Here's the bad news: One of your teeth has tooth decay. But here's even worse news: The decay has entered the pulp and root canals in the heart of the tooth. You're well on your way to losing that tooth.
But cheer up—root canal therapy might save your decayed tooth. We use root canal therapy to remove the infection from within a tooth and then fill the resulting empty spaces to prevent further infection. This routine procedure has saved millions of teeth.
But alas, along the way root canals somehow became a cultural symbol for unpleasantness. In reality, there's nothing further from the truth—the procedure itself is painless, and may even stop any pain caused by tooth decay.
So, let's take the mystery out of root canal therapy—the more you know, the less wary you'll feel. Here's what to expect if you undergo this tooth-saving procedure.
Preparation. We start by numbing the tooth and surrounding gums with local anesthesia. While we're waiting for the anesthesia to take full effect, we isolate the tooth with a dental dam to prevent cross-contamination to other teeth.
Access. Next, we drill a small opening into the tooth to access the pulp and root canals. If it's one of the large back teeth, we drill the hole in the tooth's biting surface; in a narrower front tooth, we make the access opening in the rear surface.
Removal. We remove tissue from the pulp and root canals using special instruments. Afterward, we thoroughly disinfect the pulp and canal interiors with an antibacterial solution to ensure we've stopped the infection.
Filling. After re-shaping the root canals, we fill them and the pulp chamber with gutta percha, a rubber-like material ideal for this type of dental situation. We then fill and seal the access hole. In a few weeks, you'll return to have a permanent crown installed to further protect the tooth.
You may have some minor discomfort that's usually manageable with mild pain relievers, and should dissipate over a few days. The good news, though, is that we've more than likely saved a tooth that might have otherwise been lost.
If you would like more information on treating a decayed tooth, 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.”
You could have an unattractive smile because of a chipped tooth or one slightly out of alignment. Or, it could be both of the above, plus some heavy staining to boot. Correcting each flaw individually might require a combination of different methods like orthodontics or porcelain crowns, which can take an extended period of time to complete.
But you may be able to correct numerous smile flaws with just one method—and in no more than a couple of treatment visits. It's called direct veneers.
Unlike regular veneers, direct veneers don't require a dental technician to craft a thin porcelain shell to bond over teeth. Rather, a dentist applies a tooth-colored material called composite resin to the problem teeth and "sculpts" an entirely new look that can correct multiple dental flaws at one time.
The dentist usually begins the process by creating a model ("wax-up") of proposed changes based on physical impressions of the jaw and teeth. Both dentist and patient can study the model and modify it if necessary, when finalizing the treatment plan.
At a subsequent appointment, the dentist prepares the tooth surface for bonding by removing a thin layer of tooth enamel, then shapes the teeth to better accommodate the composite resin. This tooth prep is similar to that done with traditional veneers, so it's permanent—the teeth will require some form of restoration from then on.
After applying an etchant and a bonding agent, the dentist applies the composite resin in small amounts, hardening each layer with a special light before applying the next one. With each subsequent layer, the dentist sculps the composite material to eventually resemble the wax-up model.
After completing the composite application, the dentist then uses hand tools and a dental drill to complete shaping, as well as an abrasive strip between teeth to aid future flossing. After just a few hours, the transformation is complete.
Direct veneers are durable, but not to the same extent as regular veneers or other cosmetic enhancements. They can also pick up stains over time, and may require re-treatment at some point. Still, direct veneers are a cost-effective way to improve the appearance of teeth with multiple flaws that could radically change your smile for the better.
The NBA's reigning MVP Giannis Antetokounmpo may seem unstoppable, but he proved no match for a troubled tooth. Antetokounmpo, the self-proclaimed “Greek Freak,” missed one of the final three 2020 regular season games for a dental issue that resulted in last-minute oral surgery. According to a Milwaukee Bucks spokesperson, the star underwent “a root-canal like procedure.”
Root canal therapy, often simply called “a root canal,” may be needed when there is an infection inside the tooth. When dental pulp becomes inflamed or infected, excruciating pain can result. Pulp is the soft tissue that fills the inside of the tooth. It is made up of nerves, blood vessels and connective tissue. During root canal treatment, the pulp is removed, the space inside the tooth is disinfected, it is filled with a special material, and then the hole is sealed up.
A root canal is nothing to fear. It relieves pain by getting rid of infection and is so effective that over 15 million of them are performed in the U.S. each year. This routine procedure generally requires only local anesthetic, and your mouth should be back to normal within a day or two after treatment. Antetokounmpo can attest to that, as he returned to play the next day.
However, delaying root canal treatment when you need it can have serious consequences. If left untreated, an infection inside the tooth continues to spread, and it may move into the gums and jaw and cause other problems in the body. So, how do you know if you may need a root canal? Here are some signs:
Lingering sensitivity to hot or cold temperatures. One sign of nerve damage inside your tooth is pain that is still there 30 seconds after eating or drinking something hot or cold.
