Docs on 12th Dental Services
Times have changed. In the mid 20th century, about half of our country's population had no teeth at age 50. A full swing epidemic of tooth decay was occurring and life back then was much more laid back compared to today. People are now living longer and keeping their teeth longer as well, which now has brought on a whole new set of unexpected circumstances.
Dr Katayama is now beginning to see a new epidemic of what he calls an "Epidemic of Cracked Teeth". We see this occurrence on a daily basis and have been treating these conditions of teeth now for several years in an effort to prevent tooth loss. The population base at risk with this is the middle aged and beyond. The worst case scenario is the actual splitting of a tooth which is terminal to the use of this tooth. Depending upon the location and angle of the crack, either a 'chunk' of tooth may break off or the tooth could itself split in half when the crack runs it course.
Historically, a dentist would treat what is referred to as the "Cracked Tooth Syndrome" with a crown, root canal and crown, or a full blown tooth extraction. However, in some situations, by the time the symptoms arise, it may be too late to save the tooth. Therefore, early recognition is the key here. Before the crack approaches the nerve internally. Furthermore, any tooth can crack, but the back teeth have the highest degree of frequency and a tooth with a filling has the greatest risk.
Any kind of filling will weaken the tooth and make it more susceptible to cracking. It is easier to comprehend when we examine the amalgam or also known as the "silver" filling. In its heyday, early to mid 20th century, this type of filling was the major player for stopping the cavity epidemic and this method for filling is still being used today. In order for an amalgam filling to stay lodged inside of a tooth, it must be strategically and mechanically locked into place.
Thus, the dentist learned the practice of making sharp corners with the drill internally inside of the tooth. These sharp corners is what has set in motion the very structure and environment for a crack to occur, much like the cracks we have seen in the wall of an older house that project out of sharp corner of a window or door frame. ( Have you ever wondered why commercial airplanes have rounded windows and doors in their design? )
Furthermore, those grooves or lines that you see on the chewing surfaces of your back teeth were also drilled out with the same sharp corners because this was where the cavities began. The "east to west" channel cut into a tooth is one way to describe the method used and could be thought of as a 'pane of glass' scribed with a class cutter across it surface! After the placement of the Amalgam filling was complete, the dentist could instruct the patient to not eat for a specific time period of 24 hours. During that time, the amalgam went through a "hardening" process, but with some forms of amalgam, it was also slightly "Expanding".
Keeping this in mind, that amalgam is a metal should help one understand that it is susceptive to expansion and contraction. Amalgam therefore rapidly expands when exposed to heat and conversly shrinks quickly when put into contact with something cold. The tooth on the other hand is partially a mineral based compound and responds much more slowly, much like a coffee cup or porcelain container. If you consume hot coffee and then follow up with a scoop of ice cream for example, the amalgam will act somewhat like an accordion inside of the tooth! And because of the tooth's mineral like properties, it is brittle and can suffer with cracking.
Keeping all of this in mind the reader here should know that our existence today is very different than it was in the mid 20th century. Clenching and grinding our teeth has become a "normal" condition and reaction to the daily stresses of our fast paced life. It is no wonder that so many teeth are now cracking more and more. Dr Katayama estimates that around 90% of the observable surface cracks that he sees around the amalgam fillings are also revealing the presence of internal structural cracks when further investigaged. These cracks are not static! Like cracks in a windshield of an automobile...they will continue to grow and get longer.