What is a cavity?

Our teeth are made out of two materials, a hard outer crystalline structure called enamel and an inner softer region composed of dentin. Every day, we eat and put food in our mouths to chew it and then swallow. However, every time we chew and swallow a little bit of that food remains stuck to our teeth in the grooves and spaces. Our food is not just sustenance for our own bodies, but also food for the millions of different bacteria that reside in our mouths. It turns out that a few species of these bacteria eat the sugars that pass through our mouths in our food, and create a waste product that is an acid which then sits on our teeth. Summarizing, this acid, if allowed to stay on the teeth, will slowly eat away at the hard tooth structure and create a cavity filled with more bacteria. This cavity is often darker, brown, and turns the once hard tooth into a soft sticky mush.

If the cavity is allowed to grow in size, the tooth can break, or worse, the bacteria can reach the nerve of the tooth and infect the jawbone.

What is a Rubber Dam and Tooth Isolation?

Modern dentistry heavily relies upon the strength and integrity of the restoration’s adhesion (glue) to tooth. Typically these restorations are tooth colored fillings or ceramics. The quality of this adhesion is essential to longevity, preventing sensitivity, and sealing out bacteria and preventing potential recurrent decay. Modern dental adhesive techniques require a clean and dry working field for success. You can imagine these procedures can be an uphill battle in the naturally wet mouth. This challenge in restorative dentistry has resulted in the development of several different methods for keeping the teeth dry for treatment. Some of these isolation methods include placing absorbent cotton pieces around the tooth to keep it dry, manual suctioning, and other fitted suction devices whose bulkiness only some patients can tolerate.  However, these isolation techniques are all compared to the gold standard in dental isolation, the rubber dam. 

The rubber dam is a flexible sheet of either latex or non latex material stretched over a square frame. We then punch holes in the dam material, which correspond to the tooth in question and its neighbors. The holes in the dam are then fastened to the teeth with a metal ring that hugs the tooth near the gumline. Although the rubber dam is a legal requirement for root canal therapy, only a small number of dentists perform restorative dentistry under rubber dam isolation. There are numerous benefits to using the rubber dam, a few of which are mentioned below…

• Keeps bad tastes from treatment materials out of the mouth 
• Keeps water and moisture from building up in the throat which is uncomfortable and anxiety provoking to the patient. 
• Keeps mouth bacteria out of the cavities during drilling – minimizes need for root canal treatment! 
• Superior longevity of restorations 
• Less sensitivity 
• Better visualization of the teeth for the dentist – less likely to miss something  
• Safety – prevents risk of aspiration of dental materials or instruments, or pieces of broken tooth during drilling 

We have found that most patients who initially exhibit skepticism about the rubber dam try it and walk out pleasantly surprised. Most of us don’t like receiving dental work, but in our experience those who received the rubber dam report that it made the dental experience far more positive for several reasons. Patients did not have to worry about fluid getting down their throat or be anxious about their numbed tongues getting in the way of our instruments!

Orthodontics / Invisalign

Orthodontics is the art of moving the teeth into more esthetic and harmonious positions. Traditional orthodontics involves metal brackets bonded to the teeth which are then connected by metal wires under tension. This tension moves the teeth into the desired positions. Invisalign, or similar other clear tray aligners, utilize advanced algorithms to create successive trays. The patient then wears a new tray every few weeks to gradually move the teeth into the desired positions and bite.

The importance of orthodontics and clear aligner therapy in dentistry and oral health overall cannot be overstated. Movement of the teeth allows the restorative dentist to render the most conservative and least invasive treatment. Aligning the teeth into the proper bite can also make oral hygiene easier, minimize tooth breakdown and wear and tear, and bring harmony to the jaw and muscles.