Posts for: February, 2019
A root canal treatment is a common procedure performed by dentists and endodontists (specialists for inner tooth problems). If you're about to undergo this tooth-saving procedure, here's what you need to know.
The goal of a root canal treatment is to stop tooth decay within a tooth's interior and minimize any damage to the tooth and underlying bone. This is done by accessing the tooth's pulp and root canals (tiny passageways traveling through the tooth roots to the bone) by drilling into the biting surface of a back tooth or the "tongue" side of a front tooth.
First, though, we numb the tooth and surrounding area with local anesthesia so you won't feel any pain during the procedure. We'll also place a small sheet of vinyl or rubber called a dental dam that isolates the affected tooth from other teeth to minimize the spread of infection.
After gaining access inside the tooth we use special instruments to remove all of the diseased tissue, often with the help of a dental microscope to view the interior of tiny root canals. Once the pulp and root canals have been cleared, we'll flush the empty spaces with an antibacterial solution.
After any required reshaping, we'll fill the pulp chamber and root canals with a special filling called gutta-percha. This rubberlike, biocompatible substance conforms easily to the shape of these inner tooth structures. The filling preserves the tooth from future infection, with the added protection of adhesive cement to seal it in.
Afterward, you may have a few days of soreness that's often manageable with mild pain relievers. You'll return for a follow-up visit and possibly a more permanent filling for the access hole. It's also likely you'll receive a permanent crown for the tooth to restore it and further protect it from future fracture.
Without this vital treatment, you could very well lose your tooth to the ravages of decay. The time and any minor discomfort you may experience are well worth the outcome.
If you would like more information on treating tooth decay, 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 “Root Canal Treatment: What You Need to Know.”
Canker sores, known medically as aphthous ulcers, are fairly common among people. Lasting for about a week or so, these mouth sores are usually more irritating than painful. But about a quarter of the population, especially women, frequently suffer from an acute form that doesn't often respond well to over-the-counter remedies.
A typical canker sore is usually round with a yellow-gray center ringed by a reddened "halo." They can be preceded by tingling or painful sensations at the site a few hours or so before breaking out. Recurrent aphthous stomatitis (RAS) is the more severe form of canker sore, often with outbreaks of multiple painful sores. While the more common sore is usually less than a centimeter in diameter, RAS sores are often much larger.
Canker sores often arise during periods of stress or anxiety, and seem to be connected with eating certain acidic foods like tomato sauce, citrus fruits or spicy dishes. RAS also seems to be related to underlying systemic conditions like vitamin deficiencies, anemia or digestive disorders. Besides managing diet and stress, people with regular canker sores and milder cases of RAS can often find relief with non-prescription numbing agents often found in stores and pharmacies.
For more severe RAS, though, you may need the help of your dentist or physician with treatments like prescription steroids or other medications that come in gel or rinse form or through injections. The goal of any treatment approach is to decrease pain severity and shorten healing times after an outbreak.
While most mouth sores, including RAS, aren't dangerous to your health, you should still take any sore seriously. You should especially seek medical evaluation if a sore doesn't heal after a couple of weeks, if they seem to come more frequently and are more severe, or if you don't seem to ever be without a sore in your mouth. These could indicate a serious underlying problem that needs to be addressed.
One thing's for sure: there are ways to ease your suffering if you have frequent bouts with regular canker sores or even RAS. Talk to your dentist about ways to minimize your discomfort from these irritating mouth sores.
If you would like more information on aphthous ulcers or canker sores, 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 “Mouth Sores.”
Dental implant technology has advanced at such an astounding rate in recent years that you can now walk into a dentist's office with a problem tooth and out the same day with a new one. Unfortunately, not all dental situations allow for this possibility.
For example, you might be considering an implant many years after losing a tooth. But there's a potential problem: there might not be enough supporting bone. While an implant might still be possible, inadequate bone complicates the matter.
Because implants are essentially tooth root replacements, they require a certain amount of bone for stability and the best attractive outcome. As a general rule, implants need to be surrounded by at least 1.5-2.0 millimeters of healthy bone to support an implant. But you might not have enough if your tooth has been missing for awhile, regardless if you have or haven't worn dentures or other restorations.
That's because bone has a life cycle in which older cells die and newer ones form to take their place. As we chew or bite, the force generated travels up through the teeth to the bone to stimulate this new growth. Without a tooth the bone doesn't receive this stimulus, which can slow the growth rate. Over time the affected bone can lose its volume and density.
