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Dental Conditions
Lake Oswego, OR


Our teeth are subject to continual bacteria, and keeping them clean takes constant care. If left in place, disease will come and persist. There are preventative steps that you can take, namely brushing and flossing daily, eating a healthy diet and maintaining regular dental cleanings and checkups. When prevention fails, there are restorative steps to restore your teeth to health. At Nicholas Dose, DMD, we strive to educate our patients on prevention while also being prepared with all the tools and procedures needed to restore, helping you have a healthy mouth.

Working with Dr. Dose, we can help educate our patients on the most common dental problems and how to combat them. By educating yourself on common dental problems, and their causes, we can extend your oral health. Dental education can go a long way in disease prevention. Some of the most common dental problems that we see are discussed below, they include:

•  The Loss of a Single Tooth
•  The Progression of Decay
•  Recurrent Decay
•  Cracked Tooth
•  Periodontitis or Gum Disease


The Loss of a Single Tooth


The loss of a tooth can be shocking, painful, and frustrating. A tooth can be lost from:

•  Extensive Decay:Known as a dental caries, or cavity, teeth are subject to decay. By coming to see us for regular checkups, we hope to catch cavities while they are small. In some cases, a patient may not seek treatment for a cavity until the decay has been allowed to grow quite large. When a tooth has sustained significant decay damage, the options may require the placement of a dental crown or extraction.
•  Fracture or Breakage:Though enamel is a very strong material, it is subject to fractures and breakage. From tiny cracks to large pieces of a tooth coming off, significant problems can occur. Teeth that are fractured or broken can be painful, allow bacteria to reach the root, and not allow for proper function of the tooth.
•  Tooth Trauma:A traumatic impact injury can cause the tooth to be knocked out or as known in dentistry, avulsed. In some situations, we may be able to place the tooth back in place, and in some situations, the tooth is permanently lost.

When a tooth is permanently lost, the effects are not solely limited to that space. The patient will experience changes to the entire surrounding area. After a tooth is lost, several changes occur.

Almost immediately, the bone begins to change where the tooth was. Bone requires constant stimulation to stay robust and healthy. The bone received that stimulation from the pressure that was transferred from the tooth to the root, and finally to the bone. This stimulation was a form of exercise. Once the tooth is lost, the connection between the tooth and bone is lost, and the bone is no longer exercised. The bone will quickly respond with atrophy or sorption.

The next effect comes from the open space. Many patients may initially think that open space is good, in fact, many orthodontists pull teeth to create open space. The difference is the lack of control or what happens in that space. When an orthodontist pulls teeth to create space, they move the remaining teeth in a controlled method. When a patient loses a tooth, the remaining teeth begin to shift and move in an uncontrolled method, simply shifting haphazardly. This will mean an adjustment to your bite, which can be a critical issue. Bite adjustments can be negative to your oral health. A potentially severe condition known as TMJ dysfunction can occur from out of control bite adjustments. TMJ dysfunction can create symptoms that range from a tired feeling in your jaw to pain in your jaw, to the inability to fully open or close your jaw, and even symptoms of facial pain, ear pain, or migraines have been reported.

Another effect that comes from a missing tooth is the overeruption of the tooth immediately above or below the missing tooth. Without the opposing tooth, the remaining opposite tooth will push out, over erupting, in an attempt to meet up with a tooth that is not there. This will cause an adjustment to your bite and could escalate the severity of bite issues in the patient’s mouth.

The Progression of Decay


Evaluating for decay, and determining the extent, is an important part of your dental checkups. Decay comes from the buildup of plaque, tartar or calculus, which is filled with bacteria that eats through your enamel.

The process of tooth decay starts with plaque or tartar. Your mouth naturally creates plaque, which is a blend of food particles, debris that has come into your mouth, and saliva. If the patient is diligent in brushing and flossing, most plaque is easily removed. Plaque that remains, or is not brushed or flossed away, will dry and harden. This hardened material is known as tartar or calculus. It is damaging for your teeth. Tartar should only be removed by a professional hygienist, such as ours at Nicholas Dose, DMD, so that the enamel is not damaged. As tartar remains on your teeth, the bacteria creates an acid. This acid works to erode the enamel, creating cavities.

Once the acid from the bacteria breaks through the enamel, the decay then spreads faster as it eats through the dentin because dentin is not as hard. After the bacteria eats through the dentin, the bacteria will then reach the root. With the bacteria at the root, infection occurs. This is when a patient requires root canal therapy. Root canal therapy is a procedure designed to remove the bacteria, while also treating the infection. If the patient chooses to ignore the symptoms or pain from an infected root, they will ultimately lose the tooth. Your tooth’s root can not heal from the infection on its own. Our team at Nicholas Dose, DMD, along with Dr. Dose, will tell you that it is important to detect and address tooth decay, the sooner, the better.

Recurrent Decay


Recurrent caries is a dental condition of tooth decay that occurs under existing dental restorations, such as fillings, crowns, inlays or onlays. Following the restoration of a tooth, decay can still occur. It is very important to continually care for your restored teeth, and surrounding teeth, even if a prosthetic device has been placed. Poor dental hygiene can still allow for dental caries to occur. In additional microscopic cracks or space can allow for the passage of bacteria. Keeping your teeth clean will extend the life of your tooth and your prosthetic device.

