You’ve recently learned one of your teeth needs a root canal treatment. It’s absolutely necessary: for example, if you have decay present, it will continue to go deeper within the tooth and it will spread to the roots and bone and could ultimately cause you to lose your tooth. Although you’re a little nervous, we can assure you that if we’ve recommended a root canal treatment, it’s the right step to take for your dental health.
There’s nothing mysterious — or ominous — about a root canal. To help ease any fears you may have, here’s a step-by-step description of the procedure.
Step 1: Preparing your mouth and tooth. We first take care of one of the biggest misconceptions about root canals: that they’re painful. We completely numb the tooth and surrounding tissues with local anesthesia to ensure you will be comfortable during the procedure. We isolate the affected tooth with a thin sheet of rubber or vinyl called a rubber dam to create a sterile environment while we work on the tooth. We then access the inside of the tooth — the pulp and root canals — by drilling a small hole through the biting surface if it’s a back tooth or through the rear surface if it’s in the front.
Step 2: Cleaning, shaping and filling the tooth. Once we’ve gained access we’ll clear out all of the dead or dying tissue from the pulp and root canals, and then cleanse the empty chamber and canals thoroughly with antiseptic and antibacterial solutions. Once we’ve cleaned everything out, we’ll shape the walls of the tiny root canals to better accommodate a filling material called gutta-percha, which we then use to fill the canals and pulp chamber.
Step 3: Sealing the tooth from re-infection. Once we complete the filling, we’ll seal the access hole and temporarily close the tooth with another filling. Later, we’ll install a permanent crown that will give the tooth extra protection against another infection, as well as restore the tooth’s appearance.
You may experience some mild discomfort for a few days after a root canal, which is usually manageable with aspirin or ibuprofen. In a week or so, you’ll hardly notice anything — and the tooth-threatening decay and any toothache it may have caused will be a distant memory.
If you would like more information on root canal treatments, 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.”
It’s been a long road back to oral health for you after periodontal (gum) disease. But after several plaque removal sessions and perhaps even surgical procedures to address deep infection, your gums have regained their healthy pink appearance.
But now you must face a hard reality: because you’ve had gum disease you’ll need to be extra vigilant with your oral hygiene to avoid another round with this destructive disease. But don’t worry—you won’t have to fight your prevention battle alone. We’ll continue to provide you care that reduces your risk of re-infection. We call that care periodontal maintenance (PM).
The heart of PM care involves regular dental visits for monitoring, cleanings and treatment when necessary. While most patients may visit their dentist at least twice a year, as a previous gum disease patient we may advise more frequent visits, especially if you’ve just finished periodontal treatment. Depending on the extent of your disease, we may begin with a visit every other week or once every two to three months. If your mouth continues to be disease-free we may suggest increasing the time between visits.
During your visit we’ll carefully examine your mouth, as well as screen you for any signs of potential oral cancer. We’re looking for both signs of re-infection or new issues with your teeth and gums. We’ll also assess the effectiveness of your oral hygiene efforts and advise you on ways you can improve.
If we find any signs of disease, we’ll then formulate a treatment plan to effectively deal with it. With frequent visits we have a better chance of discovering re-infection early—and the earlier the better to minimize any further damage. We may also need to take steps to make future PM care easier. This could include gum surgery to alter the tissues around certain teeth for easier access for examination and cleaning.
Our main focus with PM care is to look ahead: what can we do now to prevent a future bout of gum disease or at least lessen its effect? With continued monitoring and care we can drastically reduce your risk for further damage from this destructive disease.
If you would like more information on post-gum disease maintenance, 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 “Periodontal Cleanings.”
During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.
Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.
For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.
When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.
But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.
Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.
So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…
If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”
While lasers still seem like science fiction, they’ve been used commercially (and medically) for decades. But there’s still room for growth in practical applications with this developing technology. One promising area is in the treatment of periodontal (gum) disease.
Gum disease is a bacterial infection triggered by plaque, a thin film of bacteria and food particles caused by inadequate oral hygiene. The disease is highly destructive and can eventually lead to both tooth and bone loss. Treatment procedures vary widely, but they all have the same goal: remove the offending plaque and calculus (tartar) from tooth and gum surfaces. Without plaque the infection subsides and the gums can heal.
For decades now, dentists have removed plaque and calculus manually with special hand instruments or ultrasonic equipment. If the disease has advanced below the gum line or formed deep voids filled with infection called periodontal pockets, the dentist may also employ surgical techniques to access the infected areas.
While all these techniques have a long track record for effectiveness, they can cause the inadvertent destruction of healthy tissue, as well as create discomfort for some patients afterward. This is where a new protocol called Laser Assisted New Attachment Procedure (LANAP®) may be able to make a difference in the future.
With the LANAP® protocol, surgeons direct a laser beam of light through a fiber optic the width of three human hairs onto diseased tissue. The particular color of light interacts with the tissue, which contains the darkly-pigmented bacteria causing the disease, and “vaporizes” it. The beam, however, passes harmlessly through lighter-pigmented healthy tissue; as a result diseased tissue is eradicated with little to no harm to adjacent healthy tissue.
With these capabilities, trained dentists using LANAP® for gum disease treatment might be able to achieve conventional results with less tissue removal and bleeding, less discomfort for patients, and less tissue shrinkage than traditional procedures — and without scalpels or sutures. And some post-surgical studies have indicated LANAP® might also encourage gum tissue regeneration in the months following.
LANAP®, however, is still developing and requires further research. Thus far, though, the results have been encouraging. As laser technology advances, it’s quite possible tomorrow’s patient may experience less discomfort and more effective healing with their gum disease treatment.
If you would like more information on gum disease treatment, 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 “Treating Gum Disease with Lasers.”
Waiting is part of life for a teenager: waiting to get a driver’s license, to graduate high school or to leave home and stretch their wings. A teenager with lost teeth may also need to wait until they’re older to obtain dental implants.
The reason arises from the differences in how implants and natural teeth attach to the jaw. Although natural teeth may seem rigidly set in the bone, they’re actually held in place by an elastic tissue between them and the bone known as the periodontal ligament. Tiny filaments that attach to the teeth on one side and the bone on the other hold the teeth in place, but also allow the teeth to move gradually in response to mouth changes.
A titanium implant post doesn’t have this relationship with the periodontal ligament — it’s attached directly to the jaw bone. Over time the bone, which has a special affinity with titanium, grows and adheres to it to form a durable bond without an attachment to the periodontal ligament. Because of this the implant can’t move like a natural tooth.
This is extremely important for implant placement because the jaws in particular won’t fully develop in most people until their late teens or early twenties: the upper jaw in particular will tend to grow out and down. Natural teeth accommodate to these changes, but the implant can’t — it will appear to retreat into the jaw. The gum tissues surrounding the implant also won’t conform to the continuing growth and may appear receded.
The best approach is to choose a temporary replacement option until the jaws and other facial bone structures have finished growing. One example is a bonded bridge in which we use a bonding agent to attach a bridge of artificial teeth to teeth on either side of a missing tooth — bonding won’t permanently alter them as with a traditional bridge. Once the jaws have finished growing, we can remove the bonded bridge and install the more permanent implant.
Ask any teenager: waiting can be hard. But with dental implants, waiting until the right time will help ensure the attractive result is a permanent one.
If you would like more information on dental restorations and teenagers, 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 “Teenagers & Dental Implants.”
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