My Blog
By Barry Goodman, DDS
April 23, 2018
Category: Dental Procedures
Tags: root canal   tooth pain  
TheremaybemoretothatToothachethatSuddenlyStopsAching

If a pain you’ve been feeling goes away, you might believe the problem that caused it is gone too. But that doesn’t mean it has, especially with a tooth. An excruciating toothache that suddenly stops should still be examined. Here’s why.

Tooth decay often works its way into a tooth’s innermost layer, the pulp, which contains bundles of nerves and other tissue. The infection attacks the nerves, which send pain signals to the brain. As the infection persists, though, the nerves will eventually die and will no longer be capable of sending pain signals — hence the “mysterious” end of your toothache.

Although the pain has stopped, the infection is very much active in the tooth and will continue to work its way through the root canals to the jaw. And ultimately, the pain will return as the infection invades the bone.

But there’s good news: a tooth in this condition can be saved with a procedure known as root canal therapy. We drill a small hole in the tooth to access the pulp, usually through the biting surface of back teeth or in the rear in front teeth. Once inside the pulp chamber, we clean out the infected and dead tissue. We then fill the empty pulp chamber and the root canals with a special filling and seal the access hole. In a few weeks the tooth receives a life-like crown to further protect it from re-infection and fracture years later.

A straightforward root canal treatment can be performed by a general dentist. If there are complications like a complex root canal network, however, then the skills and specialized equipment of an endodontist (a specialist in root canals) may be needed.

A root canal treatment resolves the real cause of a toothache that suddenly stopped, as well as puts an end to future pain and infection related to the tooth. More importantly, it can save your tooth and add many more years to its life.

If you would like more information on tooth pain, 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 Severe Toothache.”

By Barry Goodman, DDS
April 13, 2018
Category: Dental Procedures
Tags: tooth pain  
DontIgnoreToothPain-YouMayNeedaRootCanal

Tooth decay is one of the most common diseases in the world, nearly as prevalent as the common cold. It’s also one of the two major dental diseases—the other being periodontal (gum) disease—most responsible for tooth and bone loss.

Tooth decay begins with high levels of acid, the byproduct of oral bacteria feeding on food remnants like sugar. Acid can erode tooth enamel, leading to a cavity that will require removal of decayed material around it and then a filling.

Sometimes, though, decay can spread deeper into the tooth reaching all the way to its core: the pulp with its bundle of nerves and blood vessels. From there it can travel through the root canals to the bone. The continuing damage could eventually lead to the loss of the infected tooth.

If decay reaches the tooth interior, the best course of action is usually a root canal treatment. In this procedure we access the pulp through the crown, the visible part of the tooth, to remove all of the diseased and dead tissue in the pulp chamber.

We then reshape it and the root canals to receive a filling. The filling is normally a substance called gutta percha that’s easily manipulated to conform to the shape of the root canals and pulp chamber. After filling we seal the access hole and later cap the tooth with a crown to protect it from re-infection.

Root canal treatments have literally saved millions of teeth. Unfortunately, they’ve gained an undeserved reputation for pain. But root canals don’t cause pain—they relieve the pain caused by tooth decay. More importantly, your tooth can gain a new lease on life.

But we’ll need to act promptly. If you experience any kind of tooth pain (even if it goes away) you should see us as soon as possible for an examination. Depending on the level of decay and the type of tooth involved, we may be able to perform the procedure in our office. Some cases, though, may have complications that require the skills, procedures and equipment of an endodontist, a specialist in root canal treatment.

So, don’t delay and allow tooth decay to go too far. Your tooth’s survival could hang in the balance.

If you would like more information on tooth decay treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Root Canal Treatment: What You Need to Know.”

KrisDunnIstheLatestNBAPlayertoInjureHisTeethontheCourt

For lots of sports fans, March is the month to get caught up in basketball “madness.” But many people forget that basketball—whether it's played on a school court or a big-city arena—can be just as dangerous for your teeth as some “full-contact” sports. Just ask Chicago Bulls point guard Kris Dunn. In the last three minutes of the January 17 NBA game between the Bulls and the Golden State Warriors, Dunn stole the ball and went in for the dunk. But the momentum from his fast break left him tumbling head-over-heels, and his face hit the floor.

The game stopped as Dunn was evaluated by medical staff; they found he had dislocated his two front teeth. The next day, the Bulls announced that his teeth had been stabilized and splinted—but Dunn would be out indefinitely because of a concussion.

Teeth that are loosened or displaced are known in dental terminology as luxated. These are fairly common dental injuries in both children and adults—but surprisingly, they don't always produce painful symptoms. Treating luxated teeth generally involves repositioning them and then splinting them in place for stability. Depending on the severity of the injury, the outlook for splinted teeth can be quite favorable. However, it may involve several treatments over a period of time—for example, a root canal if the tooth's inner pulp has been damaged, and possibly additional restorative or cosmetic work.