Whether plaque has been allowed to settle along the base of your crown or filling, or if plaque has been allowed to rest in crevices where room between the tooth and filling can be found, bacteria can still reach through a restored tooth. Microscopic bacteria has the potential to reach through the tooth, weaken the tooth, which can lead to cracking or breakage. Thinking that a tooth that is covered with a filling or crown cannot decay can be a costly and painful mistake.

Cracked Tooth


Sometimes teeth can develop cracks. They can come from injury, biting down on very hard things such as ice, teeth clenching and grinding associated with bruxism or decay. These cracks can be tiny hairline fractures, or up to large pieces of your tooth breaking off. Whether tiny or large, a patient with a fractured tooth needs to seek treatment. Dr. Dose can provide you with options based on your specific needs. If a fractured or broken tooth is not treated, the problem can lead to much larger issues.
A cracked tooth may or may not be sensitive or painful. Some patients may only notice pain or sensitivity when chewing or when the tooth is exposed to hot or cold liquids. If you are experiencing pain, pay attention to where the pain is coming from. Sometimes fractures can be so tiny that they are hard to catch. Providing as much information as possible to Dr. Dose can assist in the diagnosis.

While waiting for your appointment, avoid chewing with the tooth that potentially has a crack. Chewing with a tooth that is cracked can lead to bacteria making passage inside the tooth, or it can widen the crack, or cause an irritation of the soft tissues inside your tooth.

Depending on what Dr. Dose finds, you will be presented with a variety of treatment options. Small cracks may not require any treatment. Minor cracks are relatively common in adult patients. Other cracks may require a dental filling to avoid bacteria from settling in them.

If a crack is large enough that it has extended past the enamel and into the dentin, treatment is required. Depending on the size and depth of your crack, Dr. Dose may find that a crown and possibly a root canal treatment is necessary. Root canal therapy is a procedure that can remove infected material from inside a tooth. If we do not remove the bacteria, the tooth will require extraction. The best course of action is always to save a natural tooth structure. A dental crown serves as a protective layer for a tooth, increasing its strength and durability.

Periodontitis or Gum Disease


Periodontitis is a serious gum infection that can jeopardize the health of your teeth. Known as being a severe form of gum disease, this condition is all too common in adults. In fact, the number one cause of tooth loss is due to periodontitis. However, there are steps that you can take to reduce and eliminate the symptoms of periodontitis, increasing your oral health. Left untreated, periodontitis can lead to serious bone, tissue loss, and the loss of your teeth.

Gum disease means that your soft gum tissue has come in contact with bacteria, and infection has set in. It has become a very common dental disorder, though one that can be prevented, and should. Gum disease begins with plaque resting along the rim of your teeth, which it naturally will. If the patient does not remove all of it through brushing and flossing, the plaque remains in place where it will dry and then harden. Hardened plaque is known as tartar or calculus. Tartar is full of live bacteria that thrives on the material it is touching. In this case, the material that the bacteria feeds on is your gum tissue. If this material extends below the gum line, the bacteria will eat and create an acid material that causes infection and decay. Your gum tissue can not attack the bacteria, so instead it will begin to pull away from the source that is causing infection. This creates what is known as gum pockets. Healthy patients have gum pockets that do not exceed 3 mm in depth. Patients with gum disease, or periodontal disease, will have gum pockets that can be 4 or 5mm in depth. This depth can be dangerous for your teeth, because the gums are pulling away from them, breaking the connections that hold your teeth in place. A patient with severe periodontitis can experience their teeth feeling loose in their mouth. Teeth may begin to shift and eventually, can come out.

You can combat gum disease, and periodontitis, by taking careful oral health steps. A dental cleaning with Dr. Dose, and our professional hygienist at Nicholas Dose, DMD is very important. We will work to remove the source of the infection. Most of our adult patients require a deeper dental cleaning, using a process known as scaling and root planing.

With an ultrasonic scaler, the hygienist will loosen and blast away plaque and tartar that has built up on your teeth. This tool uses a directed stream of water, and oxygenated bubbles, to safely remove this debris without damaging your enamel. Following this step, the hygienist will then use a hand scaler to ensure that all infected material is removed. Then we will smooth your roots through a process known as root planing. This will evoke a healing response in your gums, helping them stay healthier in the future.

Your Dental Health


Your dental health is our business. We promote education, prevention and can restore when needed. Working with Dr. Dose, and the rest of our team at Nicholas Dose, DMD, we can help you have a healthy mouth. For more information, contact our front office at: (503) 765-7300
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Nicholas Dose, DMD
601 1st Street Suite A
Lake Oswego, OR 97034-2370
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Nicholas Dose DMD, 601 First Street, Suite A, Lake Oswego, OR 97034 | (503) 765-7300 | lakeoswegodentalcare.com | 4/1/2021 | Related Terms: dentist Lake Oswego OR | dentist Lake Oswego OR |