Intense pain when biting down. You may feel pain deep within your tooth, or in your jaw, face or other teeth. The pain may be hard to pinpoint—and even if it improves at times, it usually comes back.
A chipped, cracked or discolored tooth. A chip or crack can allow bacteria to enter the tooth, and the tooth may darken if the tissue inside is damaged.
A pimple on the gum. A bump or pimple on the gum that doesn't go away or keeps coming back may signify that a nearby tooth is infected.
Tender, swollen gums. Swollen gums may indicate an infection inside the tooth or the need for periodontal treatment.
And sometimes there is no pain, but an infection may be discovered during a dental exam.
Tooth pain should never be ignored, so don't put off a dental visit when you have a toothache. In fact, if a bad toothache goes away, it could mean that the nerves inside the tooth have died, but the infection may still be raging. Also, be sure to keep up with your regular dental checkups. We may spot a small problem that can be addressed before it becomes a bigger problem that would require more extensive treatment.
Remember, for dental issues both large and small, we're on your team! If you would like more information about tooth pain, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Root Canal Treatment: What You Need to Know.”
Around one in ten U.S. adults have diabetes, a metabolic disease that can disrupt other aspects of a person's health like wound healing and vision. It could also cause complications with dental implants, the premier replacement choice for missing teeth.
There are two basic types of diabetes. In type 1 diabetes, the pancreas stops producing insulin, a hormone needed to regulate the amount of sugar glucose in the bloodstream. With the more prevalent type 2 diabetes, the body either doesn't produce enough insulin or doesn't respond efficiently to the insulin produced.
Uncontrolled diabetes can contribute to several dangerous health conditions. In addition to vision impairment and poor wound healing, diabetics are at higher risk for other problems like kidney disease or nerve damage. Drastic swings in blood glucose levels can also cause coma or death.
Many diabetics, though, are able to manage their condition through diet, exercise, medications and regular medical care. Even so, they may still encounter problems with wound healing, which could complicate getting a dental implant.
An implant is composed of a titanium metal post imbedded into the jawbone. Because of its affinity with titanium, bone cells naturally grow and adhere to the implant's metal surface. Several weeks after implant surgery, enough bone growth occurs to fully secure the implant within the jaw.
But this integration process may be slower for diabetics because of sluggish wound healing. It's possible for integration to not fully occur in diabetic patients after implant surgery, increasing the risk of eventually losing the implant.
Fortunately, though, evidence indicates this not to be as great a concern as once thought. A number of recent group studies comparing diabetic and non-diabetic implant patients found little difference in outcomes—both groups had similar success rates (more than 95 percent).
The only exception, though, were diabetic patients with poor glucose control, who had much slower bone integration that posed a threat to a successful implant outcome. If you're in this situation, it's better if you're first able to better control your blood glucose levels before you undergo surgery.
So, while diabetes is something to factor into your implant decision, your chances remain good for a successful outcome. Just be sure you're doing everything you can to effectively manage your diabetes.
If you would like more information on diabetes and dental 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 “Dental Implants & Diabetes.”
In a little over a century, antibiotics have changed the face of healthcare. We no longer fear cholera, strep throat or even a small cut as our forebears did a hundred years ago. Antibiotics are also an essential weapon against infection in dental situations.
But evidence is mounting that we're overusing these miracle drugs. Besides continued growth in antibiotic prescriptions, sometimes to preempt a possible infection rather than treat an existing one, food producers are increasingly adding them to animal feed and other products as a preventive measure.
The problem with expanding our uses of antibiotics is the ability of targeted microorganisms to develop defenses against our most common drugs. Some may even mutate into a kind of "super bug" like Methicillin-resistant Staphylococcus aureus (MRSA), which no longer responds to a particular antibiotic.
As older antibiotics become less effective, we must develop newer drugs to overcome the strengthened defenses of targeted microorganisms. But this takes time—meanwhile, as antibiotic options dwindle, more than 2 million people each year encounter an antibiotic-resistant infection that results in around 20,000 deaths according to the Centers for Disease Control (CDC).
But there are hopeful signs that the world is now rising to meet the threat of antibiotic resistance. For example, support is growing within the U.S., Canada and the EU to ban the use of antibiotics in animal feed except for treating actual infections.
Many healthcare organizations are also exploring ways to reduce unnecessary antibiotic prescriptions. One way is to make better use of testing, especially to identify the precise bacteria causing an infection so that it can be targeted with a specific antibiotic that will best respond to it.
We're also seeing modifications in the use of antibiotics as a preventive measure. For example, people with certain conditions like congenital heart problems or joint prosthetics have routinely received antibiotics before dental procedures to preempt infection. In recent years that list of conditions has been trimmed substantially.
The move toward a more conservative use of antibiotics will have an impact on healthcare, including dentistry. But whatever the changes, dentists and other health professionals will continue to place their patient's health at the forefront.
If you would like more information on the use of antibiotics in dentistry, 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 “Antibiotics: Use and Abuse.”
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