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.
Brushing and flossing your teeth provides a lot of benefits, including a brighter smile and fresher breath. But the primary benefit—and ultimate goal—is removing dental plaque. This biofilm of bacteria and food remnants on tooth and gum surfaces is the number one cause for dental disease.
Brushing and flossing can effectively keep plaque under control. Unfortunately, plaque can be a stubborn foe, hiding in areas easily missed if you're not thorough enough.
So how do you know you're doing a good job brushing and flossing? One quick way is to use your tongue or dental floss to feel for any grittiness, a possible sign of remaining plaque. Ultimately, your dentist or hygienist can give you the best evaluation of your hygiene efforts during your three or six-month checkup.
But there's another way to find out more definitively how well you're removing plaque in between dental visits: a plaque disclosing agent. These over-the-counter products contain a dye solution that stains plaque so it stands out from clean tooth surfaces.
A disclosing agent, which can come in the form of tablets, swabs or a liquid, is easy to use. After brushing and flossing, you apply the agent according to the product's directions. The dye reacts with plaque to stain it a distinct color. You may also find products with two-tone dyes that stain older and newer plaque different colors to better gauge your overall effectiveness.
You then examine your teeth in the bathroom mirror, looking especially for patterns of missed plaque. For example, if you see dyed plaque running along the gum line, you'll know you need to concentrate your hygiene there.
After observing what you can do to improve your future efforts, you can then brush and floss your teeth to remove as much of the dyed plaque as you can. The staining from the dye is temporary and any remaining will fade over a few hours.
Using a disclosing agent regularly could help you improve your overall hygiene technique and reduce your risk of disease. Ask your dentist for recommendations on products.
If you would like more information on improving your oral hygiene, 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 “Plaque Disclosing Agents.”
Those unattractive teeth you see in the mirror are what are standing between you and a truly beautiful smile. If only you could make them go away.
In a way, you can do just that—with dental veneers. For the past three decades dentists have been covering the imperfections of problem teeth with these thin layers of porcelain. What's more, they're usually less involved and expensive than other restorations.
Veneers work best on teeth with moderate flaws like chipping, heavy staining or wearing, or slight misalignments like crookedness or gaps. The dental porcelain used is a ceramic material that so closely mimics the color and translucence of natural teeth it often takes a trained eye to notice any difference.
The first step to getting veneers is to plan your new look with a full examination and a diagnostic mock-up, a temporary application of tooth-colored filling materials applied directly to the teeth. This gives you and your dentist a better visual idea of how veneers will look on your teeth, and to make any adjustments ahead of time. A dental lab will use these findings to create your custom veneers.
In the meantime we'll prepare your teeth to accommodate your veneers. Although they're usually only 0.3 to 0.7 millimeters thick, veneers can still appear bulky when placed straight on the teeth. To adjust for their width we usually must remove some of the teeth's surface enamel so the veneers look more natural. Because enamel can't be replaced, the removal permanently alters the teeth and will require some form of restoration from then on.
When the veneers are ready we'll attach them with special cement so they'll form an almost seamless bond with the teeth. You'll then be able to use them just as before—but with a little caution. Although quite durable, veneers can break under too much force, so avoid biting on hard objects like ice, hard candy or nuts. And be sure you practice good dental care on your veneered teeth with daily brushing and regular dental cleanings and checkups.
The end result, though, is well worth the upkeep. Porcelain veneers can rejuvenate your smile and provide you a new level of confidence for years to come.
If you would like more information on porcelain veneers, 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 “Porcelain Veneers: Your Smile—Better than Ever.”
Proponents of legalized marijuana have won phenomenal gains over the last decade. Despite the federal government's continuing criminalization of the drug, several states including California, Colorado and Massachusetts, have voted to legalize its recreational use.
Most people are aware of the social and political controversies the marijuana legalization movement stirs. But there's another side to this roiling issue: the health effects of marijuana, particularly for your teeth and gums. What may be lost beneath the more exciting headlines about ballot initiatives is the growing evidence that habitual marijuana use may increase the risk and severity of periodontal (gum) disease.
Gum disease is a bacterial infection caused by dental plaque, a thin film of bacteria and food particles that accumulates on teeth. The spreading infection triggers inflammation, a normal bodily response to disease that's ordinarily beneficial. But if the inflammation becomes chronic it weakens the gums' attachment to the teeth. This can create voids or periodontal pockets of infection around the teeth. The disease can eventually damage the underlying bone, which could accelerate tooth loss.
Poor oral hygiene is the biggest factor for an increased risk of gum disease; thinner gum tissue (an inherited condition or related to poor tooth position) is another factor, as well as lifestyle habits like tobacco use or excessive alcohol consumption. Add marijuana to the list: there's now some evidence that its use increases the risk for more severe periodontal pockets if the disease occurs.
In a recent study, researchers with the Columbia University College of Dental Medicine reviewed statistics on the care for nearly 2,000 adult patients; a quarter of those in the study were frequent marijuana users. The marijuana users proportionately had deeper periodontal pocket occurrences than the rest of the patients in the study that didn't use the drug.
The study doesn't say that marijuana causes periodontal (gum) disease. But it does suggest that marijuana use might increase its severity. As with other substances and practices in our society, marijuana use comes with a caveat: it may be legal where you live, but it may not necessarily be good for your health.
If you would like more information on the effects of marijuana use on your oral 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 “As More States Legalize Marijuana, Link to Gum Disease is a Concern.”
More than likely your child already receives fluoride from your drinking water or toothpaste. So, is it really necessary for them to receive topical fluoride during their regular office checkups?
We highly recommend they do. A naturally occurring chemical, fluoride has the ability to make enamel more resistant to acid attacks that lead to tooth decay. It’s most effective when it works its way into the structure of the enamel during early teeth development.
Both fluoridated drinking water and dietary fluoride supplements (recommended by a doctor or dentist) can be the vehicle for this to occur while the teeth are still forming in the jaw before eruption (when teeth become visible). After the teeth have erupted, fluoride applied directly to the enamel surface (topically) can become infused with it as it continues to develop during early growth.
But can’t fluoride toothpaste accomplish the same result? No — the fluoride added to toothpaste and other hygiene products is relatively low, and only strong enough to maintain and protect enamel. The fluoride levels in topical applications like gels, foam or varnishes are much higher (in the tens of thousands of parts per million) and remain in contact with the teeth during a treatment session for much longer. Some fluoride varnishes, in fact, will continue to leach fluoride into the tooth surface for a month or more.
Topical fluoride applications are especially beneficial for children who are growing up in an area without fluoridated drinking water or without the proper means for good oral care and hygiene. But even for children with access to fluoridated water and oral care, a topical application can still be helpful.
A topical fluoride treatment isn’t a stand-alone application, but a regular part of your child’s dental care of daily brushing and flossing and semi-annual dental cleanings and checkups. Topical fluoride enhances the care they already receive to help produce stronger enamel for future healthy teeth.
If you would like more information on topical fluoride applications, 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 “Topical Fluoride: How Fluoride will Benefit Your Child.”
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