Posts for category: Dental Procedures
Tooth decay can wreak more havoc than just producing cavities. It can work its way into the innermost parts of the tooth — the pulp and tiny passageways called root canals that lead to the tooth's connection with the bone.
If that happens, you'll need more than “drilling and filling.” Without intervention, your tooth could be lost. That intervention is a root canal treatment, a procedure that removes the infection from within the tooth and preserves it from re-infection.
You've probably heard the old belief that root canal treatments are painful. With modern anesthetic techniques to deaden pain, that's not true. In fact, root canal treatments stop the pain caused by infected nerves within the pulp and root canals. More importantly, it saves your tooth.
Root canals can be performed by a general dentist. More extensive decay or complex root canal networks may require the services of an endodontist, a dentist who specializes in root canal anatomy and treatments. Endodontists have advanced techniques and equipment to handle even the most difficult case.
Regardless of who performs it, the basic procedure is the same, as is the goal: to completely remove all diseased tissue within the tooth and seal it with a special filling to prevent re-infection. To access the diseased pulp, we first drill an access hole, usually in the biting surface of a back tooth or the back of a front tooth. We then use specialized instruments to remove the infected tissue and flush out the space with antibacterial solutions.
We then insert a filling called gutta percha into the empty pulp chamber and root canals, seal off the filling with adhesive cement, and close the access hole with filling. These fillings and sealants prevent bacteria from reentering the tooth. For added protection against infection and fracturing, we also recommend placing a full-coverage dental crown. This also enhances the appearance of the tooth, which must be modified during the root canal procedure.
The end result: your once endangered tooth has been preserved for hopefully many years to come. So if we recommend you undergo a root canal treatment, don't wait — the tooth you save may be your own.
Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.
Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.
Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”
Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.
There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.
So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.
Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”
If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”
Untreated tooth decay can destroy your teeth; prompt action as soon as its diagnosed will help prevent that undesirable outcome. And even if decay has advanced into the tooth's pulp and root canals, there's still a good chance we can stop it with a root canal treatment. Using this procedure, we can clean out the infection and refill the tooth's interior space with a special filling to protect it from further infection.
Although root canal treatments have gained an unwarranted reputation for pain, they rarely cause even the mildest discomfort. More importantly, they work, which is why they're the go-to treatment dentists use for advanced decay.
But sometimes a unique dental situation might make performing a root canal extremely difficult—possibly even doing more harm than good. For example, trying to access the interior of a tooth with a crown restoration might require removing the crown, which could further weaken or damage the tooth. In other cases, the root canals might have become calcified due to trauma or aging and become too narrow to access.
Even so, we may still be able to save a tooth through a minor surgical procedure called an apicoectomy. Rather than access the diseased area through the tooth crown as with a root canal treatment, an apicoectomy makes access to the infected tissue at the root end.
An apicoectomy also differs from a root canal treatment in that we'll need to surgically go through the gum tissue. After numbing the area with a local anesthetic, we'll make a small incision through the gums at the level of the infection. After removing any infected tissue, we would then fill the space with a small filling to prevent re-infection. We then close the incised gum tissues with sutures and allow them to heal.
With the help of fiber optic lighting and surgical microscopes, endodontists (specialists in interior tooth problems) can perform an apicoectomy quickly and with very little trauma at the surgical sight. If you undergo an apicoectomy, you should be back to normal activity in a day or two at the most. And like its sister procedure the root canal, an apicoectomy could help preserve your teeth for many years to come.
If you would like more information on this and other treatments for 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 “Apicoectomy: A Surgical Option When Root Canal Treatment Fails.”
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.”
If there was an “Unsung Hero” award for dental procedures, the root canal treatment would win hands-down. Much aligned in popular culture, today’s root canal treatment is actually a valuable tool for saving teeth that would otherwise be lost. And contrary to popular belief, root canal treatments don’t cause pain — they relieve it.
To help you understand its true worth, here are some common questions and answers about the root canal treatment.
What problem does a root canal treatment fix?
A root canal treatment stops a bacterial infection that has invaded the innermost part of a tooth — the pulp — and is advancing toward the end of the root through small passageways known as root canals. Most people first notice the problem as a sharp pain in the affected tooth that may suddenly dissipate in a few days. The infection has attacked the inner pulp tissue, rich in nerve fibers; when the nerve fibers die they stop sending pain signals. The infection, however, hasn’t died: as it advances, you may then begin to experience pain when you bite down or when you encounter hot foods. You may also notice tenderness and swelling in nearby gums.
How does the procedure stop the infection?
A root canal treatment removes all the infected or dead tissue and cleanses the pulp chamber. We enter the pulp chamber through a small access hole created in the tooth’s biting surface. After tissue removal, we then “shape” and prepare the empty chamber and root canals (often with the aid of microscopic equipment) to be filled with a special filling. After filling, the tooth is then sealed to prevent re-infection (most often, we need to install a permanent crown at a subsequent visit for maximum protection).
How much pain can I expect during and after the procedure?
During the procedure, none — the tooth and surrounding gums are fully anesthetized before we begin the procedure. Afterward, you may experience mild discomfort for a few days that can be relieved with over-the-counter medications like aspirin or ibuprofen.
What’s the ultimate value for a root canal treatment?
The procedure can save a tooth severely damaged by the infection. Even covered by an artificial crown, a living tooth continuing to exist and function normally within the mouth is usually more conducive for optimum oral health than an artificial tooth replacement.
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 “Common Concerns About Root Canal Treatment.”