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TheresStillHopeforaRe-InfectedToothAfterRootCanalTreatment

Most first-time root canal treatments achieve their purpose in saving an internally decayed tooth and extending its life to match those of the patient’s non-decayed teeth. Occasionally, though, a root canal-treated tooth may become re-infected by decay.

There are a number of reasons for this: the permanent crown meant to add further protection against decay may have been delayed, giving bacteria an opening to re-infect the tooth; it’s also possible the original seal for the pulp chamber and root canals after filling wasn’t sufficient to prevent bacterial contamination.

There‘s also another reason that’s very difficult to foresee — the presence of narrow, curved root canals in the tooth that can pose complications during the procedure. Some of these known as accessory or lateral canals branch off the main canals to create a complex network that’s difficult to detect during the initial procedure. If they’re not cleaned out and filled during the procedure any tissue trapped in them can remain infected and ultimately die. If these canals also open into the periodontal membrane at the attachment between the teeth and bone, the infection can spread there and become a periodontal (gum) infection that can trigger future tooth loss.

Fortunately, a reoccurrence of infection isn’t necessarily a death sentence for a tooth. A second root canal treatment can correct any problems encountered after the first treatment, especially complications from accessory canals. It may, though, require the advanced skills of an endodontist, a dental specialist in root canal problems. Endodontists use microscopic equipment to detect these smaller accessory canals, and then employ specialized techniques to fill and seal them.

If you encounter pain or other signs of re-infection for a tooth previously treated with a root canal procedure, contact us as soon as possible. The sooner we can examine and diagnose the problem, the better your tooth’s chances of survival by undergoing a second root canal treatment.

If you would like more information on tooth preservation through root canal 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 “Accessory Canals.”

LasersBeginningtoChangeSomeRootCanalProcedures

As in other parts of medicine, lasers are beginning to change the way we provide dental care. More and more dentists are using lasers to make earlier diagnoses of dental disease or provide surgical treatment. One area prime for change is the treatment of teeth with deep decay and in danger of being lost.

For decades now, the best way to save teeth in this condition is with root canal treatment. In this common procedure we access the pulp, remove the infected tissue with specialized hand instruments, and then fill and seal the pulp chamber and root canals with a special filling.

We can now potentially improve the efficiency and increase the success rate of this treatment with laser technology. With their focused light, lasers emit a concentrated burst of energy that's extremely precise. In many instances laser energy can remove the target diseased tissue without damaging nearby healthy tissue.

In this form of root canal treatment, we use lasers to remove tissue and organic debris within the pulp and then shape the root canal walls to better receive the filling. We can also utilize the heat from laser energy to soften and mold the filling, so that it better conforms within the walls of the root canals.

Using lasers in root canal treatments may require less local anesthesia than the traditional approach and also eliminates disturbing or discomforting sounds and vibrations. Dentists who've used the new technology also report less bleeding during the procedure and less pain and occurrences of infection afterwards.

But there are a couple of disadvantages for using lasers in root canal treatment. For one, light travels in a straight line — and many root canal networks are anything but straight. More complex root canal networks may still require the traditional approach. Laser energy could also increase the tooth's inner temperature, which could potentially damage tissues even on the tooth's outer surfaces.

Used in the right circumstances, though, lasers can be an effective means to treat diseased teeth.  As laser technology continues to advance and becomes a mainstay in dental care, you may soon find it part of your next dental procedure.

If you would like more information on root canal treatments, please contact us or schedule an appointment for a consultation.

GameSetMatchMilosRaonicSaysAMouthguardHelpsHimWin

When you’re among the top players in your field, you need every advantage to help you stay competitive: Not just the best equipment, but anything else that relieves pain and stress, and allows you to play better. For top-seeded Canadian tennis player Milos Raonic, that extra help came in a somewhat unexpected form: a custom made mouthguard that he wears on the court and off. “[It helps] to not grind my teeth while I play,” said the 25-year-old up-and-coming ace. “It just causes stress and headaches sometimes.”

Mouthguards are often worn by athletes engaged in sports that carry the risk of dental injury — such as basketball, football, hockey, and some two dozen others; wearing one is a great way to keep your teeth from being seriously injured. But Raonic’s mouthguard isn’t primarily for safety; it’s actually designed to help him solve the problem of teeth grinding, or bruxism. This habitual behavior causes him to unconsciously tense up his jaw, potentially leading to problems with muscles and teeth.

Bruxism is a common issue that’s often caused or aggravated by stress. You don’t have to be a world-class athlete to suffer from this condition: Everyday anxieties can have the same effect. The behavior is often worsened when you consume stimulating substances, such as alcohol, tobacco, caffeine, and other drugs.

While bruxism affects thousands of people, some don’t even suspect they have it. That’s because it may occur at any time — even while you’re asleep! The powerful jaw muscles that clench and grind teeth together can wear down tooth enamel, and damage both natural teeth and dental work. They can even cause loose teeth! What’s more, a clenching and grinding habit can result in pain, headaches and muscle soreness… which can really put you off your game.

