Meta

Dr. Sperbeck,
A recent discovery of cavities in my children prompts my asking:
would a root canal be necessary in a seven year old child?
should all cavities be filled, even small cavities in primary teeth?
is mercury in fillings acceptable for primary teeth which will be falling out within five years or so?
what can I do specifically so that we don’t have cavities like this again?

Thanks for any time you may be able to spend in addressing these questions.
–Laura

Dear Laura,
Let me try to answer your questions as listed.

1. Should root canals be appropriate for a 7 year old?
Root canals are use when the nerve of the tooth is damaged or dead. This will cause the leakage of toxins into the body. Usually an abscess is the result with a variety of consequences. Root canals for children fall into two catagories: for permanent teeth or baby teeth. if it is for a permanent tooth it is usually a very good idea. If it for a baby tooth, it depends on how much longer the tooth is needed before its eventual loss. Baby teeth serve many purposes: they are important in helping jaws develop and holding the place for the soon to be present permanent teeth. So whether the baby teeth should be root canaled the answer is maybe. Your dentist will be able to answer the pros and cons for treatment.

2. Should all cavities be filled?
Again, the answer is usually. If the tooth is not in hopeless condition and there is continued need for the tooth then the answer is yes. With a baby tooth I usually try to gauge the size of the cavity with the expected time for the loss of the tooth. If the cavity will not grow to big and cause nerve damage or affect the tooth next to it I will not repair it. I always inform the parent so they can be in on the decisions.

3. Should Mercury fillings be used?
Mercury fillings are also known as Amalgam fillings. The material is approximately 50% mercury and 50% silver. I do not believe it should be used for any reason. Mercury is very dangerous for children and women in the child bearing years. Once mercury enters and is absorbed in the body it is very difficult to remove, not to mention the expenses for removal. There are other materials that will restore the teeth as well with out the possibility of risk.

4. How to prevent cavities?
This is a great question. Prevention is where the battle should be fought. So your areas to concentrate on are:
A. Control diet. Everything that can cause cavities should be controlled. The list is numerous but the management is doable.
B. Good oral hygiene with toothbrush and floss. These are very inexpensive and have a huge bang for your buck.
C. The use of sealants. This wonderful tool is very under utilized.
D. Oral hygiene instruction from your dentist. Always ask the dentist or the hygienist for an evaluation at each visit because each hygiene appointment should be a learning time. Patients should clean their own teeth and the professionals should instruct.
E. Frequent hygiene appointments with a dental checkups each visit. This is the standard in our office. This allows for the aforementioned instruction and for the prompt discovery of problems early in the game.
F. X-rays routinly taken. The are invaluable to help in prevention of serious problems. If you can, have digital x-rays taken. Digital x-rays have a significant reduction in the exposure of the x-ray.

I hope this helps.

Regards,
Dr. Sperbeck

This week brought two new patients that have locked jaws. Their “TMJ joints” either have been displaced or they are having muscle spams. There was a significant differences in age as well as both sexes.

So what do we do? First, I always start with a full exam. This includes history of the injury or event along with full dental exam. I check muscles and all the related supporting structures to get an idea of the extent of the problem.

A word about x-rays: I recommend a complete set of x-rays as well as additional x-rays of the TMJ. For the x-rays of the TMJ, there is a single cone x-ray called an I-Cat. The I-Cat gives a great hard tissue view of the bone. If I need additional information after I see the I-Cat, I may request an MRI. This kind of X-ray will fill in the blanks of soft tissue information that the I-Cat will not have.

With the combination of the exam, history and supporting documentation can give me a great idea as to the health of the TMJ and a prognosis. Having an accurate diagnosis is what dictates treatment and projected outcome. Based upon this information, I design and make a TMJ splint. A well designed TMJ splint is essnetial for TMJ treatment as well as for aiding in the diagnosis.

Locked jaws are nothing to waste about time about. One of hte most important factors determining recover is the time lapse between the event and a visit to your dentist. Time is critical. The sooner care is started the better the chance of complete recovery. I am pleased to say that I expect these two patients from last week to make good recoveries.

Well I can’t believe I am doing this, but it seems like a good idea to lead by example and share with you how I brush my teeth. Please bear with me.

My routine is preformed 2 times daily, once in the morning and once before bed. I am consistent six days a week, although it may vary depending on how tired I am.

The sequence is floss, then brush, then hydrofloss. Not very exciting, but very practical.

Flossing needs to be taught to you by a dental professional. I use the “wrap around the middle finger technique” that leaves the other fingers free to direct and control the floss. I will floss each side of a tooth ten times. Any floss will do, but I prefer the non-waxed floss because it gives me satisfaction when I hear it start to squeak. I like to floss first because I then use the brushing to remove the dislodged bacteria .

Brushing should take at least four minutes by the clock. How much day dreaming can you do looking at yourself for four minutes twice a day? I find an electric toothbrush to more efficient and I can very effectively brush in 2 minutes. I use a Rotodent because I think it is the best on the market.

Next is a tongue scraper. This helps with odor control.

Lastly I use a waterpik called a Hydofloss, also the best on the market. I add a couple cap-fulls of BreathRX to help me with odor control.

Total time: 4 minutes.

Best wishes,
Dr. Sperbeck