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Everything you ever wanted to know!

If you ask someone what causes a cavity to form in a tooth you'd likely be surprised at what they might come up with.

What really does cause a tooth to breakdown?

Dental cavities (or caries or decay) are considered a disease. The five factors involved are:

  1. Teeth
  2. Saliva
  3. Bacteria
  4. Food
  5. Frequency of exposure to sugars or carbohydrates

The actual process is very complex and some of the details are not yet completely understood. First the bacteria combine with proteins in saliva to attach themselves to the sides of your teeth. This bacterial/protein substance is known as "plaque" and it is the white film that can be seen or scraped off the sides of your teeth when you haven't brushed in a while.

The bacteria in plaque uses the food that comes their way (the very same food you consume), sugar (carbohydrates) are the favorite food for these particular strains of bacteria. They digest it rapidly (within minutes) and a byproduct of their eating is an acid. Since the plaque is concentrated on the teeth (usually the back in-betweens), the acid is as well concentrated and then actually dissolves the calcium in your teeth. If allowed to remain for a long period of time, these frequent exposures to acid create an opening in the enamel cover of your teeth..................a cavity is born. Here's a great question. How long does it take for plaque to reform on the teeth? The answer is 24 hours. That's the big reason for the need for very thorough hygiene each day.

Teeth do have the ability to re-mineralize these dissolved areas IF the plaque is removed (brush, floss, etc). Saliva dilutes this acid in most areas.........BUT........saliva production diminishes while we sleep allowing the bacteria and acid to have their most damaging effect. This makes brushing and flossing just prior to bedtime very important.

If a tooth surface is thoroughly cleansed of plaque and is exposed to fluoride, it will remineralize most quickly. Fluoride is much more resistant to "acid attacks".

Home care, time of day home care is carried out, fluoride, diet... it all adds up. It is TOTALLY in the hands of you to control practically all the cavities that may form. No hygienist nor dentist can come to your home each day to perform the home care you need.

Your Child's Teeth

Baby teeth are actually referred as primary teeth. Teeth first begin to appear between the 4th and 18th month of age. By the time your child reaches 3, they should have all their primary teeth in place. Permanent teeth will begin to come in at approximately 6 years of age. Permanent teeth come up under the primary teeth and cause their roots to slowly dissolve. All permanent teeth should be in by the age of 13.

There are 20 primary teeth.

Unlike the permanent dentition,
The primary dentition has no premolars.



Dental care should start early for your child. Naturally, at first you'll have to care for their teeth. Begin cleaning the baby teeth as soon as you see the first one in place. It's important not to lose a finger in the process, but try to use a small gauze or wash cloth to first clean. Begin to use a brush as soon as you can - place just a small amount of toothpaste on the brush so that they may get the idea to brush - not - eat the toothpaste.

“Bottle mouth” - this occurs when a child sleeps with a bottle. Liquids (EVEN MILK) that stay in the mouth continuously can cause rapid decay.

Thumb sucking and pacifiers - this is a very normal habit for a newborn. But, if it goes on beyond 36 months it may lead to serious problems of jaw format ion and tooth displacement.

You as the parent should be observing the teeth yourself - always checking to see if there are any signs of darkness which may be decay.

Wisdom Teeth

Wisdom teeth are actually the 3rd molars. They develop inside the bone (as all other teeth do) beginning at age 9. These teeth are the last to form and the farthest back.

If you're genetically lucky, the jaws are long enough to accommodate the wisdom teeth in a proper erupted position. In this position, if they can be kept clean, they may be used.


Most often, the jaw is not long enough and the wisdom teeth form within the curvature of the jaw. This is referred to as impacted (trapped) inside the jaw bone.

There are several possible problems that may be associated with wisdom teeth.

If a wisdom tooth becomes partially exposed thru the gums, bacteria will fill the space around the crown of the tooth. Since this is an area that you can not cleanse, an infection will begin.

Sometimes, the infection will become so intense, that the bone itself becomes infected.

It is possible that the wisdom tooth may cause destruction of the molar just in front of it.

For these reasons, most often, I advise patients to have their wisdom teeth removed. Teeth all form the crown first and then the roots form and grow to length. For this reason I recommend that the wisdom teeth be removed sooner rather than later (before the roots fully form).

Most people believe that the wisdom teeth will push the other teeth forward (especially on the lower) and cause crowding to occur in the front teeth. I do not believe this is the case, rather, I believe that the crowding that occurs is due to other factors.

[Wisdom Teeth] [Orthognatic Surgery]  [Fractures] [Chin]
[Oral Pathology] [Extraction Instructions] [TMJ Surgery]

Root Canal Therapy (Endodontic Therapy)

A root canal is something that we don't mind as long as it is happening to someone else. Root canal therapy has existed for centuries and actually was first performed in ancient civilizations - most often only the nobility and very wealthy were treated.

There is the old tale about the tooth becoming "dead" once the nerve is removed. This is simply not true. The blood supply in the tissues that support the tooth in the jaw give all the nourishment the tooth requires. Biting pressure remains normal although there is no response to hot, cold or sweets. There is a 95% + chance that you'll retain a tooth that has had root canal therapy. Some indications for a root canal are:

  • Pain while biting.
  • Sensitivity to hot or cold.
  • Deep decay.
  • Blunt injury to the tooth.
  • Infection.

When the pulp or "nerve center" of a tooth becomes unhealthy, two alternative treatments are available: extraction or root canal therapy. Root canal therapy permits the tooth to be retained and restores its health so that it can function normally and look natural.

Step 1:
In a tooth where there the pulp is exposed or unhealthy, an opening is made through the top of the tooth into the root canal system.
Step 2:
The length of the root canal is measured, and then the pulp is carefully removed from the canal using delicate instruments. The canal is cleaned and shaped to prepare it for filling.

Step 3:
The canal is dried with absorbent paper points
Step 4:
Gutta percha (a natural rubber) points coated in endodontic cement are used to completely seal the root canal system.

Step 5:
The final step is to restore the tooth. The type of restoration varies from case to case.

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Dr. Maury Hafernik
11645 Angus Road, Suite 10
Austin, Texas 78759
P: (512) 345-5552

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