Tooth Decay
Our teeth are designed to last a long time and yet, tooth decay is a common problem. Dr. Bijan Anvar discusses tooth decay, what the warning signs are, how to prevent it, and more.
Featured Speaker:
Bijan Anvar, DDS
Dr. Anvar is the Chairman of the Department of Dental Medicine at Flushing Hospital Medical Center. He served as the past president of the Queens County Dental Society and the past Chair of the New York State Dental Associations Council on Dental Practice. Dr. Anvar graduated from NYU College of Dentistry with honors in oral surgery. He completed a one-year residency at FHMC. Dr. Anvar is an active member of the Queens County Dental Society, New York State Dental Association, and the American Dental Association. He is a graduate of the ADA's Institute for Diversity in the Leadership program and also a co-founder of VeteransSmileDay.org. Transcription:
Tooth Decay
Cheryl Martin (Host): Our teeth are designed to last a long time. Yet tooth decay is a common problem. So what is tooth decay? The warning signs and how to intervene. We'll have some answers coming up. This is Flushing Hospital Med tTalk, a podcast sponsored by Flushing Hospital Medical Center. I'm Cheryl Martin. And with me is Dr. Bijan Anvar, the chairman of the department of dental medicine at Flushing Hospital Medical Center. Hello, Dr. Anvar. Thanks for joining us.
Dr Bijan Anvar: Good morning. Thank you for having me.
Cheryl Martin (Host): We're discussing the topic tooth decay. So Dr. Anvar, please describe what tooth decay is and how many Americans have it?
Dr Bijan Anvar: Sure. So tooth decay is also known as cavities are essentially parts of the tooth that get eaten away by bacteria, that produce acids and break down the teeth. Most Americans have some type of tooth decay. Some people have it worse than others and, some of the very few fortunate ones are cavity free.
Cheryl Martin (Host): Any estimate of how many Americans may suffer from, or have some tooth decay?
Dr Bijan Anvar: I would probably say at least 80% of Americans, if not more, suffer from some type of tooth decay at some point in their life.
Cheryl Martin (Host): What are some of the early warning signs of tooth decay? And when should someone seek help?
Dr Bijan Anvar: So some of the very early signs of tooth decay can be a discoloration of the teeth. Sometimes they'll appear brown or even black, and it could be stains or they could be the starting of decay at that point. They should be checked by a dentist. But sometimes there can also be areas of decalcification and that might appear white or almost chalky, and that's a little bit of the softening of the enamel. These are usually the first signs. Hopefully everyone is visiting their dentist every six months for their checkups and cleanings. But anytime you see something different or experience sensitivity to cold or sweets or hot, then that should also be followed up immediately by a dentist.
Cheryl Martin (Host): What are some of the leading factors that contribute to tooth decay?
Dr Bijan Anvar: one of the main leading factors that lead to tooth decay is diet. Obviously sweets are a big thing, but also things like potato chips and other snacks like gummies, etcetera, that can stick to your teeth, can cause tooth decay. Anything that stays prolonged on the teeth and can be broken down, are more likely to cause tooth decay. And so potato chips and things like that, that don't clear from the teeth easily, are a major factor.
Cheryl Martin (Host): So all the sweets and potato chips are things that we love are the main problems then?
Dr Bijan Anvar: So, yes, that's probably one of the biggest causes and it's something that we have to be mindful of. And obviously, everyone's going to eat some of these things, but really in moderation, when do you eat them and what you do after you eat them makes a big difference. If you eat them just before you go to bed, probably not the best idea because it might be sitting in your mouth all night. And sometimes when you eat potato chips it doesn't clear from your teeth and you're trying to get them out from, in between the crevices of your teeth.
And that could stay for a long time. So, ideally you wanna brush your teeth completely, after you eat some of these things. Another major factor that people often don't think about, especially in young children, is mouth breathing, people who tend to be stuffed up or have allergies and tend to inhale from their mouth, are more prone to getting cavities because their mouth gets dry. Anytime your mouth gets dry, you increase the risk.