There are several ways to relieve the problem of bruxism. Stress reduction is one approach that works in some cases. When it’s not enough, a custom made occlusal guard (also called a night guard or mouthguard) provided by our office can make a big difference. “When I don’t sleep with it for a night,” Raonic said “I can feel my jaw muscles just tense up the next day. I don’t sense myself grinding but I can sort of feel that difference the next day.”

 An occlusal guard is made from an exact model of your own mouth. It helps to keep your teeth in better alignment and prevent them from coming into contact, so they can’t damage each other. It also protects your jaw joints from being stressed by excessive force. Plus, it’s secure and comfortable to wear. “I wear it all the time other than when I’m eating, so I got used to it pretty quickly,” said Raonic.

Teeth grinding can be a big problem — whether you put on your game face on the court… or at home. If you would like more information about bruxism, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Stress & Tooth Habits” and “When Children Grind Their Teeth.”

By Barry Goodman, DDS
June 12, 2018
Category: Oral Health
Tags: sugar   tooth decay  
IncludeLimitationsonSugarinYourToothDecayPreventionStrategy

We’ve waged war for decades against tooth decay through oral hygiene and the increasing use of fluoride, nature’s “super weapon” against this disease. And yet, tooth decay remains a significant health problem.

One major reason is refined sugar found in many processed foods. In the 1970s researchers raised concerns about the fat content of many processed foods, so manufacturers began removing fat from their products — along with much of the flavor. To compensate, they added sugar. Today, three-quarters of approximately 600,000 food products contain sugar.

This has increased average individual consumption to 90 pounds of sugar annually. The World Health Organization says we should consume no more than 20 pounds annually, or about 6 teaspoons a day. A single can of soda contains 4 teaspoons, two-thirds of the daily allowance.

High sugar consumption is an obvious threat to dental health: decay-causing bacteria thrive on it. But the trend has also been linked to serious health problems like diabetes and heart disease.

Hopefully, changes in public policy will one day modify the addition of sugar in processed foods. In the meantime, you can take action for yourself and your family to create a more healthy relationship with this popular carbohydrate.

Shop wisely. Learn to read and understand food labels: steer clear of those containing sugar or large numbers of ingredients. Become acquainted with sugar’s many other “names” like corn syrup or evaporated cane juice. And maximize your shopping on a store’s outer perimeters where you’ll find fresh fruits, vegetables and dairy products, rather than the middle aisles with “boxed” processed items.

Avoid sugar-added drinks. Limit consumption of sodas, sports drinks, sweet teas or even juice to avoid added sugar. Make water or sugar-free beverages your go-to drinks. It’s much better to eat sugar naturally found in fresh fruits and vegetables, where fiber helps slow it’s absorption in the body, than to drink it.

Exercise. Depending on your condition, physical exertion is good for your overall health. It’s especially beneficial for your body’s ability to metabolize sugar. So with your doctor’s advice, exert your body every day.

It’s important to engender a proper relationship with sugar — a little can go a long way. Putting sugar in its rightful place can help you avoid tooth decay and increase your chances of greater overall health.

If you would like more information on sugar’s impact on dental and general health, 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 “The Bitter Truth About Sugar.”

LookatYourOptionsforSavingaToothFirstBeforeReplacingit

It's no exaggeration — dental implants have revolutionized teeth replacement. Life-like and durable, implants are the closest thing in design and function to a natural tooth.

In fact, there's only one thing better than a dental implant — a real tooth. For function and long-term oral health, you can't beat what nature provided you in the first place. So before you finally decide to remove and replace that problem tooth, consider these other options for saving it.

Root canal therapy. Tooth decay can do more than cause cavities — it can work its way into the pulp, the innermost layer of a tooth. If it isn't stopped here, it could continue on to the roots and put the tooth in real danger of loss. A root canal treatment removes the infection from the pulp and root canals and replaces the space with a filling. A life-like crown is then bonded or cemented to the tooth to protect it from further infection.

Aggressive treatment for periodontal (gum) disease. This other dental disease is just as damaging as tooth decay. Caused by bacterial plaque, the gums around a tooth become infected and inflamed. As it moves deeper into the tissues and inflammation progresses, it can affect supporting bone causing it to dissolve. To prevent this potential bone loss, it's important to seek out and remove hidden pockets of plaque. This may require surgery to access the roots for plaque and calculus (tartar) removal, but it's well worth it to preserve the tooth.

Bone grafting. As mentioned before, gum disease can ultimately lead to bone loss. But even when bone loss has occurred (a substantial threat to a tooth's survival) we may be able to reverse it with bone grafting techniques. During this procedure we insert grafting material at the loss site along with substances that stimulate growth. The graft serves as a scaffold for new bone cells to grow upon. Over time the bone volume increases and helps stabilize a weak tooth.

Of course, your best option is to avoid dental disease in the first place with daily brushing and flossing and regular dental visits for cleanings and checkups. That and treating dental disease in its earliest stages will help ensure you'll have the best teeth possible — your own.

If you would like more information on options for treating diseased 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 “Save a Tooth or Get an Implant?





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