CARIES (CAVITIES) & ROOT RESORPTION

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SIMPLE DESCRIPTION OF HOW TO STOP THE PROGRESSION OF A CAVITY WITHOUT FILLING IT

First understand the cause of cavities is bacterial destruction. They are similar to a tank that gets hit by a plasma missile. First the missile penetrates the outside. Then it blasts the plasma into the interior of the tank, destroying everything inside. Similarly the bacteria and/or acid will break through the enamel into the interior dentine. Then it starts to destroy the dentin, but largely still feeding on food made available from the saliva. But now in close quarter, like a drug nest or gangster's "crib." Here the dentine gets turned into organic matter that soaks up the sugar to provide ongoing food to the developing cavity.

WHAT DOES ALL THIS MEAN? - What this all means is that if you can debride the inside of the hole that was created to get rid of all foreign material and then prevent the latent bacteria from getting an ongoing food supply then the cavity will largely stop progressing. THEN... the dentine will invade itself with fibroblasts and create a wall to seal off the outside world.

DOES THIS MEAN THE CAVITY DOES NOT HAVE TO BE FILLED? - Yes, that is exactly what it means. The cavity can be debrided and then the hole can be maintained indefinitely and if everything is perfectly clean the tooth will seal itself in and the ongoing destruction will stop.

HOW IS THIS DONE? - Good question. But my general advice would be to break into the hole with an explorer and break off the available edges. Meanwhile purchase a Sugarman File, which is a round dental file. Then continue to use the explorer to scrape the inside and get all the crud to come out. Then intermittently use the Sugarman file to smooth the vertical walls.

ANYTHING ELSE? - Yes. But just remember the basic idea is to first debride the tooth, then to help it remineralize. Plus to keep it disinfected. And to let the fibroblasts get in there and do a repair job.

1) The bottom of the cavity will tend to feel "stalky" and not smooth. This is because the tooth is constructed from tubules. So all these stalky things have to be broken off. The explorer will work but the progress is quite slow. Expect to spent anywhere from 5 to 10 hours debriding the inside of the cavity.

2) If the cavity is close to the edge of the tooth then the hole needs to be broken out of its confines to break through the weak outer face. Basic rule is if the outside structure of the tooth is weak then it has to be broken through.

3) The cusps of the tooth are vitally important!! Don't file into the structure of any of the cusps!! But if the cavity undermines the cusps you won't have much option. So idea is to try to undermine the cusp at a vary shallow angle. Plus if there is any "cave" under the cusp then to use the explorer to clean it out. But also realize that the "cave" won't be able to get filled very well. So don't try to force an answer. Just try to get a clean hole and if there is a "cave" under the cusp then that problem can get figured out when the time comes to actually fill the hole.

4) A sickle can be used as a "hatchet." Otherwise various forms of "hatchets" might come in handy. Here you could modify a paper clip or you can clip off an old cheap curette to give you a sharp angular edge you can use to chip off any loose edges.

5) You can use hyaluronic acid and water as a "drilling mud" to lift off remnants. You can use a proxy brush to get the stuff into the cavity. Likewise you can use iodine as a disinfectant. Also can use Arm and Hammer Whitening Booster or other equivilent product to try to remineralize the  interior dentine. Plus can also use 3MIX to infiltrate the tooth with antiobiotics.

NOTE ON 3MIX-LSTR - Lesion Sterilization Tissue Repair - Logic is if the infection can be eliminated then the fibroblasts will thrive. So yes fibroblasts will infiltrate the edge. Can they fatten the dentine too? Certainly yes. But question is if this is minimal to virtually nil or whether this filling-in process can actually be significant. In any case the 3MIX can and will penetrate into the dental tubules and have the potential to eliminate any internal tooth infection of the dentine. Once the dentine is disinfected the fibroblasts can the fill in the edge of the dental tubules that are still infected.

6) If the cavity penetrates into the nerve chamber you are in big trouble. If you actually break into the nerve chamber you will not only scream bloody murder but you will likely kill the tooth. This is an ongoing dilemma of the dental profession too. But chances are you are close but not too close. It could just be the tubules. But not to take any chances. What you can do here is to try not to interfer too closely with the debris separating the hole from the nerve, but to still kill the bacteria. Here you can use iodine and hyaluronic acid and 3MIX. The goal will then become for the tooth to gradually debride the dead area itself with fibroblasts and essentially build its own wall. This is possible over a period of a number of months, like say 6 months just to make up a number. The logic is to reduce the bacterial load enough for healing to take place without getting too aggressive. Good luck! You will need it.

