Tooth Decay: The Modern Model

Tooth Decay

Tooth decay is a bacterial infection of a tooth that causes a cavity. Before the widespread acceptance of oral hygiene and professional maintenance, the concept of how a cavity was formed was considered a “top-down” infection. In this traditional model, tooth decay started on the tooth’s surface within the pits and grooves where bacterial dental plaque became easily trapped. When exposed to sugars, the bacterial plaque produces acid that decalcifies and softens the tooth’s enamel surface, thereby causing a cavity.

Today’s modern model is based on a “bottom-up” progression. With the public’s acceptance of frequent regular tooth brushing, flossing, professional dental hygiene visits, and the use of fluorides for remineralizing teeth, the outer enamel surface of a tooth has become more resistant to tooth decay. Nonetheless, some pits and grooves extend so deeply down microscopic channels that it is impossible for a toothbrush bristle or fluoride to penetrate into these areas (see Figure 1). Tooth decay can then start below the surface of a tooth. By the time the decay becomes detectable at the tooth’s surface, it has already become a large cavity (see Figure 2). That is why most fillings end up being larger than the “tiny cavity” seen during a dental examination.

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The practice of Minimally Invasive Dentistry is a preventive and optimally health oriented approach that is based on the early diagnosis and treatment of a cavity before it destroys and weakens a tooth so much that it needs a larger filling, onlay, or crown, or even a root canal if the nerve of the tooth becomes infected too. Our use of the DIAGNOdent® laser allows us to accurately diagnosis these sub-surface cavities.

Some studies also show that ozone can arrest the progression of tooth decay so that the overly aggressive drilling out of unaffected tooth structure to ensure removal of all of the tooth decay can be minimized. Ozone, an activated form of oxygen, is a potent antimicrobial. Call us to find out more about these alternative options.

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Before and After Photos

Upper front tooth replaced with an all porcelain Maryland Bonded Bridge.

Photo by Dr. Leo Arellano

Crowns - Bridges – BNA Image – 18 - 2
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I’ve been going to Dr. Arellano for about 20 years and I continue because of the excellent care and treatment I get with him and his whole office team. He is both professional and personable.
Recently I had a newer technique of gum surgery/grafting at his office called, “Pinhole Surgical Technique of gum grafting.” I personally found this to be much easier to handle than the other style of gum grafting that I received years ago for the other side of my mouth. That worked, it was where part of my roof of my mouth was cut and surgically sewn onto the gum. However, I much prefer the pinhole technique. It was actually the easiest dental work I’ve had (beyond regular cleaning) It didn’t take too long and it didn’t feel uncomfortable getting it done.... More Reviews