Posts for: July, 2020
Bad news at your last dental visit: You have a decayed tooth. And not just in the enamel—the decay has invaded the tooth's inner pulp and the resulting infection is threatening the supporting bone structure.
You're thinking that tooth is toast. Then comes the good news: your dentist believes the tooth can be rescued with a root canal treatment.
But then you begin thinking about how often Uncle Sid says he'd rather undergo a colonoscopy than have a root canal. Is the procedure really as painful and uncomfortable as popular culture says it is? What is a root canal really like?
First step: Things go numb. Uncle Sid is wrong: A root canal treatment is painless because your dentist will first make sure the entire area involving the tooth is anesthetized. This does involve injecting the local anesthetic deep within the tissues, but you won't even feel the needle prick thanks to topical anesthesia applied to the surface gums.
Second step: Drilling deep. After applying a protective dam to isolate the infected tooth from its neighbors, your dentist will drill a small access hole through the enamel and dentin to reach the pulp and root canals. If it's one of the larger back teeth, the access hole is usually drilled in the tooth's biting surface; in a front tooth, the hole is usually located on the tongue side.
Third Step: Removing diseased tissue. Using special instruments, your dentist will remove the diseased tissue in the pulp and root canals, essentially stopping the infection and any tooth pain you've been experiencing. The empty pulp chamber and canals are often then disinfected with a special antibacterial solution.
Fourth Step: Protecting the tooth. After some shaping, the pulp chamber and root canals are filled with a special filling to prevent further infection. The access hole is then filled and sealed to complete the procedure. At some point in the future, the tooth typically will need a crown to add support and further protection.
You may have some minor discomfort afterward, but this can usually be managed with a mild pain reliever like ibuprofen or acetaminophen. After a week or so, you'll be good as new—and so will your tooth.
If you would like more information on root canal therapy, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Step-By-Step Guide to Root Canal Treatment.”
If you're an adult, your teeth shouldn't wiggle—not even a little bit. If you have a loose tooth, you need to see your dentist as soon as possible to avoid losing it permanently.
Loose teeth usually happen because of one of two kinds of bite-related trauma. One is known as primary occlusal, which usually happens when the periodontal (gum) structures that help secure teeth encounter higher than normal biting forces. This is usually due to a clenching or grinding habit.
The other and more common kind is secondary occlusal: This happens when the periodontal structures and supporting bone are in a weakened state, usually because of gum disease. In this condition, even normal biting forces can cause damage to a tooth's gum attachment and result in looseness.
To stop a loose tooth from becoming a lost tooth, we'll need to take these immediate steps.
Treat any underlying disease. If a gum infection is the culprit, our first priority is to stop it from doing any more damage. The main treatment for gum disease is to remove dental plaque, a thin film of bacteria and food particles that's the usual cause for the infection. Depending on how much the infection has advanced, this could take several sessions to bring it under control.
Reduce abnormal biting forces. If teeth are loose from abnormally high bite forces, there are a few things we can do. One is to selectively reshape the biting surfaces of teeth so that they receive less force while biting. Another approach is to minimize the effect of teeth grinding with an occlusal guard worn in the mouth: Its slick plastic surface prevents teeth from making solid contact while biting.
Splint loose teeth to secure them. We can secure loose teeth by splinting them to more stable teeth with metal strips or other means. Splinting is often done in conjunction with the aforementioned treatments, and is usually temporary until the tooth regains its periodontal attachments. Sometimes, though, it may be necessary to permanently splint a weakened tooth.
A loose tooth isn't necessarily destined to be lost. But we'll have to act quickly—if you have a loose tooth see us as soon as possible to determine how best to save it.
If you would like more information on saving loose teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treatment for Loose Teeth.”
Your child could hit a speed bump on their road to dental maturity—tooth decay. In fact, children are susceptible to an aggressive form of decay known as Early Childhood Caries (ECC) that can lead to tooth loss and possible bite issues for other teeth.
But dentists have a few weapons in their arsenal for helping children avoid tooth decay. One of these used for many years now is the application of sealants to the biting surfaces of both primary and permanent teeth. Now, two major research studies have produced evidence that sealant applications help reduce children's tooth decay.
Applying sealant is a quick and painless procedure that doesn't require drilling or anesthesia. A dentist brushes the sealant in liquid form to the nooks and crannies of a tooth's biting surfaces, which tend to accumulate decay-causing bacterial plaque. They then use a curing light to harden the sealant.
The studies previously mentioned that involved thousands of patients over a number of years, found that pediatric patients without dental sealants were more than three times likely to get cavities compared to those who had sealants applied to their teeth. The studies also found the beneficial effect of a sealant could last four years or more after its application.
The American Dental Association and the American Academy of Pediatric Dentistry recommend sealants for children, especially those at high risk for decay. It's common practice now for children to first get sealants when their first permanent molars erupt (teeth that are highly susceptible to decay), usually between the ages of 5 and 7, and then later as additional molars come in.
There is a modest cost for sealant applications, but far less than the potential costs for decay treatment and later bite issues. Having your child undergo sealant treatment is a worthwhile investment: It could prevent decay and tooth loss in the near-term, and also help your child avoid more extensive dental problems in the future.