SPECIAL NOTE - DANGER DANGER - At some point you will undoubtedly get a sense that the curette or file is "stuck." Or in fact the curette will actually get stuck with no apparent way to get it to escape.  At this point I generally tend to start to flip out. Flipping out is a very dangerous mental phenomona not to be trifled with. What I try to do is chill out and then exit the curette ASAP without panicking. If you get the curette stuck in the cavity you are in a perfect position to crack or break the tooth, thereby destroying it. The strategy for exiting the curette is always the same. Move it opposite the opposite side. Imagine it like a wheel and imagine you are exiting the side you can see. Plus wiggle it. Plus respect your fear, but don't cave in to it. Just thinking about this subject gives me the willies.

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WHAT ABOUT FILLING THE CAVITY?? - You just want to leave a big hole? - Unfortunately yes. The problems of trying to fill in a cavity are quite difficult and hairy. In addition it may be possible for the hole to be maintained indefinitely. Or you can get it filled when you want to and not right away. Plus the dentine will be better repaired.

GEOMETRY OF THE HOLE - PER FILLING CAVITIES - Regarding filling in cavities the main issues seem to be -

1) Having the sides shaped wider at the bottom than the top to be able to jam in the filling so it doesn't pop out. So you mean they have to drill a wider hole at the bottom than the opening at the top? YES. Tough break but that is how it is. No way around it unless somebody can figure out some type of "catch" to hold the filling in place without it slipping even a micro-millimeter. 

2) Avoiding the so-called "lens effect." HUH? - The "lens effect" is where the very strong forces of the teeth meeting each other combine together at critical spots to crack the tooth - CRACK THE TOOTH? YIKES! - YIKES IS RIGHT.

WHAT CAUSES THE LENS EFFECT - The primary cause is a bottom or "well" that is overly rounded. What will happen here is the force will concentrate at the bottom of the well. The bottom will then transfer the excessive force outward to crack the tooth. The second primary cause is really just a variation. Where the top of the cavity is wide and the bottom narrow and so the forces pushing down also push out.

HOW IS THIS LENS EFFECT OBVIATED? - DRILL BABY DRILL - This is the primary reason why what might start out as a reasonably small cavity ends up so big once the drilling starts. The dentist has to expand the sides as he goes down. Then... since the bottom of the cavity will be naturally rounded the dentist has to expand the bottom to flatten it.

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CAN DIYPERIO HELP ALL THIS? - Maybe yes, maybe no. You can imagine the cavity cleared of debris, leaving a damaged surface, but reasonably smooth. With ongoing debridement with an explorer or what-not and ongoing proxy brushing. And ongoing disinfection with hyaluronic acid, iodine and 3MIX intermittently, like one or the other every few days, probably mostly with the iodine. Then you can imagine the fibroblasts going in there and creating a clean edge. Then is it so far fetched the fibroblasts will push out this edge and rebuilt the tooth? Or at least make the hole smaller? No it is not so far-fetched. So you can imagine that after a year the hole on the bottom is more nicely filled in. So when the dentist drills there won't be so much lost structure.

This sounds like BS - Granted you might get a 1/10th of a millimeter or so but the dentist is just going to drill that right out. Good call. But still you never know. Maybe the bottom won't be so rounded. Maybe the hole in the top will be a little bit narrower. Maybe your tooth will last just a little bit longer as a result. No miracle. Just slightly marginal. Plus you didn't get the cavity filled in anyway did you? So stop complaining! Plus if you want to maintain the hole for say ten years maybe it really will fill in, who knows.

NOTE - If you have any ongoing open cavities it is probably a good idea to stop eating sugar! Plus to use an irrigator to keep the cavity cleaned out at all times. And not to let any food debris reside in the hole for longer than a few hours.

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WHAT IS USED TO FILL IN CAVITIES - AND WHAT ARE THE PROBLEMS? - The main problem is that there is almost always a gap between the cavity and the tooth. Measured in microns. If the gap is larger than the width of a bacterium then the bacteria will infiltrate into the "fissure" and attempt to secure a food supply. What then results is more infection, more destruction and a second cavity, called "secondary caries." Leading to more trouble. With the usual solution being to drill out the old filling, expand the hole and to put in a new filling.

FILLING MATERIALS

1) GOLD - This used to be old school. Now it is virtually non-existent. The great thing about gold is the gap is so microscopic the bacteria can't get through. So gold can last as long as you do. The key to gold is what you can think of as cold fusion. Or cold welding. 100% gold without any infiltration from atmospheric gases or other contamination will fuse together under pressure. That way the dentist does not have to pour hot molten gold into the cavity to make it solid gold. OUCH! Very few dentists work with gold because it is too cumbersome to work with and they either have to charge more or make less money per hour.