Cheryl Martin (Host): Now I also understand that there are certain medical conditions and medications that can have an impact. Can you provide more details on this?
Dr Bijan Anvar: So certain diseases or health issues and medications can do the same thing they can cause dry mouth. So for example, diabetes can cause dry mouth. There's a symptom called Sjogren syndrome that's relatively common. And, that can cause dry mouth people who had maybe some type of radiation to their head and neck is also another, cause of dry mouth and people who are taking different types of medications. For example, antidepressant medications and anti-anxiety medications, muscle relaxants, antihistamines, high blood pressure medications. Many of these medications can also have the side effect of dry out your mouth and not giving you the saliva that you need to help protect the teeth.
Cheryl Martin (Host): So, what do you need to do in those instances? Do you need to brush more frequently?
Dr Bijan Anvar: Really you'd need to brush frequently, but not over brushing. It's more important to keep the moisture in your mouth. The more moist you can keep your mouth the better off you're going to be. And so if it's because of the medication, sometimes there's different medication that you can take that can prevent the dry mouth. Sometimes there's other medication that the doctor can give you to help, your body create and produce a little bit more saliva and also obviously getting into really good habits for brushing and flossing.
Cheryl Martin (Host): Now we're talking about medical conditions. It's my understanding that we are seeing more patients develop tooth decay as a result of marijuana use, please explain?
Dr Bijan Anvar: As I mentioned, anything that can cause dry mouth will increase your risk of tooth decay. The use of marijuana often has a side effect of creating dry mouth. And this is affected because the THC binds to specific receptors to reduce the amount of saliva that the mouth produces. It is worth for people who use marijuana at night because the body usually decreases its salivary flow at night as well. And then you combine that with being more hungry.
And now you're providing the bacteria in your mouth with more food and create a more acid, environment in a dryer field. And so since people might be eating a lot more sweets or tend to eat not as healthy, the extra sugar or acidity, combined with the dry mouth, is just a recipe for disaster for the teeth. And one more thing I want to add for patients who are using marijuana or really patients in general, who experience severe dry mouth.
The rate of decay for those patients tends to be a lot faster. And I have seen patients, get some pretty severe decay in less than six months. So it's something that they need to be on top of and it's information they need to share with their dentist. So their dentist can help them create a better strategy to try to help prevent, or at least slow down any rate of decay that might be occuring.
Cheryl Martin (Host): So if a person is using marijuana in light of what you're saying, is there anything that they can do to counter this, or this is just what they have to live with,that there's an increased chance of them experiencing tooth decay as a result of taking the marijuana?
Dr Bijan Anvar: Not only just with marijuana, but with anything again, that dries your mouth out, anything that's gonna dry your mouth out, you have to be a little bit extra careful. And you want to just keep the moisture in your mouth and you wanna make your mouth as moist as possible. You want to decrease the amount of sugar and the amount of acidity that you're in taking, especially when your mouth is dry.
Your dentist will be able to tell you if you're at a higher risk of tooth decay from whatever medication that you're taking, including the use of medical marijuana, and they can help prescribe specific toothpastes that might be a little helpful for you with increased Fluoride.
Cheryl Martin (Host): That's great doctor. Now, do you have any other advice for patients who may be more at risk for getting tooth decay, any additional things that they can do to prevent it?
Dr Bijan Anvar: Oh, absolutely. there's a few things that patients can do to help them not come to see us so often and prevent getting tooth decay. the first thing, is to brush properly and floss properly. This is the first step in keeping everything clean and keeping these things off of the teeth that can create a bad environment, creating a good habit is really the first step for anyone who wants to try to avoid getting cavities. But this starts much earlier than you think.
This starts as an infant. I like to have discussion with parents before the baby is born, even because there's a lot of things they need to know. We talk about good habits and best practices to help the child develop as good as possible. And we talk about not introducing our own bacteria from our mouth into the infant's mouth. For example, not using the spoon that was in your mouth or not licking off a pacifier that might have fallen on the floor and you have no way to clean it.
