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By Dr. James M. Maragos, DDS, PC
October 11, 2018
Category: Dental Procedures
Tags: tooth decay   gum disease  
StopRootCavitieswithPreventionandPromptTreatment

Tooth decay is a highly destructive dental disease, responsible along with periodontal (gum) disease for most adult tooth loss. And we become even more susceptible to it as we get older.

One form of decay that’s especially prominent among senior adults is a root cavity. Similar to a cavity in the crown (visible tooth), this form instead occurs at or below the gum line in the roots. They happen mainly because the roots have become exposed due to gum recession, a common consequence of periodontal (gum) disease and/or brushing too hard.

Exposed roots are extremely vulnerable to disease because they don’t have the benefit of protective enamel like the tooth crown, covered instead with a thin and less protective mineral-like material called cementum. Normally, that’s not a problem because the gums that would normally cover them offer the bulk of the protection. But with the gums receded, the roots must depend on the less-effective cementum for protection against disease.

Although we treat root cavities in a similar way to those in the crown by removing decayed structure and then filling them, there’s often an added difficulty in accessing them below the gum line. Because of its location we may need to surgically enter through the gums to reach the cavity. This can increase the effort and expense to treat them.

It’s best then to prevent them if at all possible. This means practicing daily brushing and flossing to remove bacterial plaque, the thin, built-up biofilm on teeth most responsible for both tooth decay and gum disease. You should also visit your dentist at least twice a year for professional cleanings and advanced prevention methods like topical fluoride to strengthen any at-risk teeth.

You should also seek immediate treatment at the first sign of gum disease to help prevent gum recession. Even if it has occurred, treating the overall disease could help renew gum attachment. We may also need to support tissue regeneration with grafting surgery.

Root cavities are a serious matter that could lead to tooth loss. But by practicing prevention and getting prompt treatment for any dental disease, you can stop them from destroying your smile.

If you would like more information on diagnosing and treating root cavities, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Cavities: Tooth Decay near the Gum Line Affects Many Older Adults.”

By Dr. James M. Maragos, DDS, PC
August 04, 2016
Category: Oral Health
ActorDavidRamseyDiscussesBabyBottleToothDecay

Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.

“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavi­ties. How did this happen?

Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.

While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.  Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.

This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”

Here are some other basics of infant dental care that every parent should know:

  • Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
  • Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
  • Start regular dental checkups by the first birthday.

Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.

“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”

If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”

By Dr. James M. Maragos, DDS, PC
December 16, 2013
Category: Oral Health
GiulianaandBillRancicTalkToothDecay

For some kids, having a cavity or two is just part of growing up. Not for Giuliana Rancic. When she was a child, the TV personality didn't have a single cavity — and she still doesn't. But for her husband Bill, co-star of the Style Network reality show Giuliana and Bill, it was a different story. A cavity-prone kid, he was never certain what a visit to the dentist might hold in store. “I can still remember the anticipation,” he recently told Dear Doctor magazine. “I always hoped I would get out of the checkups without a cavity!”

Why do some people get more cavities than others? There are a number of factors at work, but to understand it better, let's look at how tooth decay occurs.

How Cavities Form
Cavities — also called dental caries — are small pits or holes in the teeth that are caused by tooth decay. Tooth decay itself is a chronic disease that can flare up when plaque isn't kept under control. A thin, bacteria-laden film, plaque sticks to tooth surfaces both above and below the gum line, and can build up in the absence of effective oral hygiene.

Of course, everyone has bacteria in their mouth, both “good” and “bad” (pathogenic) types. But when the bad guys outnumber the good, trouble can start. When you consume sweets, plaque bacteria process the sugars and release acid as a byproduct. The acid eats into tooth surfaces, causing decay — and cavities that need filling. Left untreated, decay can work its way into the tooth's pulp, resulting in infection and pain. Eventually, treatment might involve a root canal — or, in the worst case, extraction.

What can you do if you seem to be prone to cavities? One effective way to fight tooth decay is by maintaining good oral hygiene. Brush at least twice daily, for at least two minutes each time. Use a soft-bristled brush and a dab of fluoride toothpaste to clean all around your teeth. Most importantly, floss above and below the gum line, every day. And just as important, don't forget to have regular dental checkups every six months.

A Healthy Balance
Another cavity-fighting strategy is eating a balanced diet. Avoid soda, sugary “energy” drinks and sweet treats — but if you choose to consume sugar, have it with meals instead of between meals. This will give your saliva, which has natural cavity-fighting properties, a chance to work.

“It's all about maintaining a healthy balance,” Giuliana told Dear Doctor. And Bill agrees: “I love nuts and fruit for a healthy snack,” he said, adding that he's meticulous about brushing and flossing. And when the couple smiles, you can see how those healthy habits pay off.

If you would like more information on preventing tooth decay, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Tooth Decay” and “Tooth Decay – How To Assess Your Risk.”



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James M. Maragos, D.D.S.

Dr. Maragos’ commitment to his community parallels his commitment to his profession. In 2007, he was elected to... 

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