Dental Works - in Your Local Area

Root Caries: An Epidemic of Age

People are living longer and keeping their natural teeth more than ever before. The advances in tooth retention, the desire to look one's best, and higher expectations about oral health have raised dental awareness among older adults.

With the significant increase in the older portion of society, with even greater increases expected, more older adults will have more teeth that are susceptible to root caries. Root caries may emerge as one of the most significant dental problems among older adults during the next decade. A recent study conducted by the National Institute for Dental and Craniofacial Research (NIDCR) showed that over half of older adults have decayed or filled root surfaces. The frequency of root caries is strongly age-dependent and will continue to be a major dental problem among the elderly.

Root caries lesions can be caused by new or primary root caries, caries around existing dental fillings or recurrent caries, and abrasion or erosion of the root surfaces. Root caries progress quickly due to the relatively soft nature of the root surface, as well as the risk factors associated with the incidence of root caries.

Risk factors associated with the high prevalence of root caries among older adults include decrease salivary flow or xerostomia, exposure of root surfaces due to periodontal (gum) disease, chronic medical conditions, radiation treatment for head and neck cancer, physical limitations, and diminished manual dexterity due to stroke, arthritis, or Parkinson's disease, cognitive deficits due to mental illness, depression, Alzheimer's disease or dementia, Sjögren's syndrome (an autoimmune disease), diabetes, poor oral hygiene, multiple medication use, and changes in dietary habits. One or more of these risk factors or life changes, which are more common among older adults, can increase root caries in an individual who has not had dental caries for many years.

Root caries can be a challenge for the dentist to treat depending on the size and the type of root caries lesion, the extent and rate of caries activity for that person, the physical and mental condition of the individual, and where the root caries are located in the mouth. Many root lesions have limited accessibility and visibility, are often more complicated by pre-existing extensive dental work, and are difficult to isolate from oral fluids during the restoration process. Also, many people who have widespread root lesions have limited tolerance for dental treatment because of medical conditions, illness, and mental health problems.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

False Teeth: Porcelain vs. Plastic - Discover The Difference!

In the past, false teeth made with porcelain were generally preferred over false teeth made from plastic due to their greater durability and esthetics. However, in recent years, new generation biomaterials have resulted in the development of very wear-resistant false teeth made from plastic.

Clinically, the esthetics of plastic and porcelain denture teeth is nearly comparable, with good quality false teeth made from porcelain still being the standard for esthetics. However, the majority of dentures today probably are fabricated with false teeth made from plastic. For all practical purposes, the cost of porcelain and false teeth made from plastic are about the same.

While porcelain and plastic teeth are competitive with regards to durability, and to a lesser extent, esthetics and wear, there are other factors that may favor the selection of one type of tooth over another.

Some Selection Factors for False Teeth

Balanced bite and force transmission:

Denture bite (called occlusion) changes due to the constantly changing jawbone (called alveolar bone) upon which a denture rests, and, to varying degrees, uneven tooth wear resulting from use. Unless a denture is evaluated and its occlusion adjusted to a uniform and even contact (called balanced bite or balanced occlusion) at regular intervals, denture occlusion will become unbalanced.

Since false teeth made from porcelain are more wear-resistant, their occlusion will not become significantly self-altered by wear, as will false teeth made from plastic. However, when alveolar bone changes cause an unbalanced occlusion, the resulting biting forces from false teeth made from porcelain will be unevenly transmitted to underlying supporting alveolar bone. Frequent tissue refitting of the denture usually eliminates or lessens this problem.

Porcelain denture teeth tend to transmit the impact of biting forces to the alveolar ridge with greater intensity than that transmitted by plastic teeth in an unbalanced tooth contact situation. Some practitioners are of the opinion that this greater force, especially when uneven as in an unbalanced occlusion, may be damaging to the alveolar ridges and could result in accelerated bone loss.

Therefore, unless denture occlusion is checked and balanced on a regular basis, false teeth made from plastic would probably be a preferred choice over false teeth made from porcelain.

Bone loss:

If a person has lost a great deal of supporting alveolar bone and their gum tissue is not of a sturdy type, then plastic denture teeth might be a better choice. These teeth are more forgiving of excessive forces developing from habits such as clenching, grinding, and tapping or "clacking" of teeth, which seems to be more prevalent among older individuals. Plastic teeth do not transmit forces to underlying bone as intensely as false teeth made from porcelain.

Noise:

If false teeth made from porcelain are vigorously used or sometimes habitually tapped together, a "clacking" sound can be heard. Plastic teeth will muffle this sound and be quiet during normal function or habit jaw motions (called parafunction).

Which Type of Tooth Is Best?

If a person has been successfully wearing dentures with false teeth made from porcelain, then they should probably continue with false teeth made from porcelain. These teeth will not wear as fast as false teeth made from plastic, and the relationship between upper and lower jaws will tend to stay normal for a longer time than with false teeth made from plastic.

Regardless of which type of tooth is selected, the success of the selection is strongly based upon regularly checking dentures for proper balanced occlusion and fit on regular intervals.

If a denture is going to be worn against opposing natural teeth, then false teeth made from plastic should be selected because false teeth made from porcelain, being harder, could excessively wear natural teeth away.

After a thorough examination and frank discussion of what a person wants from wearing a denture, a licensed dentist can effectively discuss which type of tooth would best meet a particular individual's unique needs and desires.

Tooth Strength

Because false teeth made from porcelain are extremely hard in comparison to false teeth made from plastic, they tend to chip and crack more easily. For this reason, when dentures having false teeth made from porcelain are brushed and cleaned, they are generally handled over a sink filled with water or over a towel. Should the denture accidentally fall, the water or towel would help break the fall and hopefully reduce tooth breakage.

by Joseph J. Massad, D.D.S.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.