Is it possible that a routine dental visit could actually increase the risk of tooth decay by making remineralization of surface decay more difficult contra angle handpiece? We love our dentist friends. They provide us so much clinical, ‘from the trenches’ insight to share with you. Among the dentists we are so honored to call our friend is Dr Ellie Phillips. In her excellent book, Kiss Your Dentist Goodbye, Dr Phillips puts forward a premise that the method dentistry uses to probe for potential decay may in fact increase the risk of tooth decay. Before we explain the details how this risk has great merit, we need to get some foundations in place about tooth anatomy, types of cavities, and the relative success of routine dental probing to detect decay. Tooth Anatomy 1.0 Our teeth are living crystals. Each tooth has a flow of blood and nerve into, throughout and back out of each one. Despite our cultural understanding that our teeth are ‘just’ bone (which is of course alive too), the fact is teeth are alive. Furthermore, many of you already know that although our teeth feel smooth, they are in fact more like a honeycomb structure with lots and lots of tiny holes in the surface. Similar to a honeycomb structure, our teeth are actually composed in a crystalline structure. Minerals and proteins bound together in a crystal matrix structure form our teeth. And just like a crystal, the strength of the surface relies on the strength and integrity of the whole. If one part of the crystal is compromised, the strength of the whole is compromised. Anatomy of a cavity… The development of a cavity generally occurs slowly through the process of demineralization at a certain spot on a tooth. As the demineralization continues, more and more minerals are liberated from within the crystalline structure of the tooth scian nebulizer. However, unlike the analogy of digging a hole, beginning decay occurs by washing away the strength (minerals) of the tooth tissue at the site while the crystal structure ‘scaffolding’ remains intact. As more minerals are liberated from the tooth matrix at the site, the area becomes ‘soft’ and begins to show up on a dental X-ray. The important takeaway is that demineralization resulting in initial decay is not a hole but tooth tissue that still has its full shape but lacks the mineral density. As the decay process continues unhindered, the crystal matrix continues to demineralize until ultimately, the scaffolding itself breaks down and a hole in the crystal occurs. The three types of cavities Pit and Fissure Cavity – The first insult to the tooth almost without exception Occurs in the chewing surface of the tooth dental instruments. Smooth surface cavity – Normally between the teeth (you know, when the dentist says you aren’t flossing enough). Root cavity – Occurs at or below the gum line on the root of the teeth. With these three pieces of the puzzle established, let’s go to the dentist’s office to see how a routine discovery strategy designed to help the dentist identify areas of demineralization may compromise this crystalline structure and actually increase the risk of decay…