Root canal treatments are the go-to procedures dentists use to treat a tooth with advanced internal decay that has resulted in the pulp (nerve) dying. And for good reason: root canals are responsible for saving millions of teeth that would otherwise be lost.
In the basic root canal procedure, dentists make access into a tooth's interior with a small hole drilled into the crown. They then remove all diseased tissue within the pulp chamber and root canals. These now empty spaces are then filled, and the tooth is sealed and crowned to prevent further infection.
This is usually a straightforward affair, although it can be complicated by an intricate root canal network. In those cases, the skills and microscopic equipment of an endodontist, a specialist in root canals, may be needed to successfully perform the procedure.
But there are also occasional cases where it may be inadvisable to use a conventional root canal procedure to treat an endodontic infection. For example, it may be difficult to retreat a root canal on a restored tooth with a crown and supporting post in place. To do conventional root canal therapy, it would be necessary to take the restoration apart for clear access, which could further weaken or damage the remaining tooth's structure.
In this and similar situations, a dentist might use a different type of procedure called an apicoectomy. Rather than access the source of infection through the tooth's crown, an endodontist approaches the infection through the gums. This is a minor surgical procedure that can be performed with local anesthesia.
Making an incision through the gums at the level of the affected root, the endodontist can then remove any infected tissue around the root, along with a small portion of the root tip. They then place a small filling and, if necessary, grafting material to encourage bone growth around the area. The gums are then sutured in place and the area allowed to heal.
An apicoectomy is another way to attempt saving a tooth that's well on its way to demise. Without it or an attempt at a conventional root canal treatment, you might lose your tooth.
If you would like more information on treating advanced 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.”
As summer reaches its apex here in the western hemisphere, warmer weather beckons many of us out of doors. And there's plenty of fun to be had, from hiking and camping to frolicking in the pool, so long as you're playing it safe—and that includes with your family's dental health.
As physical activity increases during the summer months, so does the potential for accidents. And our mouths—especially the teeth, gums and jaws—aren't immune: In the blink of an eye an accident could cause a serious oral injury that can reverberate for weeks, months or even years. Not only that, but dental diseases like tooth decay or gum disease don't take the summer off.
So have fun this summer, but take precautions with your family's dental health. Here are a few top things that deserve your focus.
Sports-related injuries. Summer often means outdoor sports like basketball and baseball. Even if you are shooting hoops alone or honing batting and catching skills with family members, accidents can happen, possibly resulting in an injury to the mouth. To guard against this, be sure the athletes in your family wear appropriate protective gear like helmets or mouthguards.
Slips and falls. Moving around outdoors, especially in unfamiliar territory, increases the risk for falls that could injure the mouth. A pool area can be especially hazardous: Hard surfaces that are slippery when wet, for example, are a tooth injury waiting to happen. So, try to eliminate structural hazards around pools or other high-risk areas as much as possible, and insist that everyone adhere to safety rules like “No running.”
Oral hygiene. Although not in the category of an accidental blow or fall, dental disease is still a year-round risk: Your family may be taking a break from routine, but disease-causing oral bacteria don't. So, encourage your family even in the more laid-back summer months to continue to brush and floss every day to minimize the development of tooth decay or gum disease.
Sugary snacks. Summer may also occasion a break from what your family normally eats. As a result, you may be munching more on foods with added sugar. Remember, though, oral bacteria love this particular carbohydrate as much as your family does. More sugar in the mouth means more bacteria and a higher risk of tooth decay. So, choose items like nuts or fresh fruit as much as possible in lieu of sugary treats.
Summer is a great time for relaxing in the open air and building fond family memories. Just be sure to exercise these preventive measures to keep oral accidents or dental disease from ruining the fun.
If you would like more information about dental prevention measures, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”
If you love ice cream, then you'll get a kick out of this: Your favorite treat has its own month. That's right, July is National Ice Cream Month, when we celebrate—and indulge in—one of the most delicious concoctions ever known. Just don't overdo it, among other reasons, for the sake of your teeth.
In a way, it's a bit of a love-hate relationship between this frozen wonderfulness and your dental health. Like any dairy, ice cream is full of nutrients like calcium, phosphorous and vitamin D that together strengthen tooth enamel and help prevent decay. But this nutritional benefit is tempered in most ice cream by its other major ingredient: sugar.
Sugar can be a problem for your teeth because disease-causing oral bacteria love it just as much as you do. It's a prime food source for them, and when there's a lot available (like right after you finish that dipped cone) bacteria go crazy multiplying and producing acid. This could lead to tooth decay or gum disease.
Sugar's effect on dental health is an issue not only with ice cream but with other desserts and sweetened snacks as well. What can you do, then, to have your ice cream (or cake) and your dental health too?
Moderate your consumption. We're not saying you have to give up sweet desserts like ice cream—just keep your portions small and infrequent. Partake of them mainly as an occasional treat rather than as standard everyday fare.
Brush after eating. The biggest threat to dental health is the sugar that lingers in the mouth after we eat something sweet like ice cream. So, wash your mouth out with water and then brush your teeth after eating to remove any residual sugar. But not right away—give your saliva a chance to neutralize any mouth acid first by waiting about thirty minutes.
Choose healthier options. Instead of diving into a bowl of butter pecan or rocky road when you get the urge to snack, try a little non-fat Greek yogurt or cheese with some fresh fruit. Choosing alternatives like these can still give you the benefit of dairy without the excess sugar.
Ice cream is one of those indulgent little pleasures that make life sweet. Just be sure you're enjoying it within healthy limits to protect your dental health.
If you would like more information about nutrition and dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Nutrition & Oral Health” and “The Bitter Truth About Sugar.”
The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.
While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”
The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.
Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.
Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.
Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.
Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.
Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.
If you've been dealing with a tooth that needs to be removed—or it's already missing—you may be looking to replace it with a dental implant. And it's a great choice: No other restoration can provide the appearance and function of a real tooth like an implant.
You and your smile are ready for it. The question is, though, are your gums and underlying bone ready? These dental structures play a critical role in an implant's stability and eventual appearance. A problem with them may make placing an implant difficult if not impossible.
An implant requires around 2.0 millimeters of bone thickness surrounding the implant surface for adequate support and to minimize the chances of gum recession. But tooth loss often leads to bone loss that can drop its thickness below this threshold. This can make placing an implant problematic.
Fortunately, though, we may be able to address the lack of sufficient bone through bone grafting. By placing grafting material within the empty socket, we create a scaffold for new bone cells to grow upon. Over time this subsequent growth may be enough to maintain an adequate thickness of bone for an implant to be placed.
The gums may also pose a problem if they've shrunk back or receded from their normal positions, as often happens because of gum disease (which may also have precipitated the tooth loss). Again, grafting procedures can help ensure there's adequate gum coverage for the implant. And healthier gums may also help protect the underlying bone from loss.
There are several techniques for placing gum tissue grafts, depending on how much recession has taken place. One procedure in particular is often used in conjunction with implant placement. A small layer of synthetic collagen material or gum tissue referred to as pa dermal apron is included with the implant when its placed. Settling into the bone socket, this apron helps thicken the gum tissues, as well as preserve the underlying bone.
During your preliminary exams, we'll assess your bone and gum health to determine if we should take any steps like these to improve them. It may add some time to the implant process, but the end result will be well worth it.
If you would like more information on dental implants, 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 “Immediate Dental Implants.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.