2) CAST FILLINGS - The most common material used is porcelain. But gold can also be used. Here a wax model of the hole is made and a casting is poured.

2) SILVER - AMALGAM (Mercury) - Yes, mercury. What happens is that mercury is liquid at room temperature. When mixed in with powdered silver it creates a paste. As the mercury combines with the silver into an alloy it hardens. But remains slightly flexible. Key importance here is amalgam fillings also close the gap between filling and teeth. Not as well as gold. But the best alternate choice. Dentists like it because they can mix it up and stick it in. And should work for a good 10-20 to even 30 years or more. So they won't hear back from the patient about any failures.

3) WHITE FILLINGS - This is basically putty that generally gets hardened by light. Problem is it starts off with water. So it shrinks as the water gets chemically converted. This leaves gaps. The bacteria gets in and causes secondary caries. So you dump the mercury means you get a secondary cavity. Nice huh? Plus they don't take stress too well. General idea is to "etch" the inside of the cavity with acid to the filling material "sticks" to the inside. Not much hope here for DIY here. IMHO. There is the structuring of the cavity. Then the acid. Then the light curing. GFL. No way to do a credible job without screwing it up. Go see the dentist! Best case scenario is you can beg him not to drill more than he has to.

4) GLASS IONOMER FILLINGS - These are basically white fillings with some ground up glass tossed in to provide body. There is less water needed. So less shrinkage. So less likelihood of secondary caries. But the glass makes the filling brittle. So they are generally ill advised on chewing surfaces. Here there is some hope for DIY. In fact some 3rd world countries who work with cadres of "barefoot dentists" and do-what-you-can logic usually use glass ionomer. Check out - WHERE THERE IS NO DENTIST - general logic is to fill the cavity in for a few years and then check it out later and replace it if it fails. This would be the "easy filling material."

IS THAT ALL THERE IS? ANYTHING BETTER? - SORRY YOU SHOULD HAVE BRUSHED BETTER AND NOT EATEN SO MUCH SUGAR - Yes indeed, this is a sorry state of affairs. Any way to improve on all of this? Well certainly the materials get better and better. But dentists also have to make a living and aren't running a charity.

ANY IDEAS FOR SOME IDEALISTIC REPAIR? - My thinking would be to separate the debridement and filling into two separate steps as described. But the dentist still has to create the proper geometry. Which would pretty much destroy any healing and regeneration you managed to get to take place. So it might not make any sense to wait to fill in the cavity. Just let the dentist do his work.

HOWEVER... with the white cavities in some imaginary world you could imagine the dentist filling the cavity like a donut with a hole in the middle. That way the forces of shrinkage won't pull the filling away from the cavity walls so much. Then to go back and fill in the rest of the hole. Or likewise the dentist could put in a plug into the middle to make the hole. Then pull the plug to make the hole. Then go back later after the filling has cured and fill in the hole.

ANY DIY IDEAS? - My main idea is gold. Do it the old fashioned way. But this is obviously tricky. Other interesting idea would be to layer the inside of the cavity with a varnish the dentists use known as a cavity liner. Copalite is one brand name. Here you can imagine painting the inside of the hole with the Copalite, layer after layer, until you finally fill in the hole. But this "solution" is problematic too. First if you do try it then the dentist would have to drill it all out to use the white fillings, from what I understand. So you are actually screwing things up. Second is the layers are going to tend to either be too thin, meaning you have to repeat the process upwards of dozens of times to get the hole to fill in. Or you are going to put it in too thick so it will crack. Then consider that varnish is water-soluble. So it will tend to disintegrate after a few years. Perhaps in a way to encourage another cavity. Plus also consider that nobody seems to have proposed any solutions like this. Nor any other solutions involving a layer approach. Also consider with layers the layers have to stick together. But if they get saliva between the layers they may not stick together so well will they? So the Copalite idea does not seem like a good one. Perhaps it could work. But the negatives appear to outweigh any positives.

SO WHAT DO YOU BELIEVE IN? - My opinion is if you have an otherwise hopeless tooth, or one where you would have to drill out the filling of a compromised tooth in order to put in a new filling then the best approach might just be to maintain the open hole. Debride. Let it heal. Maintain. Then shop around and see if any dentists have any good ideas.


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For simplicity diyperio imagines both caries and root resorption as essentially the same event. Both caused by bacteria, mostly. Though there is some extra stuff about auto-immune response which I don't really understand. So perhaps this approach is ignorant. But regardless it is still practical and should cover most situations.

