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..
= = =
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
= = =
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.
= = =
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.