So you use your saliva on napkin or something like that to wipe it down because the baby's crying. Another thing that patients can do is use fluoride. Fluoride has been shown to help fight cavities. And for most people it can be very helpful. And as we mentioned before, diet is also very important trying to avoid a lot of acidic foods and foods that might be more sticky to your teeth, like potato chips, etcetera, and avoiding drinks that might be very acidic.
Sometimes the sports drinks can be very acidic and sweet. So that's a double danger for your teeth. And then, practicing breathing in from your nose and out through your mouth to maintain the moisture in your mouth as much as possible.
Cheryl Martin (Host): That's a great list of what we can do. If a person, they didn't do all those things and they come to you, what treatments can you offer as a dentist to help the patient with tooth decay?
Dr Bijan Anvar: So the first thing that we do is we take x-rays and we check everything, visually and inspect the x-rays. And then we also go over with the patient what their habits are and what might be causing the issue. So if it's diet, we really try to help them get a better sense of how they can maintain a better diet, but if the decay is already there, then we treat it. And usually it just involves removing the decay and placing a filling over it. Sometimes if the filling is very small, we might put them on a high fluoride toothpaste and wait and see in maybe three months or six months, if it's gotten better or if it's gotten worse.
If we can arrest the decay, if we can stop the decay from expanding, and getting worse, then we just keep an eye on it and we'll watch it until it gets to a point where it needs to be treated. And if someone lets a tooth go too far and the decay gets really bad, then they risk having to remove the nerve of the tooth. Then that's called a root canal. And in, the worst case scenario, they could actually lose the tooth. So it's very important that they maintain a good relationship with their dentist and come often because prevention is really the best way of treat.
Cheryl Martin (Host): Well said, Dr. Anvar, thanks so much for educating us on tooth decay and how we can intervene and treat. That was Dr. Bijan, Anvar, the chairman of the department of dental medicine at Flushing Hospital Center. For more information, or to schedule an appointment with a dentist at Flushing Hospital, please call 718-670-5521. That's 718-670-5521. For more information about the services Flushing Hospital offers, visit our website at flushinghospital.org/podcasts. All content of this podcast is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions discussed on this podcast. This has been Flushing Hospital Med Talk. I'm Cheryl Martin.
Tooth Decay
Cheryl Martin (Host): Our teeth are designed to last a long time. Yet tooth decay is a common problem. So what is tooth decay? The warning signs and how to intervene. We'll have some answers coming up. This is Flushing Hospital Med tTalk, a podcast sponsored by Flushing Hospital Medical Center. I'm Cheryl Martin. And with me is Dr. Bijan Anvar, the chairman of the department of dental medicine at Flushing Hospital Medical Center. Hello, Dr. Anvar. Thanks for joining us.
Dr Bijan Anvar: Good morning. Thank you for having me.
Cheryl Martin (Host): We're discussing the topic tooth decay. So Dr. Anvar, please describe what tooth decay is and how many Americans have it?
Dr Bijan Anvar: Sure. So tooth decay is also known as cavities are essentially parts of the tooth that get eaten away by bacteria, that produce acids and break down the teeth. Most Americans have some type of tooth decay. Some people have it worse than others and, some of the very few fortunate ones are cavity free.
Cheryl Martin (Host): Any estimate of how many Americans may suffer from, or have some tooth decay?
Dr Bijan Anvar: I would probably say at least 80% of Americans, if not more, suffer from some type of tooth decay at some point in their life.
Cheryl Martin (Host): What are some of the early warning signs of tooth decay? And when should someone seek help?
