Posts for: July, 2020
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.”
A shingles outbreak can be painful and embarrassing. It could also interfere with many areas of your life—including your dental care.
Known medically as herpes zoster, shingles is a viral form of chicken pox. The virus can lie dormant for many years or decades in people that had chicken pox as a child, breaking out later in life (sometimes repeatedly). It's estimated about a quarter of people who had chicken pox as a child, about 90% of adults, will experience a shingles outbreak.
In the beginning, a person with shingles may notice an itching or burning skin irritation, as well as numbness or sensitivity to touch. In time, a red, crusty rash can develop, usually forming a belted or striped pattern on the torso, head or facial areas. The patterning is caused by the virus's disruption of nerves that serve those parts of the body.
Shingles could impact your dental care because it can be contagious early in an outbreak. As such, it can be transmitted to other people via contact with the rash or through airborne respiratory particles. Dental staff members or other patients who are pregnant, undergoing cancer treatment or with other conditions that compromise their immune systems can develop serious health problems if they contract the virus.
If you have an upcoming appointment, it's best then to let your dentist know you've been diagnosed with shingles. If your treatment involves physical contact that could spread the virus, they may wish to reschedule you until the outbreak clears up.
There are ways to hasten the healing process with antiviral treatments like acyclovir or famciclovir. For best results, these treatments should begin within 3 days of a shingles outbreak. There is also a shingles vaccine that can help you avoid an outbreak altogether. The U.S. Centers for Disease Control (CDC) recommend it for adults over 60.
Having shingles can be painful and stressful, and pose a major interruption of your daily life and routine. With proper management, though, it can be contained so you can get on with your life—and your dental care.
If you would like more information on managing shingles and dental care, 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 “Shingles, Herpes Zoster.”
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.”