If we find you've experienced loss to the point your bone won't support an implant, that doesn't automatically mean this popular restoration is out of the picture. But it will require us first performing a procedure known as augmentation or bone grafting to help rejuvenate some of the lost bone.
With grafting, we place processed bone grafting material in the jaw through a minor surgical procedure to form a scaffold for new bone to grow upon. After several months this can result in several millimeters of new growth maintaining the width of the underlying bone, which in turn may be able to support an implant.
Bone grafting is quite common, often performed at the same time as tooth extraction if there's going to be a time lag before installing an implant. Even if performed later, though, it can successfully rejuvenate lost bone and make it possible for you to take advantage of durable, life-like implants.
If you would like more information on dental implants, 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 “Dental Implants after Previous Tooth Loss.”
Wearing orthodontic braces brings challenges to daily life. During treatment a patient will need to avoid certain foods and habits, take more time to brush and floss properly, and may endure occasional discomfort. But the effect of metal braces on appearance can be especially difficult, especially for peer-conscious teens.
Clear aligners, though, offer an alternative to braces that could make some of these challenges easier, particularly with your appearance. Aligners are clear plastic trays that fit over the teeth to move them. They can be removed by the wearer for easier brushing and flossing or for special occasions. Best of all, they're much less noticeable than metal braces.
Clear aligners were developed thanks to advances in digital technology. An orthodontist uses a computer application incorporating the data from photographs, x-rays or CT scans of a patient's teeth and jaws to produce a series of clear plastic trays. The patient then wears each tray for about two weeks before changing to the next tray in the sequence.
The trays apply pressure much like metal braces to gradually move teeth to the desired position on the jaw. Each tray is slightly smaller in size than the previous tray in the sequence, so that the progression of tooth movement continues with each succeeding tray. The treatment time is about the same as with conventional braces.
This new orthodontic tool works well for many common bite problems, but until recently they've been limited in scope. But new designs in trays and attachments called buttons added to teeth to provide more leverage have greatly increased their use for more complex bite issues.
Clear aligners also have one other disadvantage, ironically due to one of their principal benefits, removability. Although they can be taken out, they must be worn consistently to achieve results. Some younger patients may not have the maturity level and discipline to responsibly wear their aligners as they should.
That's one issue you'll need to discuss with your orthodontist if you're considering clear aligners for your teen. But if they can maintain wearing consistency, and they have a bite problem that can be corrected with aligners, both you and your teen may find this choice more agreeable and attractive than braces.
If you would like more information on clear aligners, 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 “Clear Aligners for Teens.”
Around ages 6 to 8, a child's primary teeth will begin to loosen to make way for their permanent teeth. If all goes well, the new set will come in straight with the upper teeth slightly overlapping the bottom.
But sometimes it doesn't go that well: a child may instead develop a poor bite (malocclusion) that interferes with normal function. If we can detect the early signs of a developing malocclusion, however, we may be able to intervene and lessen its impact. You as a parent can play a vital role in this early detection.
The first thing you should be watching for is teeth spacing.Â Normal teeth come in straight with a slight gap between them. But there are two abnormal extremes to look for: teeth having no space between them or crowded together in a crooked, haphazard manner; or they seem to have too much space between them, which indicates a possible discrepancy between the teeth and jaw sizes.
You should also notice how the teeth come together or “bite.” If you notice the lower front teeth biting in front of the upper (the opposite of normal) it may be a developing underbite. If you see a space between the upper and lower teeth when they bite down, this is a sign of an open bite. Or, if the upper front teeth seem to come down too far over the lower, this could mean a deep bite: in extreme cases the lower teeth actually bite into the roof of the mouth behind the upper teeth.
You should also look for crossbites, in which the teeth in one part of the mouth bite abnormally in front or behind their counterparts, while teeth in other parts bite normally. For example, you might notice if the back upper teeth bite inside the lower teeth (abnormal), while the front upper teeth bite outside the lower front teeth (normal).
The important thing is to note anything that doesn't look right or seems inconsistent with how your child's teeth look or how they function. Even if you aren't sure it's an issue, contact us anyway for an examination. If it really is a developing bite problem, starting treatment now may lessen the extent and cost of treatment later.