If the injured teeth can't be saved, they can usually be replaced by dental implants or a bridge. Bridges rely on adjacent teeth (also called abutment teeth) for their support. These teeth must be prepared (reduced in size) to accommodate the dental crowns that will hold the bridge in place, as well as the ones that will replace the missing tooth or teeth. Dental implants, today's gold standard of tooth replacement, are supported by root-like inserts made of titanium that are set directly into the jawbone. These dental implants support lifelike crowns that look and feel like natural teeth, and can last for years with routine care.

Better still, many dental injuries can be prevented by wearing a protective mouthguard. We can provide a custom-fabricated mouthguard, made from an exact model of your bite, which offers the maximum in comfort and protection. This is a vital piece of safety equipment that should be part of every sports enthusiast's gear.

With good dental care, it's a sure bet that Kris Dunn will be smiling when he returns to the court. We wish him a speedy recovery.

If you have questions about treating injured teeth or obtaining a custom mouthguard, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Athletic Mouthguards.”

EarlyActionNeededtoSaveYourToothfromRootResorption

Along with the gums, your teeth’s roots help stabilize them. Without them your teeth couldn’t handle the normal biting forces you encounter every day. That’s why a rare condition called root resorption must be treated promptly: this gradual breakdown and dissolving of root structure could eventually cause you to lose your tooth.

Resorption is normal in primary (“baby”) teeth giving way for permanent teeth or sometimes during orthodontic treatment. But the form of resorption we’re referring to in permanent teeth isn’t normal, and is highly destructive.

The condition begins in most cases outside the tooth and works its way in, usually at the gum line around the cervical or “neck-like” region of the tooth (hence the term external cervical resorption or ECR). ECR produces pink spots on the teeth in its early stages: these are spots of weakened enamel filled with pink-colored cells that cause the actual damage. The cells create cavity-like areas that can continue to enlarge.

We don’t fully understand what causes ECR, but there seems to be links with excessive force during orthodontics, tooth trauma (especially to the gum ligaments), tooth grinding habits or internal bleaching procedures. However, most people with these problems don’t develop ECR, so the exact mechanism remains a bit of a mystery.

The good news, though, is that we can treat ECR effectively, provided we discover it before it inflicts too much damage. That’s why regular dental visits are important, coupled with your own observation of anything out of the ordinary and immediate dental follow-up.

If the affected area is relatively small, we may be able to remove the cells causing the damage and repair the area with a tooth-colored filling. If it appears the pulp (the tooth’s innermost layer) is involved, we may need to perform a root canal treatment to remove infected tissue and fill the empty space with a special filling. You may also need other procedures to reduce the chances of gum recession around the affected tooth.

Proactive dental care is your best insurance against losing a tooth to root resorption. So keep an eye on your teeth and see your dentist regularly to keep your teeth and gums healthy.

If you would like more information on the signs and treatments for root resorption, 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 Resorption: An Unusual Phenomenon.”

By Barry Goodman, DDS
February 27, 2018
Category: Dental Procedures
HowLongWillRootCanalTreatmentLast

Root canal treatment can be an effective life preserver for a heavily decayed tooth. The question a lot of people ask, though, is how long might the tooth survive after treatment.

That’s an important concern since the treated tooth was in dire straits beforehand as decay had infected its inner most layer, the pulp. The infection, which had caused the living bundles of nerves, blood vessels and connective tissue within to become inflamed and diseased, was poised to invade even deeper through the root canals. During the root canal treatment, the infected pulp tissue is removed and the empty chamber and root canals are filled with a special filling to seal the tooth from further infection.

The protection, though, isn’t an absolute certainty: how long a treated tooth survives depends on a number of factors. For one, the earlier a diseased tooth can be initially diagnosed — especially if the infection hasn’t spread into the jawbone — the better the procedural outcome. Likewise, the chances of longevity are also better if the initial root canal treatment was thorough in identifying and filling all the root canals as well as capping the tooth with a life-like crown in a timely manner after treatment.

The type and location of the tooth can also affect its long-term health. Front teeth, with their single roots and canals are easier to access and treat. Back teeth, by contrast, can have two or more roots and a more intricate canal network. These kinds of complications could require the use of special microscopic equipment and the expertise of an endodontist, a specialist in root canals.

Even if a re-infection occurs, the tooth isn’t necessarily lost. A repeat root canal treatment that addresses these and other issues, could give the tooth a “third” chance. In any case, if a tooth is worth saving attempting a root canal treatment is generally preferable to losing the tooth and replacing it with a prosthetic tooth — it’s well worth the try.

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 “Root Canal Treatment: How Long Will it Last.”





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