Hughes’ Views Dr. Michael Hughes’ Dental Blog

What You Should Know About Tooth Decay. Really!


Old school treatment is to “drill and fill” and admonish the patient to “brush and floss better”.

Over the past decade dental researchers have made huge strides in understanding why people get cavities. Dental offices at the forefront of this science use CAMBRA and ATP Bioluminescence to help you to reduce your risk of getting cavities. CAMBRA is an acronym for Caries Management By Risk Assessment ( caries is the formal name for decay in teeth ).

Old school believed the concept that decay was a result of sugar on the teeth and two specific bacteria; Strep. Mutans and Lactobacillus. Now we know that we all have a biofilm in our mouths that has anywhere from 120 to 500 different bacteria with some being good and some not so much. There are at the current count over 50 different acid producing bacteria possible in a person’s biofilm that can cause decay. More importantly we understand that it is more about the overall balance of bacteria in our biofilm than it is about specific bacteria so tooth decay is actually due to a Biofilm Imbalance. What this means is that our biofilm has more acid producing bacteria in proportion to non-acid producing…

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3M Dental Digital Scanners

After using the 3M COS digital scanner for 5 years I have decided to put this expensive device in the closet. The technology for doing digital impressions for crowns and bridges is very exciting and the future is very bright but the future is not now. I received the first device in the southeast United States and have gotten very good results with it, however, the results are not predictable causing this dental staff, our dental labs and our patients significant inconvenience.

The scanning device works as expected and when the lab at 3M performs professionally the resulting crowns and bridges are the best fitting most accurate I have ever seen.

The problem lies with 3M labs. The model production necessary to make the crowns and bridges must be as accurate as the digital scans. This only occurs about 10% of the time causing endless frustration for the lab technicians as crowns must be sent back to the lab and then they take excessive amounts of adjustment time chairside to seat the restorations. The end result can be fantastic but the predictability of delivering a crown is nonexistent. This naturally reflects poorly on the practitioner as patients experience the rescheduling and…

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Creative Diagnosis

In 2013 a dentist coined the term “Creative Daignosis” to describe a growing trend in dentistry.This is a direction that ethical and honest dentists find disturbing. Dr.Camm described patients coming to his practice for a second opinion after being diagnosed with needing as many as 10 fillings. Dr. Camm repeatedly found that there was little or no treatment needed. Dr. Camm is a Pedodontic dentist. His patients are all innocent young children.

Here in my practice I have seen a similar disturbing trend. Lured in by advertisements for $59 cleaning exam and x-rays, the patient is immediately told that they can’t participate in the special because they have gum disease consisting of many 4-5 mm pockets throughout their mouth. Instead of the $59  special they will need gum therapy for $1200 and another $3-4,000 worth of work to repair small crack lines or old fillings.

These patients sought a second opinion and were able to see precisley what was going on in their mouth via the live video feed from the Microscope and were able to realize that they were not suffering from the problems suggested in the “Creative Diagnosis”.

Lesson # 1. It is very expensive to provide high quality Dental…

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Acid Erosion of Your Teeth

The newly advertised problem of Acid Erosion suggests that you must use Pronamel to prevent terrible damage to your teeth. Is this a significant problem that should encourage you to run to the store or quit eating the foods you love?

It is true that acid in strong enough concentrations can erode the outer tooth structure enamel. Does the food that you eat pose this problem? No. Unless you suck on lemons or limes all day long, a habit that was popular in Florida many decades ago, a normal healthy diet does not pose unusual risk to your enamel.

Acid Reflux, which should not be confused with indigestion, is a common source of erosion of the enamel right along the gum line. Reflux occurs when you lie down horizontal and the Hydrochloric Acid in your stomach seeps up into your mouth. This is a strong enough concentration of acid to dissolve away some of the tooth and root surface. Pronamel will not prevent or help this situation.

The biggest concern with Acid Reflux is not the minor damage to your teeth but the effect the acid can have on the lining of your esophagus and throat. There has been a big increase…

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Microscope Dentistry

See what others are missing
For more than 25 years the World’s Top Dentists have been using the Dental Microscope to provide the most ideal dental treatment...
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Dr. Hughes’ Blog

February 8, 2022 Magnification Cleaning. Solve Gum Disease Non-Surgically
DeVA-1® 2G Pro now has the camera located at the distal tip of the fiber and delivers clear, crisp images...
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January 27, 2016 Final Part: ” Acid Erosion” Prevention
Final Part : “Acid Erosion” The 3 most important things to know if you have Acidity issues, either Decay or Tooth...
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