Dr Bijan Anvar: So some of the very early signs of tooth decay can be a discoloration of the teeth. Sometimes they'll appear brown or even black, and it could be stains or they could be the starting of decay at that point. They should be checked by a dentist. But sometimes there can also be areas of decalcification and that might appear white or almost chalky, and that's a little bit of the softening of the enamel. These are usually the first signs. Hopefully everyone is visiting their dentist every six months for their checkups and cleanings. But anytime you see something different or experience sensitivity to cold or sweets or hot, then that should also be followed up immediately by a dentist.
Cheryl Martin (Host): What are some of the leading factors that contribute to tooth decay?
Dr Bijan Anvar: one of the main leading factors that lead to tooth decay is diet. Obviously sweets are a big thing, but also things like potato chips and other snacks like gummies, etcetera, that can stick to your teeth, can cause tooth decay. Anything that stays prolonged on the teeth and can be broken down, are more likely to cause tooth decay. And so potato chips and things like that, that don't clear from the teeth easily, are a major factor.
Cheryl Martin (Host): So all the sweets and potato chips are things that we love are the main problems then?
Dr Bijan Anvar: So, yes, that's probably one of the biggest causes and it's something that we have to be mindful of. And obviously, everyone's going to eat some of these things, but really in moderation, when do you eat them and what you do after you eat them makes a big difference. If you eat them just before you go to bed, probably not the best idea because it might be sitting in your mouth all night. And sometimes when you eat potato chips it doesn't clear from your teeth and you're trying to get them out from, in between the crevices of your teeth.
And that could stay for a long time. So, ideally you wanna brush your teeth completely, after you eat some of these things. Another major factor that people often don't think about, especially in young children, is mouth breathing, people who tend to be stuffed up or have allergies and tend to inhale from their mouth, are more prone to getting cavities because their mouth gets dry. Anytime your mouth gets dry, you increase the risk.
Cheryl Martin (Host): Now I also understand that there are certain medical conditions and medications that can have an impact. Can you provide more details on this?
Dr Bijan Anvar: So certain diseases or health issues and medications can do the same thing they can cause dry mouth. So for example, diabetes can cause dry mouth. There's a symptom called Sjogren syndrome that's relatively common. And, that can cause dry mouth people who had maybe some type of radiation to their head and neck is also another, cause of dry mouth and people who are taking different types of medications. For example, antidepressant medications and anti-anxiety medications, muscle relaxants, antihistamines, high blood pressure medications. Many of these medications can also have the side effect of dry out your mouth and not giving you the saliva that you need to help protect the teeth.
Cheryl Martin (Host): So, what do you need to do in those instances? Do you need to brush more frequently?
Dr Bijan Anvar: Really you'd need to brush frequently, but not over brushing. It's more important to keep the moisture in your mouth. The more moist you can keep your mouth the better off you're going to be. And so if it's because of the medication, sometimes there's different medication that you can take that can prevent the dry mouth. Sometimes there's other medication that the doctor can give you to help, your body create and produce a little bit more saliva and also obviously getting into really good habits for brushing and flossing.
Cheryl Martin (Host): Now we're talking about medical conditions. It's my understanding that we are seeing more patients develop tooth decay as a result of marijuana use, please explain?
Dr Bijan Anvar: As I mentioned, anything that can cause dry mouth will increase your risk of tooth decay. The use of marijuana often has a side effect of creating dry mouth. And this is affected because the THC binds to specific receptors to reduce the amount of saliva that the mouth produces. It is worth for people who use marijuana at night because the body usually decreases its salivary flow at night as well. And then you combine that with being more hungry.
And now you're providing the bacteria in your mouth with more food and create a more acid, environment in a dryer field. And so since people might be eating a lot more sweets or tend to eat not as healthy, the extra sugar or acidity, combined with the dry mouth, is just a recipe for disaster for the teeth. And one more thing I want to add for patients who are using marijuana or really patients in general, who experience severe dry mouth.
The rate of decay for those patients tends to be a lot faster. And I have seen patients, get some pretty severe decay in less than six months. So it's something that they need to be on top of and it's information they need to share with their dentist. So their dentist can help them create a better strategy to try to help prevent, or at least slow down any rate of decay that might be occuring.
