area for bacteria to accumulate and breed decay.

Root caries is a type of tooth decay common among older adults. Root caries is likely to occur in adults who have receding gums as a result of periodontal disease. When the gums recede, the root surface becomes exposed. The root surface is softer than enamel and thus decays more easily. The exposed root may be also be the result of hard brushing. Over 70% of individuals over age 60 have root caries.

Tooth decay can also be caused by dry mouth, common among older adults. Dry mouth occurs when the supply of saliva is greatly reduced. Medications such as sedatives, barbiturates, antihistamines, and drugs for muscle control, produce dry mouth. It can also result from radiation therapy to the head or neck, or in individuals who are mouth breathers. Without adequate saliva, food is not washed away from around the teeth, and the acids produced by bacteria in plaque are not neutralized. This can enhance the chance of tooth decay.

If the dentist recommends that a tooth with a cavity be treated and more than a few weeks pass after the initial diagnosis, the cavity will almost always get bigger and can cause pain. Once this happens, it will likely require more extensive and expensive treatment. The tooth may even have to be removed and replaced with a false (or artificial) tooth. If a restoration is needed, there are different kinds of materials that may be used to restore the functionality of the tooth. Please remember that a tooth may need treatment before it causes pain. If a tooth causes pain, it may be able to be saved, but the treatment time and cost typically increase due to the complexity of the necessary procedures.

How a Cavity Forms

A cavity is a very small hole that forms on the surface, side, or root of a tooth. Cavities are caused when sugars in the food eaten combine with the bacteria in the mouth. This combination produces a mild acid that eats away at the enamel, the hard outer layer of the tooth. . There is a genetic component to dental health, including teeth, gums, and the bone that holds the teeth. No matter how good your genes are, if you don’t take good care of your teeth you may be prone to very serious consequences.

Cavities and Restoration Choices

As part of any dental exam, we check all restorations such as crowns, fillings, bridges, veneers, etc. for any sign of decay or old age and we may recommend x-rays so that we can see inside and between your teeth. If we spot any cavities, we will recommend different options for restoring the tooth to full function. If the cavity is in the very early stages, we may decide to keep an eye on it and recommend a home fluoride rinse to help the tooth fight the cavity and possibly prevent the need for a restoration.