If you think you'd rather wrestle a pack of porcupines than go to the dentist for a root canal treatment — then maybe it's time to think again! This common procedure has been the butt of jokes for a long time. Let's set the record straight by answering some common questions about the much-maligned procedure.
Q: What is a root canal?
A: Coursing through the central part of each root is a hollow space or canal, which contains the pulp tissue. The pulp tissue contains the nerves which respond to temperature changes transmitted through the tooth. When the temperatures are extreme the nerves signal sensitivity and pain. It's also shorthand for the dental procedure that is performed when the pulp tissue that fills these canals develops a disease.
Q: Why do I need to get a root canal?
A: Because an infection or inflammation has developed deep inside one or more of your teeth. When the living pulp tissue — which contains nerves and blood vessels — becomes inflamed or infected, it can cause intense pain. It also releases bacterial toxins, which can lead to further problems.
Q: What happens if I don't get a root canal?
A: Your acute pain may temporarily go away, but the infection won't. It will eventually travel through the tooth's roots into the surrounding tissues. If left untreated, it may result in an abscess or even a systemic infection. That's why you need to take care of it now.
Q: Will it be painful?
A: Generally, a root canal procedure is no more painful than getting a filling. In fact, it starts the same way: An anesthetic is given to numb the tooth and the surrounding area. Then a small hole is made through the tooth's chewing surface and down into the canal. Diseased pulp tissue is removed through the hole via a set of tiny instruments. Finally, the root canal is cleaned, disinfected, filled with inert biocompatible material and sealed up.
Q: What happens after that?
A: Your tooth may be sensitive for a few days after the treatment, but the acute pain will be gone. Over-the-counter pain relievers generally work well for pain relief at this point. To restore your tooth to its fully-functioning state, a crown or other restoration is usually needed after root canal treatment. Properly done, the restored tooth can last as long as any of your natural teeth.
Q: Is there an alternative?
A: Yes. You can relieve the pain by having the tooth removed. But you don't want to go there. Tooth loss can lead to unwanted side effects, like migration of teeth, bone loss and eventually the inability to chew properly. It's far better to save your natural teeth when you can.
If you would like more information about root canals, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Signs and Symptoms of a Future Root Canal.”
Your son has fallen and hit his face against a hard surface. Not only is he in pain but now there is also a chip missing from his front tooth. He is worried that his smile will never be the same. What should you do?
Answer: If you can find that missing chip, sometimes we can bond the fragment back on to the tooth. The tooth should be evaluated and repaired as soon as possible, although in the absence of other signs and symptoms of injury, and if your child is not in acute pain, it can probably wait up to 12 hours.
If the fragment can't be found, then the tooth can be restored with tooth-colored filling materials, which are also physically bonded to the natural tooth. Done well, these “composite resin” fillings can last for years and look perfectly natural. They may eventually need to be replaced with something more permanent.
If the chipped tooth is a child's primary (baby) tooth rather than a permanent (adult) tooth, the treatment will be similar.
However, a blow to a tooth can cause damage to the pulp — the living tissue within the tooth, which can become infected and die. If the damage to a primary tooth is too extensive it may be better to remove it to avoid damage to an underlying and developing permanent tooth. A place-holding appliance called a space maintainer may be used. If it is a permanent tooth it may need root canal treatment.
If a tooth is not chipped but is loosened or tender to the touch, it may require temporary stabilization, called splinting, until it has healed. Sometimes no treatment is required. If there has been a fracture to the tooth's root (the part below the gum line) it may heal by itself, or it may require further treatment especially if it is a permanent tooth, depending on the individual situation.
It is important to evaluate teeth that have been hit or damaged as a result of injury to ensure that they remain healthy and functional. We will keep track of the tooth or teeth, with observation, x-rays when necessary and monitoring over time to make sure no permanent damage has been done.
Contact us today to schedule an appointment or to discuss your questions about repairing a chipped tooth. You can also learn more by reading the Dear Doctor magazine article “The Field-Side Guide to Dental Injuries.”
Without a doubt, an effective root canal treatment can extend the life of a tooth for many years. But sometimes even a well-maintained tooth can fall prey to disease months or even years after a root canal treatment. While there are a number of reasons to account for this failure, a common one is so tiny it could have easily been missed during the first treatment.
A root canal is an open space within the tooth that contains the pulp. The pulp is a connective tissue with a network of nerve fibers connected to the root that alert the brain to environmental changes involving the tooth. It is most important during the tooth’s early development, but becomes less important as we age. The pulp is susceptible to infection from tooth decay or periodontal (gum) disease, which if left untreated can threaten the tooth’s survival. During a root canal treatment, we enter these spaces, clear out the diseased pulp and fill the canal with a bio-compatible filling; we then seal it off to deter further decay.
