Your Teeth and You

THE DENTIST
A practising dentist must have a doctoral degree, awarded after seven or more years of university education and be licensed by the Royal College of Dental Surgeons of Ontario. The RCDSO has rigorous requirements regarding quality assurance and mandatory continuing education. The dentist is the only professional trained and licensed to diagnose dental disease, to order dental x-rays, and to prescribe medications for treatment of dental conditions. The dentist has the knowledge and skill necessary to diagnose and treat dental diseases, and to design and institute programs to prevent dental problems.

Some dentists, after further years of study, have chosen to specialize in or restrict their practice to certain aspects of dentistry. These areas include:

THE DENTAL TEAM
Under the direction of the dentist, the dental team generally includes assistants, hygienists and receptionists.

DENTAL HEALTH
Dental health means, of course, the absence of dental disease. Healthy, straight, white teeth - free of cavities and gum disease - are your dentist’s goal.

DENTAL DISEASE
The most common dental diseases are Caries (cavities), and Periodontal Disease (gum disease).  There are many other less common oral diseases.

Dental caries (or cavities) are an infection caused by bacteria (chiefly streptococcus mutans and lactobacillus). These bacteria are present in virtually all mouths. Caries-causing bacteria consume sugar, producing acid as a waste product. If enough of these bacteria are allowed to grow on the teeth, the acid they produce can dissolve part of the tooth resulting in a hole called a cavity.

TREATMENT OF DENTAL CARIES
A cavity is repaired by removing the bacteria and the infected tooth structure, and filling the resulting hole with a material designed to restore the shape and function of the tooth.

Small cavities may be directly filled with white plastic or silver amalgam filling materials. Larger cavities may require an inlay, an onlay, or perhaps a crown, which may be made of porcelain, gold or acrylic.

If a cavity is allowed to become too large, it may invade the pulp (nerve) of a tooth - resulting in pain, infection and swelling. The dentist, to save the tooth, may need to perform a procedure known as a root canal or endodontic treatment. This is really just a filling of the hollow centre (root canal space) of a tooth to remove the infection. Root canal trearment may be performed by your family dentist, or by a specialist known as an endodontist.

Very large cavities may not be able to be treated, resulting in the need for tooth removal and replacement.

Your dentist, with a knowledge of bacteriology, restorative techniques and biomaterials, has the expertise to treat caries.

PREVENTION OF DENTAL CARIES
As in all diseases, prevention is the ideal treatment. Cavity prevention involves first, not feeding the bacteria, by consuming a healthy diet low in sugar. Unfortunately, there is sugar in many foods and therefore it cannot be completely avoided. It is also critical to remove the bacteria that grow on the teeth - by brushing and flossing, sometimes supplemented by other means.

Other strategies developed by dentists to prevent cavities are the application of fluoride, which makes teeth much more resistant to acid, and fissure sealants, which seal the grooves of back teeth with acrylic. These two treatments have been enormously successful in reducing cavities.

GUM DISEASE
There are two major forms of gum disease: gingivitis and periodontitis. Gingivitis involves swelling and redness of the gum tissues around the teeth. It is caused by the layer of bacteria that grows on the surface of the teeth at and under the gum line. If this condition is not adequately treated it usually progresses to periodontitis.

Periodontitis is a chronic infection involving the bacterial breakdown of the bone and ligament that support the teeth. The risk factors for gum disease include bacterial plaque on teeth, lack of professional care, and smoking. Gum disease must be diagnosed by the dentist and treated early since it does not usually have any symptoms identifiable by the patient. Left untreated it leads to loose teeth, an acute infection or tooth loss. Untreated periodontitis is associated with medical conditions such as stroke, coronary heart disease, and pneumonia.

Treatment of gum disease in mild cases may be as simple as thorough and regular professional cleaning with guidance in home care techniques. More advanced cases may require surgical procedures to save the teeth. Treatment may be given by your family dentist or in some cases referred to a specialist known as a periodontist.

OTHER DENTAL DISEASES
Other Dental Diseases include bacterial, viral or other infections, cysts and tumors, and congenital conditions. The dentist, with knowledge of anatomy, physiology and oral pathology is responsible for the diagnosis and treatment of these conditions.

Again, prevention is better than treatment, and your dental team will help with advice on a healthy diet, and elimination of specific risk factors (such as smoking and excessive alcohol consumption).

INJURIES
The teeth and jaws can easily be damaged by trauma, from motor vehicle accidents, abuse and, most commonly, sports. Most competitive sports and some individual sports can result in fractured teeth or jaws, loss of teeth or concussion. The dentist can help you choose appropriate dental sports mouthguards to help prevent such injuries.

YOUR SMILE
Healthy teeth generally result in a pleasing natural smile. However, teeth that are discoloured, crowded or uneven can be treated with many different procedures such as tooth whitening, veneering or orthodontics. Your dentist can explain the various treatments that will give you the smile you want.