Posts for category: Dental Procedures
As the host of America's Funniest Home Videos on ABC TV, Alfonso Ribeiro has witnessed plenty of unintentional physical comedy…or, as he puts it in an interview with Dear Doctor–Dentistry & Oral Health magazine, "When people do stuff and you're like, 'Dude, you just hurt yourself for no reason!'" So when he had his own dental dilemma, Alfonso was determined not to let it turn onto an "epic fail."
The television personality was in his thirties when a painful tooth infection flared up. Instead of ignoring the problem, he took care of it by visiting his dentist, who recommended a root canal procedure. "It's not like you wake up and go, 'Yay, I'm going to have my root canal today!'" he joked. "But once it's done, you couldn't be happier because the pain is gone and you're just smiling because you're no longer in pain!"
Alfonso's experience echoes that of many other people. The root canal procedure is designed to save an infected tooth that otherwise would probably be lost. The infection may start when harmful bacteria from the mouth create a small hole (called a cavity) in the tooth's surface. If left untreated, the decay bacteria continue to eat away at the tooth's structure. Eventually, they can reach the soft pulp tissue, which extends through branching spaces deep inside the tooth called root canals.
Once infection gets a foothold there, it's time for root canal treatment! In this procedure, the area is first numbed; next, a small hole is made in the tooth to give access to the pulp, which contains nerves and blood vessels. The diseased tissue is then carefully removed with tiny instruments, and the canals are disinfected to prevent bacteria from spreading. Finally, the tooth is sealed up to prevent re-infection. Following treatment, a crown (cap) is usually required to restore the tooth's full function and appearance.
Root canal treatment sometimes gets a bad rap from people who are unfamiliar with it, or have come across misinformation on the internet. The truth is, a root canal doesn't cause pain: It relieves pain! The alternatives—having the tooth pulled or leaving the infection untreated—are often much worse.
Having a tooth extracted and replaced can be costly and time consuming…yet a missing tooth that isn't replaced can cause problems for your oral health, nutrition and self-esteem. And an untreated infection doesn't just go away on its own—it continues to smolder in your body, potentially causing serious problems. So if you need a root canal, don't delay!
If you would like additional information on root canal treatment, please contact us or schedule a consultation. You can learn more by reading the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: What You Need to Know.”
If you regularly participate in sports or other physical activity, you’re at a higher risk for dental injuries. While chipped teeth are the most common result of these injuries, a few may result in more serious trauma — dislodged, cracked or knocked out teeth. In these cases, the core of the tooth — the pulp — and the root may have been damaged. Saving the tooth may require endodontic treatment and possibly the expertise of a specialist in the field, an endodontist.
Endodontics, from the Greek words for “within” and “tooth,” is a specialty of dentistry that treats disease or damage affecting the inner parts of a tooth, particularly the pulp chamber, the root canals, and the root. While all dentists are trained in endodontic procedures, an endodontist has advanced training, experience and specialized equipment to address complex cases.
The type of endodontic treatment needed for an injured tooth will depend on the extent of damage. A mature, permanent tooth with pulp damage, for example, may require a root canal treatment. In this procedure the pulp chamber and root canals are thoroughly cleaned out, and then are filled with a special filling to prevent any future infection. Later the tooth should be crowned to permanently seal it. Although a general dentist may perform a root canal, more complex cases, such as a tooth with an extensive root canal network, may need to be performed by an endodontist using microscopic equipment.
A tooth that has undergone severe trauma, especially a knocked out tooth, will need extensive follow-up care by a general dentist and possibly an endodontist to improve its chances of long-term survival. Because of the severity, the tooth may lose viability and the body ultimately may begin to reject it. For this reason, the tooth should be monitored on a regular basis and may need further treatment from time to time, even up to five years after the injury.
One final word: if you participate in sports or exercise activity, you can significantly reduce your risk of dental injury with a mouthguard. There are various types, but the best protection is one custom designed to fit the specific contours of your mouth. We’ll be glad to advise you further on how to protect your teeth from injury.
If you would like more information on dental injury prevention and treatment, 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 “Trauma & Nerve Damage to Teeth.”
With all the new tooth-colored fillings for cavities, it's easy to overlook metal amalgam. While this mainstay of dental care for over a century might not be as attractive as composite resins or glass and resin ionomers, it still has the advantage of strength and durability.
Amalgam is a stable metal alloy usually made up of silver, tin, copper and mercury. The metals are proportioned and mixed precisely to guard against “free” mercury molecules, which could pose a health hazard. The mixture is pliable at first, but then sets hard once molded into the prepared area of the tooth.
Besides strength, amalgam's other advantages include low cost, high resistance to wear and biocompatibility (not toxic to the body or allergy-producing). At the same time, it can require more tooth structure removal to accommodate a filling and cause higher sensitivity to temperature for a while after installation. Its main disadvantage, however, is appearance — it's now considered unacceptable from an aesthetic point of view to use it in visible areas like the front teeth.
Because of this, materials resembling natural tooth color are coming into vogue, especially as their strength improves. Still, dental amalgam continues to play a useful role, especially in less visible back teeth with higher chewing forces.
One past concern about dental amalgam is the inclusion of mercury in the alloy. As mentioned before, mercury is hazardous in a “free” form when not knit microscopically with other metals; as such it can emit a vapor that could enter the bloodstream and damage the nervous system. But after several studies by various organizations, the American Dental Association has concluded amalgam's precise mixture prevents the mercury from taking this form: although some vapor is given off during chewing it's far too low in concentration to pose any danger.
Dental amalgam continues to be an effective choice for fillings. Whether it's the right choice for you will depend on the type and location of a tooth to be filled, and whether durability is a higher concern than appearance. If we do recommend an amalgam filling, you can be assured it's a safe and lasting choice.
If you would like more information on your choices for dental fillings, 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 “Silver Fillings — Safe or Unsafe?”
The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.
Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”
Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?
It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.
If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.
For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.
It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.
If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”
While many people still consider dental implants the "new kids on the block" in dental restoration, they're now in their fourth decade of use. And since their inception implant technology has continued to improve and revolutionize how we replace missing teeth.
Implants are a different "species" compared to other restoration methods. To be precise, an implant is a tooth root replacement—usually a titanium metal post imbedded directly into the jaw bone. Titanium is not only a biocompatible metal, but bone cells naturally grow on its surface to create a strong and durable hold. It's this secure hold that's most responsible for implants' high long-term success rate.
But we should also credit some of this success to the steady stream of advances over the years in implant construction and supporting technologies. For one thing, we're now more accurate and precise with implant placement thanks to advances in computer tomography (CT) and cone beam CT (CBCT) scanning.
These digital processes merge a series of images taken by a special camera to form a three-dimensional model of the jaw. We can manipulate this model on a computer monitor to view it from different vantage points. It can help us locate and avoid anatomical structures like nerves and sinuses when determining where to place a future implant. CT and CBCT are especially useful when there's a concern about adequate available bone, a necessity for stable implants.
Technology has also improved how we create surgical guides, often used during implant surgery to obtain the most accurate results. Surgical guides are custom-made devices that fit over the teeth with the drilling locations for the implants marked on them. Recent advances in 3-D printing have made these guides even more accurate so that they fit more securely in the mouth. This greater stability increases their accuracy during the drilling sequence during surgery.
These and other advances are helping ensure every implant is a success story. The end result is both a functional restoration and a beautiful smile.
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 “How Technology Aids Dental Implant Therapy.”