Cheryl Martin (Host): So if a person is using marijuana in light of what you're saying, is there anything that they can do to counter this, or this is just what they have to live with,that there's an increased chance of them experiencing tooth decay as a result of taking the marijuana?
Dr Bijan Anvar: Not only just with marijuana, but with anything again, that dries your mouth out, anything that's gonna dry your mouth out, you have to be a little bit extra careful. And you want to just keep the moisture in your mouth and you wanna make your mouth as moist as possible. You want to decrease the amount of sugar and the amount of acidity that you're in taking, especially when your mouth is dry.
Your dentist will be able to tell you if you're at a higher risk of tooth decay from whatever medication that you're taking, including the use of medical marijuana, and they can help prescribe specific toothpastes that might be a little helpful for you with increased Fluoride.
Cheryl Martin (Host): That's great doctor. Now, do you have any other advice for patients who may be more at risk for getting tooth decay, any additional things that they can do to prevent it?
Dr Bijan Anvar: Oh, absolutely. there's a few things that patients can do to help them not come to see us so often and prevent getting tooth decay. the first thing, is to brush properly and floss properly. This is the first step in keeping everything clean and keeping these things off of the teeth that can create a bad environment, creating a good habit is really the first step for anyone who wants to try to avoid getting cavities. But this starts much earlier than you think.
This starts as an infant. I like to have discussion with parents before the baby is born, even because there's a lot of things they need to know. We talk about good habits and best practices to help the child develop as good as possible. And we talk about not introducing our own bacteria from our mouth into the infant's mouth. For example, not using the spoon that was in your mouth or not licking off a pacifier that might have fallen on the floor and you have no way to clean it.
So you use your saliva on napkin or something like that to wipe it down because the baby's crying. Another thing that patients can do is use fluoride. Fluoride has been shown to help fight cavities. And for most people it can be very helpful. And as we mentioned before, diet is also very important trying to avoid a lot of acidic foods and foods that might be more sticky to your teeth, like potato chips, etcetera, and avoiding drinks that might be very acidic.
Sometimes the sports drinks can be very acidic and sweet. So that's a double danger for your teeth. And then, practicing breathing in from your nose and out through your mouth to maintain the moisture in your mouth as much as possible.
Cheryl Martin (Host): That's a great list of what we can do. If a person, they didn't do all those things and they come to you, what treatments can you offer as a dentist to help the patient with tooth decay?
Dr Bijan Anvar: So the first thing that we do is we take x-rays and we check everything, visually and inspect the x-rays. And then we also go over with the patient what their habits are and what might be causing the issue. So if it's diet, we really try to help them get a better sense of how they can maintain a better diet, but if the decay is already there, then we treat it. And usually it just involves removing the decay and placing a filling over it. Sometimes if the filling is very small, we might put them on a high fluoride toothpaste and wait and see in maybe three months or six months, if it's gotten better or if it's gotten worse.
If we can arrest the decay, if we can stop the decay from expanding, and getting worse, then we just keep an eye on it and we'll watch it until it gets to a point where it needs to be treated. And if someone lets a tooth go too far and the decay gets really bad, then they risk having to remove the nerve of the tooth. Then that's called a root canal. And in, the worst case scenario, they could actually lose the tooth. So it's very important that they maintain a good relationship with their dentist and come often because prevention is really the best way of treat.
Cheryl Martin (Host): Well said, Dr. Anvar, thanks so much for educating us on tooth decay and how we can intervene and treat. That was Dr. Bijan, Anvar, the chairman of the department of dental medicine at Flushing Hospital Center. For more information, or to schedule an appointment with a dentist at Flushing Hospital, please call 718-670-5521. That's 718-670-5521. For more information about the services Flushing Hospital offers, visit our website at flushinghospital.org/podcasts. All content of this podcast is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions discussed on this podcast. This has been Flushing Hospital Med Talk. I'm Cheryl Martin.