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COVID-19 update: Office is open with policy changes.

In the past, dental patients were limited in their filling options to just silver amalgam. This filler has been used to restore tooth decay since the very beginning of the dentistry profession. While there are some opponents of amalgam, due to the possible environmental and health issues, people are mainly shifting away from this option because they want aesthetic options.

Some people prefer ceramic, since they are nigh invisible. The downside is that these kinds of fillings may not be covered by insurance. The happy medium between the two is composite fillings. Not only are they aesthetically pleasing, but they are more affordable. You can learn more about composite fillings at:

However, even though each filling option has its pros and cons in regards to price, durability, etc., nothing can beat the natural structure of enamel. In fact, some patients may want to remove some of their old amalgam fillings, but their dentists may recommend that they don’t since the removal may necessitate the removal of some enamel also.

If patients can, they should try not to rely on fillings to fix their problems, but try to work on preventative care. Lori Roniger–an editor for a dental site–says that there are options that can increase the effectiveness of preventative care:

Which Treatments are Most Effective for Caries Prevention?

The most widespread diseases in “civilized populations,” with a prevalence of 40% in 7-year-old boys and 85% in 17-year-old boys, the study authors noted. However, some evidence has shown that dental caries incidence in 5- to 17-year-olds has decreased around 36% in recent decades, with half of children caries-free.

With that in mind, the researchers from Italy conducted a comprehensive literature search in four databases for systematic reviews of treatments for preventing caries conducted by “renowned” scientific institutions and published from 2002 through 2015.

They found 30 eligible systematic reviews that met all of the study’s requirements, 20 of which were conducted by the Cochrane Oral Health Group. Four researchers independently reviewed the articles that were identified.

The researchers summarized the results of the reviews, dividing them into three categories by treatment:

  • Fluoride gel, toothpaste, and mouthrinses
  • Pit-and-fissure sealants
  • Fluoridated supplements, water, and milk

Overall, they found that topical application of fluoride gel and fluoride supplements appear to be convenient and inexpensive methods of reducing caries. Also, pit-and-fissure sealants and fluoride varnishes appear to effectively reduce caries risk, they concluded. Read full article here . . .

Although sealants are mainly recommended for children, if they are so effective at reducing caries, then why shouldn’t adults get them as well? In the meantime, this study shows that keeping good oral hygiene is the easiest method at your disposal to avoid caries and the need for fillings.

And even if a patient has fillings to repair a cavity, that doesn’t mean that the filling acts as a barrier (like sealants). There could even be future decay in the same tooth . . . which brings us to the question: besides fillings, will there ever be other options to help decay if preventative measures fail? According to one study, the answer is yes:

Study Offers New Treatment for Larger Caries

January 9, 2017 — Soon you might be treating your patient’s caries with a collagen sponge filled with a drug — first tested to treat Alzheimer’s patients — that stimulates the natural ability of teeth to restore dentine.

A study published January 9 in Scientific Reports by researchers in the U.K. documented a new method of stimulating the renewal of living stem cells in tooth pulp. While still needing human clinical trials, this approach may allow large cavities to be repaired without the use of cement or fillings.

“The simplicity of our approach makes it ideal as a clinical dental product for the natural treatment of large cavities, by providing both pulp protection and restoring dentine,” stated lead study author Paul Sharpe, PhD, in a press release. “In addition, using a drug that has already been tested in clinical trials for Alzheimer’s disease provides a real opportunity to get this dental treatment quickly into clinics.”

Sharpe is the head of the craniofacial development and stem cell biology division at the King’s College London Dental Institute . . .

After removing caries decay, a tooth’s soft inner pulp is exposed, and a natural dentine repair process begins. This process uses a form of stem cells in the patient’s mouth that becomes new cells. These cells release a form of reparative dentine, according to the study authors. Read the full here . . .

Even though this kind of technology to repair tooth damage may not be around immediately, it is pretty nice to know that patients won’t always need to weigh the pros and cons of filling materials. And if a patient does all they can to prevent decay and it still happens, it’s nice to know that dentistry will continue to evolve to help people maintain as much of their teeth’s integrity as possible.

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