The treatment could ultimately fail, though, because of accessory or lateral canals missed during the procedure. Like a tree with smaller branches growing out of its larger limbs, accessory canals are smaller access ways that branch off of the main root canals. These accessory canals, which can occur anywhere along a main canal, can be quite small and not easily detected during an initial root canal treatment. They are especially susceptible to infection due to gum disease if they open into the periodontal membrane, the main attachment point between teeth and bone.
If we suspect the presence of accessory canals (either initially or after ensuing problems following a root canal treatment), this could require the skills of an endodontist, a dentist who specializes in the treatment of a tooth’s interior. Accessory canals are treated in much the same way as larger canals, but may require an endodontist’s specialized microscopic equipment and filling techniques. Effective treatment of these smaller accessory canals will certainly improve the chances of a successful, long-term outcome for the tooth.
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 “Accessory Canals.”
Your toothbrush serves the invaluable purpose of minimizing bacterial buildup (plaque) that can irritate gums and lead to periodontal disease, infection of the bone and tissues supporting your teeth. Brushing also helps dislodge food particles that certain oral bacteria would otherwise feed on, producing acids in the process that can eat through protective tooth enamel and the vulnerable dentin below. Given its importance to your oral health, you can maximize your toothbrush’s effectiveness by using and storing it properly, and replacing it (or the brush head if you have a powered model) regularly.
Using and Storing Your Brush
All that’s needed to dislodge plaque from oral surfaces is a relaxed grip and a gentle jiggling motion. Too much pressure can wear away tooth enamel, cause gum tissue to recede, and shorten the life of your brush head.
When you’re done using your brush:
- Thoroughly rinse it to remove any remaining tooth paste, food particles, etc.
- If you’re super-vigilant, you also can disinfect your brush by soaking it in mouthwash, brush-sanitizing rinse, or a half water/half hydrogen peroxide solution, or dipping it in boiling water for 5 to 10 seconds.
- Air dry in an upright position and do not routinely cover your toothbrush or store it in a closed container. A dark, moist environment is more conducive to the growth of microorganisms.
Replacing and Recycling Your Toothbrush
Even with the best of care, toothbrush bristles become frayed and worn and their cleaning effectiveness diminishes after 3 or 4 months, according to the American Dental Association, though it could be sooner depending on factors unique to each patient. Besides checking the bristles regularly, a good way of keeping track is to write the date you start using your toothbrush in permanent pen on a big-enough spot on the handle (or doing it on masking tape applied to the base of a power brush).
Once your brush has passed its useful life for oral hygiene, you can still get plenty of mileage out of it. You’ll find plenty of ideas on the internet for cleaning grout between tiles and grime-filled spots around taps and toilet lid hinges; removing mud from boot treads; scrubbing off corrosion from around car battery terminals and more!
If you would like more information about oral hygiene, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Toothbrush Lifespan” and “Manual vs Powered Toothbrushes.”
Your otherwise beautiful smile has one noticeable flaw — one or more of your teeth are deeply discolored or stained. More than likely this staining is deep within the teeth, what we refer to as intrinsic staining. There are a number of reasons this can occur — from fillings or use of antibiotics, for example — and our first approach should be to attempt a whitening technique.
However, if that doesn't produce the desired result, porcelain laminate veneers are another option you might consider. Veneers are made of dental porcelain, a bio-compatible material that can be shaped and colored to closely match neighboring teeth. After a minimal amount of tooth reduction (removal of some of the enamel from the tooth surface) to prepare for the laminate, the veneers are then permanently bonded to the tooth surface and cover the discolored natural tooth. Besides changing the appearance of discolored or stained teeth, veneers can also be used to correct other imperfections such as chipped or misshapen teeth.
Patients, however, have a common question: how long will the veneers last? With proper care, veneers can last anywhere from seven years to more than twenty years. It's possible, though, to damage them — for example, you can break them if you bite down on something that goes beyond the porcelain's tolerance range, such as cracking nut shells with your teeth (not a good idea even for natural teeth!). You should also keep in mind that veneers are composed of inert, non-living material and are attached and surrounded by living gum tissue that can change over time. This process may eventually alter your appearance to the point that the veneer may need to be removed and reapplied to improve the look of your smile.
If a veneer is damaged, all is not necessarily lost. It may be possible to re-bond a loosened veneer or repair a chipped area. The worst case is replacement of the veneer altogether. Chances are, though, this will only happen after the veneer has already served you — and your smile — for many years.
If you would like more information on porcelain laminate veneers, 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 “Porcelain Veneers.”
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