CROWN CARIES - This is the common view of cavities. What happens? The inside of the tooth is made of dentine. Which is fairly hard, but not on a cosmic scale. The outside of the tooth however is made of enamel. Which is one of the hardest substances in existence. It is also made out of a matrix. Resembling a series of tightly packed together rods. You can imagine it as similar to a broom. Or the Roman Fascist symbol of a faggot of sticks tightly bound together. Which means it can shed off mineral molecules and then capture them back again, depending on whether the mouth is acid or base. Acid loosens up mineral. Base recaptures mineral. But acid also removes the "slime layer" that is preventing the teeth from remineralizing. While base can add chalky stuff which won't remineralize. So the process is not so simple and is fairly complex. Ideally what will happen is the enamel layer will not develop any holes. Or right before it breaks through the person will magically remineralize the enamel crown once again. But when this process fails the person gets a cavity.

FIRST CRITICAL EVENT - FORMATION OF THE HOLE IN THE ENAMEL - What happens next? Basically you get a cavity. Caused by acids, which are also typically caused by bacterial waste products, not just acid foods. Once the actual hole forms supposedly it cannot be undone. It is equivalent to getting a hole in a piece of cloth. Where prior to the hole getting formed the cloth can repair itself. But once the hole forms there is no turning back..


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of these phenomena as essentially the same event. Just happening in different places. More radically diyperio also takes the position that cavities do not need to be drilled out and filled, as conventionally explained to people. But rather may preferably be debrideded and maintained. Additionally diyperio also takes a similar position on root caries.

Is diyperio right? Or is diyperio BSing you? With a combination of arrogance and ignorance. Or does your very own dog know more about teeth than diyperio? Or your fish? Or the first person you meet on the street. Or even a bad dentist, the one who wants to pull out all your teeth and replace your gold fillings with silver ones? Who wants to replace your diseased old teeth with new clean healthy fresh new teeth. And to just forget about those stupid worries you may have about your jaw or sinuses. - "We'll cross that bridge when we come to it." - Don't you trust me?" - "Why are you making this so difficult?" - "Look! If you cared so much about your teeth then you would have flossed! But you didn't floss twice a day like you promised, did you?" - "Your new teeth will be better than your old ones. You won't miss them." etc etc etc blah blah blah

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So... How are caries and root resorption the same phenomena? They are both caused by bacteria. What is the difference? In caries the outer shell of the tooth, the enamel, is destroyed by the bacteria. The containment of the enamel then enables the destroyed debris to stay in place, hence perpetuating the phenomona. Meanwhile though the bacteria need a food supply, which comes from the mouth. So the food supply has to go through the hole in the enamel.

Meanwhile, in root resorption there is no enamel, only dentin. The food source is the saliva. And any local debris field.

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WHAT IS THE DIYPERIO SOLUTION FOR ROOT RESORPTION? - Debride and let heal. Remineralize. Plus can also use 3MIX to sterilize the area so the fibroblasts can do some repair work on their own. Logic here again is that penetration of the antibiotic into the dentinal tubules will diffuse the antibiotic throughout the interior of the tooth, including the nerve, essentially leaving any intact tooth structure sterile. This gives the fibroblasts a chance to come to the fore and penetrate into the dentine that is more "twilight," ie not sure if it is alive or dead. Not sure if it still has remnants of intact structure that can survive or not. In essence the antibiotic and fibroblast project will enable to body to do its own sorting - "Bring out your Dead!" - "Stop! I am not dead yet!"

Over a period of time the fibroblasts will recuperate the areas that are definitely alive, but that were just hurting really bad. This would be the equivalent of cleaning out a flooded house.  Likewise they will tend to advance the cause of living tissue that might wish to occupy semi-dead structures or remnants. This would be the equivalent of gutting then renovating the gutted house.  What happens here is the remnants function as scaffolding for new living tissue to take up occupancy. In addition the fibroblasts can set up brand new scaffolding, literally into the air, equivilent to building a new building from the ground up. But not to count too much on the total rebuilding. But can expect revitalization of areas that still have intact scaffolding, whether dead or alive.

NOTE - This process of living cells infiltrating and rebuilding on scaffolding that is essentially dead is similar to how bones can regenerate from so-called "fossil bone." HOWEVER... The DIYPERIO position is that dead bone cannot be revitalized on a practical basis. It is simply asking too much. Theoretically possible, yes, but not practically so. WHY? Because the dead bone area is too infiltrated with infection. Meanwhile the tooth is too infiltrated with infected calculus. So how are you supposed to separate the good from the bad?? It would be the equivalent to having a group of enemy mixed in with friendlies. What to do? How to tell them apart. Bottom line is you can't tell them apart so they all have to go. Even if some of the friendlies have latent abilities to regenerate. Could DIYPERIO be wrong? Certainly so. But what is the correct answer? Do you have the correct answer? Then let us hear it.